Urden Priorities in Critical Care Nursing 8th Edition Test
Bank Actual Exam 2026/2027 – Complete 135 Questions with
Detailed Rationales | 100% Verified | Pass Guaranteed – A+
Graded
Section A: Foundations of Critical Care Nursing & Professional Practice
(Questions 1–12)
Q1: A key premise of the AACN Synergy Model is that:
A. Patient outcomes depend primarily on the sophistication of monitoring technology
B. Optimal patient outcomes occur when patient characteristics are matched with nurse
competencies [CORRECT]
C. All critically ill patients require the same level of nursing intervention
D. Nursing care should be assigned based on bed availability rather than patient needs
Correct Answer: B
Rationale: The Synergy Model holds that patient characteristics (stability, complexity,
vulnerability) must be matched with nurse competencies (clinical judgment, advocacy,
caring practices) to achieve optimal outcomes. The other options ignore the model's
core matching principle.
Q2: A patient on a medical-surgical unit develops new confusion, respiratory rate
28/min, and blood pressure 88/54 mm Hg over 2 hours. The nurse's BEST action is to:
A. Recheck vital signs in 1 hour and document the findings
B. Offer oral fluids and encourage deep breathing
C. Activate the rapid response team [CORRECT]
D. Document the changes and mention them at evening shift report
Correct Answer: C
Rationale: New confusion with tachypnea and hypotension meets rapid response team
criteria for deterioration outside the ICU, enabling early intervention before arrest.
Delaying reassessment or deferring to shift report wastes critical time.
Q3: Which handoff statement reflects the most complete use of SBAR?
A. "The patient in bed 4 is not doing well; please keep an eye on her."
,B. "Mr. Jones is a 62-year-old post-CABG day 1. Heart rate 118, blood pressure 84/50,
PAOP 20, chest tube drainage 250 mL/hr for the last hour. I believe he is bleeding. I need
you to evaluate him now for possible reoperation." [CORRECT]
C. "Bed 4's blood pressure is low, but his morning labs were fine."
D. "I'm worried about bed 4, but I can't say exactly why. Maybe you should come see him
sometime."
Correct Answer: B
Rationale: This statement includes all SBAR elements—Situation, Background,
Assessment with data, and a specific Recommendation. The vague alternatives omit
essential clinical data and requested actions, compromising patient safety.
Q4: Which task may be safely delegated to unlicensed assistive personnel (UAP) in the
critical care unit?
A. Performing the hourly neurologic assessment on a patient with an ICP monitor
B. Obtaining routine vital signs and recording intake and output totals [CORRECT]
C. Titrating the norepinephrine infusion per protocol
D. Interpreting hemodynamic waveforms and reporting changes
Correct Answer: B
Rationale: Routine vital signs and I&O totals are within UAP scope and do not require
clinical judgment. Assessment, titration of vasoactive medications, and interpretation of
invasive monitoring data require RN-level judgment and cannot be delegated.
Q5: At the start of shift, which patient should the critical care nurse assess FIRST?
A. A patient 6 hours post-extubation with a mildly hoarse voice
B. A patient whose norepinephrine was titrated up 30 minutes ago and now has a MAP
of 55 mm Hg [CORRECT]
C. A patient due for a scheduled surgical dressing change
D. A patient whose family is waiting at the desk requesting an update
Correct Answer: B
Rationale: A MAP of 55 despite escalating vasopressors signals inadequate perfusion
and potential shock progression—an immediate safety threat per ABC prioritization.
Hoarseness, routine dressings, and family updates, while important, are lower acuity.
Q6: A nurse administers an incorrect medication dose and self-reports the error.
Following "just culture" principles, the charge nurse's BEST response is to:
A. Immediately report the nurse to the licensing board and suspend her from practice
B. Conduct a systems-focused event analysis examining contributing factors without
premature individual blame [CORRECT]
C. Advise the nurse to document the dose as "wasted" to avoid paperwork
D. Issue a written reprimand without investigating the event
,Correct Answer: B
Rationale: Just culture balances accountability with systems thinking, identifying
contributing factors (workload, interruptions, labeling) to prevent recurrence.
