SOLE’S INTRODUCTION TO
CRITICAL CARE NURSING
9TH EDITION
• AUTHOR(S)MARY MAKIC
TEST BANK
1
Reference: Ch. 1 — Introduction / Overview of Critical Care
Nursing
Stem: A 58-year-old admitted to the ICU with community-
acquired pneumonia has RR 28, SpO₂ 89% on 4 L NC, HR 108, BP
118/66, temp 38.3°C. The nurse notes increased work of
breathing and mental confusion. Which action is the priority?
A. Increase oxygen to 6 L via nasal cannula and re-evaluate in 15
minutes.
B. Call the respiratory therapist for immediate high-flow nasal
cannula or NIV assessment.
C. Obtain a stat chest x-ray to evaluate for worsening
,consolidation.
D. Administer PRN antipyretic and recheck respiratory status in
30 minutes.
Correct Answer: B
Rationales — Correct Option: Immediate respiratory support
assessment (HFNC/NIV) addresses hypoxemia and increased
work of breathing—preventing imminent respiratory failure.
Early escalation is aligned with critical care priority for
deteriorating oxygenation and altered mental status. This is
fastest action to stabilize oxygenation and reduce work of
breathing.
Incorrect Options:
A. Increasing NC flow to 6 L may be insufficient and delays
appropriate escalation to HFNC/NIV.
C. CXR is diagnostic but not immediate therapy for hypoxemia;
delaying respiratory support risks deterioration.
D. Antipyretic treats fever but does not address hypoxemia or
work of breathing—unsafe to wait.
Teaching Point: Prioritize respiratory support escalation when
SpO₂ <90% with increased work of breathing and mental status
change.
Citation: Makic, M. B. F. (2025). Sole’s Introduction to Critical
Care Nursing (9th ed.). Ch. 1.
2
,Reference: Ch. 1 — Critical Care Nursing / Professional
Organizations (teamwork)
Stem: During morning rounds, the ICU team cannot agree on
timing of central line removal for a patient with resolving sepsis
but persistent leukocytosis. The nurse notices conflicting orders
between the ICU attending and the consulting surgeon. What's
the nurse’s best immediate action?
A. Follow the attending physician’s order and remove the
central line.
B. Postpone any action and document disagreement in the
chart.
C. Facilitate a brief huddle with both providers to clarify the
plan and ownership.
D. Call the hospital ethics committee for mediation.
Correct Answer: C
Rationales — Correct Option: Facilitating a focused huddle
improves collaborative plan of care, resolves ambiguity quickly,
and prevents unsafe unilateral action. This aligns with
professional organization guidance for team communication
and safe care transitions. It clarifies roles and mitigates delays in
care.
Incorrect Options:
A. Acting without consensus risks conflicting care and possible
patient harm.
B. Documenting disagreement without resolution leaves patient
care ambiguous.
D. Ethics committee involvement is not appropriate for
, operational clinical decisions and causes unnecessary delay.
Teaching Point: Use brief interdisciplinary huddles to resolve
care conflicts and clarify ownership.
Citation: Makic, M. B. F. (2025). Sole’s Introduction to Critical
Care Nursing (9th ed.). Ch. 1.
3
Reference: Ch. 1 — Certification / CCRN relevance to
competence
Stem: A newly hired ICU nurse expresses concern about
administering vasoactive infusions due to limited experience.
The unit requires competency validation. Which is the nurse
educator’s best next step?
A. Allow supervised administration after a one-hour orientation.
B. Require completion of a structured simulation and
documented competency before independent administration.
C. Restrict the nurse from working any shifts with vasoactive
patients.
D. Assign the nurse to medication administration only under the
charge nurse’s verbal oversight.
