SOLE’S INTRODUCTION TO
CRITICAL CARE NURSING
9TH EDITION
• AUTHOR(S)MARY MAKIC
TEST BANK
1
Reference
Ch. 1 — Introduction — Role of the Critical Care Nurse
Stem
A 62-year-old man is admitted to the ICU after emergent
abdominal surgery for bowel obstruction. Post-op vitals: T
37.8°C, HR 112 bpm, BP 96/58 mm Hg, RR 20, SpO₂ 96% on
room air. He appears anxious, has low urine output (20 mL/hr),
and the nurse notes capillary refill of 4 seconds. Which nursing
priority best reflects the critical care nurse role now?
,A. Encourage the patient to ambulate as tolerated to prevent
atelectasis
B. Notify the surgical team and prepare for fluid resuscitation
and hemodynamic reassessment
C. Increase opioid analgesia to reduce anxiety and tachycardia
D. Obtain a chest x-ray to rule out postoperative pneumonia
Correct Answer: B
Rationale — Correct (B)
Postoperative hypotension with tachycardia, oliguria, and
delayed capillary refill suggests early hypovolemia or poor
perfusion. The critical care nurse prioritizes rapid assessment
and team notification to initiate fluid resuscitation and re-
evaluate hemodynamics. This aligns with the nurse’s role in
early detection and initiating evidence-based interventions to
prevent deterioration.
Rationale — Incorrect
A. Ambulation is important later but is not priority during
hemodynamic instability.
C. Increasing opioids may worsen hypotension and respiratory
drive; anxiety should be addressed after stabilizing perfusion.
D. CXR is not the immediate priority; it delays needed
resuscitation.
Teaching Point
Early hemodynamic changes + oliguria = assess perfusion and
initiate resuscitation immediately.
,Citation
Makic, M. B. F. (2025). Sole’s Introduction to Critical Care
Nursing (9th ed.). Ch. 1.
2
Reference
Ch. 1 — Critical Care Nursing — Quality and Safety Emphasis
Stem
A registered nurse working in the ICU notices that handoff
reports vary widely between shifts, with missing allergy and
code status information documented in 3 of 5 recent
handovers. The nurse’s best next action to improve unit safety
is:
A. Complete a worksheet for each handoff and keep it at the
bedside
B. Report the inconsistency to human resources for disciplinary
action
C. Implement and propose a structured SBAR-based handoff
tool to unit leadership
D. Continue current practice but emphasize verbal reporting
during rounds
Correct Answer: C
Rationale — Correct (C)
Quality and safety principles support standardized
communication tools (e.g., SBAR) to reduce information loss
, and adverse events. As a critical care nurse, proposing
evidence-based process improvement addresses systemic
issues and aligns with unit-level quality initiatives.
Rationale — Incorrect
A. A personal worksheet may help one nurse but does not
systemically improve unit safety.
B. Disciplinary action bypasses quality improvement processes
and is premature.
D. Emphasizing verbal reporting without structure will not
reliably solve variability.
Teaching Point
Standardized handoffs (SBAR) reduce communication errors and
enhance ICU safety.
Citation
Makic, M. B. F. (2025). Sole’s Introduction to Critical Care
Nursing (9th ed.). Ch. 1.
3
Reference
Ch. 1 — Professional Organizations — Certification
Stem
A new ICU nurse is planning career development and asks
whether pursuing CCRN certification will affect patient
outcomes. Which statement best reflects evidence-based
benefits of specialty certification?
CRITICAL CARE NURSING
9TH EDITION
• AUTHOR(S)MARY MAKIC
TEST BANK
1
Reference
Ch. 1 — Introduction — Role of the Critical Care Nurse
Stem
A 62-year-old man is admitted to the ICU after emergent
abdominal surgery for bowel obstruction. Post-op vitals: T
37.8°C, HR 112 bpm, BP 96/58 mm Hg, RR 20, SpO₂ 96% on
room air. He appears anxious, has low urine output (20 mL/hr),
and the nurse notes capillary refill of 4 seconds. Which nursing
priority best reflects the critical care nurse role now?
,A. Encourage the patient to ambulate as tolerated to prevent
atelectasis
B. Notify the surgical team and prepare for fluid resuscitation
and hemodynamic reassessment
C. Increase opioid analgesia to reduce anxiety and tachycardia
D. Obtain a chest x-ray to rule out postoperative pneumonia
Correct Answer: B
Rationale — Correct (B)
Postoperative hypotension with tachycardia, oliguria, and
delayed capillary refill suggests early hypovolemia or poor
perfusion. The critical care nurse prioritizes rapid assessment
and team notification to initiate fluid resuscitation and re-
evaluate hemodynamics. This aligns with the nurse’s role in
early detection and initiating evidence-based interventions to
prevent deterioration.
Rationale — Incorrect
A. Ambulation is important later but is not priority during
hemodynamic instability.
C. Increasing opioids may worsen hypotension and respiratory
drive; anxiety should be addressed after stabilizing perfusion.
D. CXR is not the immediate priority; it delays needed
resuscitation.
Teaching Point
Early hemodynamic changes + oliguria = assess perfusion and
initiate resuscitation immediately.
,Citation
Makic, M. B. F. (2025). Sole’s Introduction to Critical Care
Nursing (9th ed.). Ch. 1.
2
Reference
Ch. 1 — Critical Care Nursing — Quality and Safety Emphasis
Stem
A registered nurse working in the ICU notices that handoff
reports vary widely between shifts, with missing allergy and
code status information documented in 3 of 5 recent
handovers. The nurse’s best next action to improve unit safety
is:
A. Complete a worksheet for each handoff and keep it at the
bedside
B. Report the inconsistency to human resources for disciplinary
action
C. Implement and propose a structured SBAR-based handoff
tool to unit leadership
D. Continue current practice but emphasize verbal reporting
during rounds
Correct Answer: C
Rationale — Correct (C)
Quality and safety principles support standardized
communication tools (e.g., SBAR) to reduce information loss
, and adverse events. As a critical care nurse, proposing
evidence-based process improvement addresses systemic
issues and aligns with unit-level quality initiatives.
Rationale — Incorrect
A. A personal worksheet may help one nurse but does not
systemically improve unit safety.
B. Disciplinary action bypasses quality improvement processes
and is premature.
D. Emphasizing verbal reporting without structure will not
reliably solve variability.
Teaching Point
Standardized handoffs (SBAR) reduce communication errors and
enhance ICU safety.
Citation
Makic, M. B. F. (2025). Sole’s Introduction to Critical Care
Nursing (9th ed.). Ch. 1.
3
Reference
Ch. 1 — Professional Organizations — Certification
Stem
A new ICU nurse is planning career development and asks
whether pursuing CCRN certification will affect patient
outcomes. Which statement best reflects evidence-based
benefits of specialty certification?