Punishment without analysis, concealment, or superficial discipline undermine safety
reporting.
Q7: Which intervention is part of the central line-associated bloodstream infection
(CLABSI) prevention bundle?
A. Routine replacement of central lines every 3 days to reduce colonization
B. Instilling prophylactic antibiotics through the catheter lumen weekly
C. Daily review of line necessity with prompt removal of catheters that are no longer
needed [CORRECT]
D. Changing the transparent dressing only when it becomes visibly soiled
Correct Answer: C
Rationale: The CLABSI bundle includes hand hygiene, maximal barrier insertion
precautions, chlorhexidine skin antisepsis, optimal site selection, and daily assessment
of line necessity. Routine scheduled replacements and antibiotic instillation are not
recommended, and dressings are changed per standard intervals.
Q8: When applying evidence-based practice, the STRONGEST form of evidence to guide
a change in clinical practice is:
A. Expert opinion of senior physicians in the unit
B. A single retrospective case series
C. A systematic review and meta-analysis of randomized controlled trials [CORRECT]
D. A tradition that has been followed in the unit for many years
Correct Answer: C
Rationale: Systematic reviews and meta-analyses of RCTs sit at the top of the evidence
hierarchy because they synthesize multiple rigorously controlled studies. Expert opinion,
case series, and tradition occupy the lowest evidence levels.
Q9: A critical care nurse titrates a vasoactive infusion according to a written institutional
protocol. This action is within the nurse's legal scope of practice when:
A. Authorized by the state nurse practice act and institutional protocols/policies
[CORRECT]
B. The physician is physically present at the bedside
C. The nurse has worked in the ICU for more than 10 years
D. The patient's family consents to the titration
Correct Answer: A
, Rationale: Prescriptive authority and titration authority derive from the state nurse
practice act, medical direction, and institutional protocol—not from physician proximity,
seniority, or family consent.
Q10: The most effective method for transferring critical care patients between units is:
A. A brief text message summarizing the main diagnosis
B. A standardized bedside handoff including current status, lines, drips, and pending
issues, with the receiving nurse able to ask questions [CORRECT]
C. Reliance on the electronic medical record without verbal communication
D. Verbal report at the nurses' station away from the patient and family
Correct Answer: B
Rationale: Standardized bedside handoff using tools such as SBAR reduces information
loss, allows verification of drips and equipment, and promotes shared situational
awareness. Text summaries, EMR-only transfers, or reports away from the bedside
increase omissions and errors.
Q11: A critical care nurse experiences moral distress believing ongoing aggressive
treatment is futile for a patient. The nurse's BEST initial action is to:
A. Unilaterally reduce support on the ventilator
B. Request an ethics consultation or initiate a care conference to explore goals of care
with the team and family [CORRECT]
C. Post concerns anonymously on social media
D. Avoid the patient's room to reduce emotional discomfort
Correct Answer: B
Rationale: Ethics consultation and team/family conferences provide legitimate avenues
to address perceived futility and align treatment with patient values. Unilateral actions,
public complaints, or avoidance violate professional standards and compound distress.
Q12: Following report, which patient should be seen FIRST?
A. A post-op day 1 patient rating incisional pain 6/10 requesting analgesia
B. A ventilated patient with new decreased breath sounds on the left and oxygen
saturation falling from 96% to 88% [CORRECT]
C. A stable DKA patient due for the hourly glucose check
D. A patient requesting help completing breakfast tray selection
Correct Answer: B
Rationale: Falling saturation with absent breath sounds suggests acute deterioration
(pneumothorax, tube migration, mucous plug) threatening oxygenation—the highest
priority by ABCs. Pain, routine glucose checks, and meal assistance follow once airway
and breathing are secured.
