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