AACN CERTIFICATION CCRN/PCCN
CRITICAL CARE EXAM 1
QUESTIONS AND ANSWERS
2026/2027 A+ GRADED 100%
VERIFIED
AACN - ANS -certify nurses; protect consumer by establishing high standards of professional practice
CCRN - ANS -certification for nurses who provide care in critically ill adult, pediatric, or neonatal
populations
PCCN - ANS -certification for nurses who provide acute care in progressive care, telemetry, and
similar units
CNML - ANS -certification for critical care managers and leaders
CCNS - ANS -certification for acute and critical care clinical nurse specialists
Level A (Scale for Rating Research Evidence) - ANS -meta-analysis or metasynthesis studies; results
consistently support specific action, intervention, or treatment
Level B (Scale for Rating Research Evidence) - ANS -randomized and nonrandomized controlled
studies; results consistently support specific action, intervention, or treatment
Level C (Scale for Rating Research Evidence) - ANS -qualitative, descriptive, or correlational studies,
reviews, or trials with inconsistent results
,Level D (Scale for Rating Research Evidence) - ANS -Peer-reviewed with clinical studies to support
recommendations
Level E (Scale for Rating Research Evidence) - ANS -theory-based evidence from expert opinions
Level M (Scale for Rating Research Evidence) - ANS -Manufacturer's recommendation only
Ask-Tell-Ask (Communication) - ANS -Communication technique that assesses concerns before
providing info
Situational Awareness (Communication) - ANS -being aware of one's surroundings
Calgary Family Assessment - ANS -Assessment that involves structural, developmental, and
functional assessments
Family Bundle - ANS -Provide structure for planning and carrying out family care; based on 5
concepts: evaluate, plan; involve; communicate; support (EPICS)
Principlism - ANS -widely applied ethical approach based of 4 fundamental moral principles to
contemporary ethical dilemmas; respect for autonomy; beneficence; nonmaleficence; justice
Beneficence - ANS -the duty to provide benefits to others when in a position to do so, to help
balance harms and benefits; the benefits of an action should outweigh the burdens
Futility - ANS -states that care should not be given if it is futile in terms of improving comfort or the
medical outcome
Veracity - ANS -states that persons are obligated to tell the truth in their communication with others
Fidelity - ANS -requires that one has a moral duty to be faithful to the commitments made to others
,Elements of Informed Consent - ANS -competence (capacity); voluntariness; disclosure of
information
Living Will - ANS -a witnessed written document or oral statement voluntarily executed by a person
that expresses the person's instructions concerning life-prolonging procedure; not legally binding in
some states
Proxy - ANS -a competent adult, not designated to make health care decisions for an incapacitated
person, but is authorized by state statute to make healthcare decisions for the person
Surrogate - ANS -a competent adult designated by a person to make health care decisions should
that person become incapacitated
Patient Self-Determination act (End-of-life issue) - ANS -requires that all healthcare facilities that
receive medicare or medicaid funding inform their patients about their right to initiate an advance
directive and the right to consent to or refuse medical treatment
Withholding, Limiting, or Withdrawing Therapy - ANS -Priority should be anticipating patient
symptoms; assessment of patient response; titration of therapy to relieve emotional and physical
distress; common meds used are analgesics (ie. Morphine) and anxiolytics (ie. benzodiazepines)
Ventilator WIthdrawal - ANS -Known as "terminal weaning"; consist of titration of ventilator support
to minimal levels, removal of ventilator, but not artificial airway, or complete extubation; titrate pain
meds and sedation as needed to relieve symptoms of respiratory distress
Commonly withheld therapy - ANS -vasopressors; antibiotics; done when goal of treatment shift to
palliation instead of cure; address these before withdrawing or withholding ventilation
Ethical Principles for withholding and withdrawing life-sustaining treatment - ANS -life-sustaining
treatment should not be withdrawn while patient is receiving paralytic agents. When paralytic drugs
are discontinued, patient must demonstrate sufficient motor activity to allow thorough clinical
assessment before withdrawal of support
, Hemodynamic Assessment - ANS -Used to titrate therapies to a specific end point; detect
inadequate tissue perfusion; quantify severity of disease; and guide therapy
normal cardiac output (CO) (hemodynamic values) - ANS -4 to 8 L/minute
normal central venous pressure (CVP) and Right atrial pressure (RAP) (hemodynamic values) - ANS -
2 to 6 mm Hg
Normal stroke volume (SV) (hemodynamic values) - ANS -60 to 130 mL/beat
normal mixed venous O2 sat (SvO2) (hemodynamic values) - ANS -60% to 75%
Normal central venous O2 sat (ScvO2) - ANS -65% to 85%
what affects BP reading - ANS -presence of cardiac dysrhythmias; respiratory variation; shivering;
external cuff compression; decreased peripheral perfusion
Jugular Venous Pressure - ANS -Provides an estimate of intravascular volume; an indirect measure
of central venous pressure (CVP); Normal is 7 to 9 cm
jugular venous distention - ANS -occurs when CVP is elevated due to fluid overload, RV dysfunction,
superior vena cava obstruction, right HF
Assessment of jugular venous pressure - ANS -look for highest point of pulsation; measure the
vertical distance between this pulsation and the angle of Louis in cm; add 5 cm to this number for an
estimation of CVP
Lactate - ANS -normal levels is 0.5 to 1.6 mEq/L; determine tissue hypoperfusion in circulatory
shock, establish adequacy of resuscitation; assist in diagnosis of patients who have metabolic