Bank Actual Exam 2026/2027 – Complete 135 Questions with
Detailed Rationales | 100% Verified | Pass Guaranteed – A+
Graded
Section A: Foundations of Critical Care Nursing & Professional Practice
(Questions 1–12)
Q1: A key premise of the AACN Synergy Model is that:
A. Patient outcomes depend primarily on the sophistication of monitoring technology
B. Optimal patient outcomes occur when patient characteristics are matched with nurse
competencies [CORRECT]
C. All critically ill patients require the same level of nursing intervention
D. Nursing care should be assigned based on bed availability rather than patient needs
Correct Answer: B
Rationale: The Synergy Model holds that patient characteristics (stability, complexity,
vulnerability) must be matched with nurse competencies (clinical judgment, advocacy,
caring practices) to achieve optimal outcomes. The other options ignore the model's
core matching principle.
Q2: A patient on a medical-surgical unit develops new confusion, respiratory rate
28/min, and blood pressure 88/54 mm Hg over 2 hours. The nurse's BEST action is to:
A. Recheck vital signs in 1 hour and document the findings
B. Offer oral fluids and encourage deep breathing
C. Activate the rapid response team [CORRECT]
D. Document the changes and mention them at evening shift report
Correct Answer: C
Rationale: New confusion with tachypnea and hypotension meets rapid response team
criteria for deterioration outside the ICU, enabling early intervention before arrest.
Delaying reassessment or deferring to shift report wastes critical time.
Q3: Which handoff statement reflects the most complete use of SBAR?
A. "The patient in bed 4 is not doing well; please keep an eye on her."
,B. "Mr. Jones is a 62-year-old post-CABG day 1. Heart rate 118, blood pressure 84/50,
PAOP 20, chest tube drainage 250 mL/hr for the last hour. I believe he is bleeding. I need
you to evaluate him now for possible reoperation." [CORRECT]
C. "Bed 4's blood pressure is low, but his morning labs were fine."
D. "I'm worried about bed 4, but I can't say exactly why. Maybe you should come see him
sometime."
Correct Answer: B
Rationale: This statement includes all SBAR elements—Situation, Background,
Assessment with data, and a specific Recommendation. The vague alternatives omit
essential clinical data and requested actions, compromising patient safety.
Q4: Which task may be safely delegated to unlicensed assistive personnel (UAP) in the
critical care unit?
A. Performing the hourly neurologic assessment on a patient with an ICP monitor
B. Obtaining routine vital signs and recording intake and output totals [CORRECT]
C. Titrating the norepinephrine infusion per protocol
D. Interpreting hemodynamic waveforms and reporting changes
Correct Answer: B
Rationale: Routine vital signs and I&O totals are within UAP scope and do not require
clinical judgment. Assessment, titration of vasoactive medications, and interpretation of
invasive monitoring data require RN-level judgment and cannot be delegated.
Q5: At the start of shift, which patient should the critical care nurse assess FIRST?
A. A patient 6 hours post-extubation with a mildly hoarse voice
B. A patient whose norepinephrine was titrated up 30 minutes ago and now has a MAP
of 55 mm Hg [CORRECT]
C. A patient due for a scheduled surgical dressing change
D. A patient whose family is waiting at the desk requesting an update
Correct Answer: B
Rationale: A MAP of 55 despite escalating vasopressors signals inadequate perfusion
and potential shock progression—an immediate safety threat per ABC prioritization.
Hoarseness, routine dressings, and family updates, while important, are lower acuity.
Q6: A nurse administers an incorrect medication dose and self-reports the error.
Following "just culture" principles, the charge nurse's BEST response is to:
A. Immediately report the nurse to the licensing board and suspend her from practice
B. Conduct a systems-focused event analysis examining contributing factors without
premature individual blame [CORRECT]
C. Advise the nurse to document the dose as "wasted" to avoid paperwork
D. Issue a written reprimand without investigating the event
,Correct Answer: B
Rationale: Just culture balances accountability with systems thinking, identifying
contributing factors (workload, interruptions, labeling) to prevent recurrence.