Correct Answer: B
Rationales — Correct Option: Competency validation via
simulation provides measurable skills assessment and aligns
with certification/competency standards for safe vasoactive
management. Evidence supports simulation for building clinical
judgment before independent practice. This balances patient
CRITICAL CARE NURSING
9TH EDITION
• AUTHOR(S)MARY MAKIC
TEST BANK
1
Reference: Ch. 1 — Introduction / Overview of Critical Care
Nursing
Stem: A 58-year-old admitted to the ICU with community-
acquired pneumonia has RR 28, SpO₂ 89% on 4 L NC, HR 108, BP
118/66, temp 38.3°C. The nurse notes increased work of
breathing and mental confusion. Which action is the priority?
A. Increase oxygen to 6 L via nasal cannula and re-evaluate in 15
minutes.
B. Call the respiratory therapist for immediate high-flow nasal
cannula or NIV assessment.
C. Obtain a stat chest x-ray to evaluate for worsening
,consolidation.
D. Administer PRN antipyretic and recheck respiratory status in
30 minutes.
Correct Answer: B
Rationales — Correct Option: Immediate respiratory support
assessment (HFNC/NIV) addresses hypoxemia and increased
work of breathing—preventing imminent respiratory failure.
Early escalation is aligned with critical care priority for
deteriorating oxygenation and altered mental status. This is
fastest action to stabilize oxygenation and reduce work of
breathing.
Incorrect Options:
A. Increasing NC flow to 6 L may be insufficient and delays
appropriate escalation to HFNC/NIV.
C. CXR is diagnostic but not immediate therapy for hypoxemia;
delaying respiratory support risks deterioration.
D. Antipyretic treats fever but does not address hypoxemia or
work of breathing—unsafe to wait.
Teaching Point: Prioritize respiratory support escalation when
SpO₂ <90% with increased work of breathing and mental status
change.
Citation: Makic, M. B. F. (2025). Sole’s Introduction to Critical
Care Nursing (9th ed.). Ch. 1.
2
,Reference: Ch. 1 — Critical Care Nursing / Professional
Organizations (teamwork)
Stem: During morning rounds, the ICU team cannot agree on
timing of central line removal for a patient with resolving sepsis
but persistent leukocytosis. The nurse notices conflicting orders
between the ICU attending and the consulting surgeon. What's
the nurse’s best immediate action?
A. Follow the attending physician’s order and remove the
central line.
B. Postpone any action and document disagreement in the
chart.
C. Facilitate a brief huddle with both providers to clarify the
plan and ownership.
D. Call the hospital ethics committee for mediation.
Correct Answer: C
Rationales — Correct Option: Facilitating a focused huddle
improves collaborative plan of care, resolves ambiguity quickly,
and prevents unsafe unilateral action. This aligns with
professional organization guidance for team communication
and safe care transitions. It clarifies roles and mitigates delays in
care.
Incorrect Options:
A. Acting without consensus risks conflicting care and possible
patient harm.
B. Documenting disagreement without resolution leaves patient
care ambiguous.
D. Ethics committee involvement is not appropriate for
, operational clinical decisions and causes unnecessary delay.
Teaching Point: Use brief interdisciplinary huddles to resolve
care conflicts and clarify ownership.
Citation: Makic, M. B. F. (2025). Sole’s Introduction to Critical
Care Nursing (9th ed.). Ch. 1.
3
Reference: Ch. 1 — Certification / CCRN relevance to
competence
Stem: A newly hired ICU nurse expresses concern about
administering vasoactive infusions due to limited experience.
The unit requires competency validation. Which is the nurse
educator’s best next step?
A. Allow supervised administration after a one-hour orientation.
B. Require completion of a structured simulation and
documented competency before independent administration.
C. Restrict the nurse from working any shifts with vasoactive
patients.
D. Assign the nurse to medication administration only under the
charge nurse’s verbal oversight.
Correct Answer: B
Rationales — Correct Option: Competency validation via
simulation provides measurable skills assessment and aligns
with certification/competency standards for safe vasoactive
management. Evidence supports simulation for building clinical
judgment before independent practice. This balances patient