acidosis
CRITICAL CARE EXAM 1
QUESTIONS AND ANSWERS
2026/2027 A+ GRADED 100%
VERIFIED
AACN - ANS -certify nurses; protect consumer by establishing high standards of professional practice
CCRN - ANS -certification for nurses who provide care in critically ill adult, pediatric, or neonatal
populations
PCCN - ANS -certification for nurses who provide acute care in progressive care, telemetry, and
similar units
CNML - ANS -certification for critical care managers and leaders
CCNS - ANS -certification for acute and critical care clinical nurse specialists
Level A (Scale for Rating Research Evidence) - ANS -meta-analysis or metasynthesis studies; results
consistently support specific action, intervention, or treatment
Level B (Scale for Rating Research Evidence) - ANS -randomized and nonrandomized controlled
studies; results consistently support specific action, intervention, or treatment
Level C (Scale for Rating Research Evidence) - ANS -qualitative, descriptive, or correlational studies,
reviews, or trials with inconsistent results
,Level D (Scale for Rating Research Evidence) - ANS -Peer-reviewed with clinical studies to support
recommendations
Level E (Scale for Rating Research Evidence) - ANS -theory-based evidence from expert opinions
Level M (Scale for Rating Research Evidence) - ANS -Manufacturer's recommendation only
Ask-Tell-Ask (Communication) - ANS -Communication technique that assesses concerns before
providing info
Situational Awareness (Communication) - ANS -being aware of one's surroundings
Calgary Family Assessment - ANS -Assessment that involves structural, developmental, and
functional assessments
Family Bundle - ANS -Provide structure for planning and carrying out family care; based on 5
concepts: evaluate, plan; involve; communicate; support (EPICS)
Principlism - ANS -widely applied ethical approach based of 4 fundamental moral principles to
contemporary ethical dilemmas; respect for autonomy; beneficence; nonmaleficence; justice
Beneficence - ANS -the duty to provide benefits to others when in a position to do so, to help
balance harms and benefits; the benefits of an action should outweigh the burdens
Futility - ANS -states that care should not be given if it is futile in terms of improving comfort or the
medical outcome
Veracity - ANS -states that persons are obligated to tell the truth in their communication with others
Fidelity - ANS -requires that one has a moral duty to be faithful to the commitments made to others
,Elements of Informed Consent - ANS -competence (capacity); voluntariness; disclosure of
information
Living Will - ANS -a witnessed written document or oral statement voluntarily executed by a person
that expresses the person's instructions concerning life-prolonging procedure; not legally binding in
some states
Proxy - ANS -a competent adult, not designated to make health care decisions for an incapacitated
person, but is authorized by state statute to make healthcare decisions for the person
Surrogate - ANS -a competent adult designated by a person to make health care decisions should
that person become incapacitated
Patient Self-Determination act (End-of-life issue) - ANS -requires that all healthcare facilities that
receive medicare or medicaid funding inform their patients about their right to initiate an advance
directive and the right to consent to or refuse medical treatment
Withholding, Limiting, or Withdrawing Therapy - ANS -Priority should be anticipating patient
symptoms; assessment of patient response; titration of therapy to relieve emotional and physical
distress; common meds used are analgesics (ie. Morphine) and anxiolytics (ie. benzodiazepines)
Ventilator WIthdrawal - ANS -Known as "terminal weaning"; consist of titration of ventilator support
to minimal levels, removal of ventilator, but not artificial airway, or complete extubation; titrate pain
meds and sedation as needed to relieve symptoms of respiratory distress
Commonly withheld therapy - ANS -vasopressors; antibiotics; done when goal of treatment shift to
palliation instead of cure; address these before withdrawing or withholding ventilation
Ethical Principles for withholding and withdrawing life-sustaining treatment - ANS -life-sustaining
treatment should not be withdrawn while patient is receiving paralytic agents. When paralytic drugs
are discontinued, patient must demonstrate sufficient motor activity to allow thorough clinical
assessment before withdrawal of support
, Hemodynamic Assessment - ANS -Used to titrate therapies to a specific end point; detect
inadequate tissue perfusion; quantify severity of disease; and guide therapy
normal cardiac output (CO) (hemodynamic values) - ANS -4 to 8 L/minute
normal central venous pressure (CVP) and Right atrial pressure (RAP) (hemodynamic values) - ANS -
2 to 6 mm Hg
Normal stroke volume (SV) (hemodynamic values) - ANS -60 to 130 mL/beat
normal mixed venous O2 sat (SvO2) (hemodynamic values) - ANS -60% to 75%
Normal central venous O2 sat (ScvO2) - ANS -65% to 85%
what affects BP reading - ANS -presence of cardiac dysrhythmias; respiratory variation; shivering;
external cuff compression; decreased peripheral perfusion
Jugular Venous Pressure - ANS -Provides an estimate of intravascular volume; an indirect measure
of central venous pressure (CVP); Normal is 7 to 9 cm
jugular venous distention - ANS -occurs when CVP is elevated due to fluid overload, RV dysfunction,
superior vena cava obstruction, right HF
Assessment of jugular venous pressure - ANS -look for highest point of pulsation; measure the
vertical distance between this pulsation and the angle of Louis in cm; add 5 cm to this number for an
estimation of CVP
Lactate - ANS -normal levels is 0.5 to 1.6 mEq/L; determine tissue hypoperfusion in circulatory
shock, establish adequacy of resuscitation; assist in diagnosis of patients who have metabolic
acidosis