Punishment without analysis, concealment, or superficial discipline undermine safety
reporting.
Q7: Which intervention is part of the central line-associated bloodstream infection
(CLABSI) prevention bundle?
A. Routine replacement of central lines every 3 days to reduce colonization
B. Instilling prophylactic antibiotics through the catheter lumen weekly
C. Daily review of line necessity with prompt removal of catheters that are no longer
needed [CORRECT]
D. Changing the transparent dressing only when it becomes visibly soiled
Correct Answer: C
Rationale: The CLABSI bundle includes hand hygiene, maximal barrier insertion
precautions, chlorhexidine skin antisepsis, optimal site selection, and daily assessment
of line necessity. Routine scheduled replacements and antibiotic instillation are not
recommended, and dressings are changed per standard intervals.
Q8: When applying evidence-based practice, the STRONGEST form of evidence to guide
a change in clinical practice is:
A. Expert opinion of senior physicians in the unit
B. A single retrospective case series
C. A systematic review and meta-analysis of randomized controlled trials [CORRECT]
D. A tradition that has been followed in the unit for many years
Correct Answer: C
Rationale: Systematic reviews and meta-analyses of RCTs sit at the top of the evidence
hierarchy because they synthesize multiple rigorously controlled studies. Expert opinion,
case series, and tradition occupy the lowest evidence levels.
Q9: A critical care nurse titrates a vasoactive infusion according to a written institutional
protocol. This action is within the nurse's legal scope of practice when:
A. Authorized by the state nurse practice act and institutional protocols/policies
[CORRECT]
B. The physician is physically present at the bedside
C. The nurse has worked in the ICU for more than 10 years
D. The patient's family consents to the titration
Correct Answer: A
, Rationale: Prescriptive authority and titration authority derive from the state nurse
practice act, medical direction, and institutional protocol—not from physician proximity,
seniority, or family consent.
Q10: The most effective method for transferring critical care patients between units is:
A. A brief text message summarizing the main diagnosis
B. A standardized bedside handoff including current status, lines, drips, and pending
issues, with the receiving nurse able to ask questions [CORRECT]
C. Reliance on the electronic medical record without verbal communication
D. Verbal report at the nurses' station away from the patient and family
Correct Answer: B
Rationale: Standardized bedside handoff using tools such as SBAR reduces information
loss, allows verification of drips and equipment, and promotes shared situational
awareness. Text summaries, EMR-only transfers, or reports away from the bedside
increase omissions and errors.
Q11: A critical care nurse experiences moral distress believing ongoing aggressive
treatment is futile for a patient. The nurse's BEST initial action is to:
A. Unilaterally reduce support on the ventilator
B. Request an ethics consultation or initiate a care conference to explore goals of care
with the team and family [CORRECT]
C. Post concerns anonymously on social media
D. Avoid the patient's room to reduce emotional discomfort
Correct Answer: B
Rationale: Ethics consultation and team/family conferences provide legitimate avenues
to address perceived futility and align treatment with patient values. Unilateral actions,
public complaints, or avoidance violate professional standards and compound distress.
Q12: Following report, which patient should be seen FIRST?
A. A post-op day 1 patient rating incisional pain 6/10 requesting analgesia
B. A ventilated patient with new decreased breath sounds on the left and oxygen
saturation falling from 96% to 88% [CORRECT]
C. A stable DKA patient due for the hourly glucose check
D. A patient requesting help completing breakfast tray selection
Correct Answer: B
Rationale: Falling saturation with absent breath sounds suggests acute deterioration
(pneumothorax, tube migration, mucous plug) threatening oxygenation—the highest
priority by ABCs. Pain, routine glucose checks, and meal assistance follow once airway
and breathing are secured.
