AACN CERTIFICATION CCRN/PCCN CRITICAL
CARE EXAM 1 (2025) – PRACTICE QUESTIONS &
VERIFIED ANSWERS
AACN - correct answer-certify nurses; protect consumer by establishing high standards of
professional practice
CCRN - correct answer-certification for nurses who provide care in critically ill adult, pediatric,
or neonatal populations
PCCN - correct answer-certification for nurses who provide acute care in progressive care,
telemetry, and similar units
CNML - correct answer-certification for critical care managers and leaders
CCNS - correct answer-certification for acute and critical care clinical nurse specialists
Level A (Scale for Rating Research Evidence) - correct answer-meta-analysis or metasynthesis
studies; results consistently support specific action, intervention, or treatment
Level B (Scale for Rating Research Evidence) - correct answer-randomized and nonrandomized
controlled studies; results consistently support specific action, intervention, or treatment
Level C (Scale for Rating Research Evidence) - correct answer-qualitative, descriptive, or
correlational studies, reviews, or trials with inconsistent results
Level D (Scale for Rating Research Evidence) - correct answer-Peer-reviewed with clinical
studies to support recommendations
Level E (Scale for Rating Research Evidence) - correct answer-theory-based evidence from
expert opinions
Level M (Scale for Rating Research Evidence) - correct answer-Manufacturer's recommendation
only
Ask-Tell-Ask (Communication) - correct answer-Communication technique that assesses
concerns before providing info
Situational Awareness (Communication) - correct answer-being aware of one's surroundings
Calgary Family Assessment - correct answer-Assessment that involves structural,
developmental, and functional assessments
,Family Bundle - correct answer-Provide structure for planning and carrying out family care;
based on 5 concepts: evaluate, plan; involve; communicate; support (EPICS)
Principlism - correct answer-widely applied ethical approach based of 4 fundamental moral
principles to contemporary ethical dilemmas; respect for autonomy; beneficence;
nonmaleficence; justice
Beneficence - correct answer-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 - correct answer-states that care should not be given if it is futile in terms of improving
comfort or the medical outcome
Veracity - correct answer-states that persons are obligated to tell the truth in their communication
with others
Fidelity - correct answer-requires that one has a moral duty to be faithful to the commitments
made to others
Elements of Informed Consent - correct answer-competence (capacity); voluntariness; disclosure
of information
Living Will - correct answer-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 - correct answer-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 - correct answer-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) - correct answer-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 - correct answer-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 - correct answer-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 - correct answer-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 - correct answer-
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 - correct answer-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) - correct answer-4 to 8 L/minute
normal central venous pressure (CVP) and Right atrial pressure (RAP) (hemodynamic values) -
correct answer-2 to 6 mm Hg
Normal stroke volume (SV) (hemodynamic values) - correct answer-60 to 130 mL/beat
normal mixed venous O2 sat (SvO2) (hemodynamic values) - correct answer-60% to 75%
Normal central venous O2 sat (ScvO2) - correct answer-65% to 85%
what affects BP reading - correct answer-presence of cardiac dysrhythmias; respiratory variation;
shivering; external cuff compression; decreased peripheral perfusion
Jugular Venous Pressure - correct answer-Provides an estimate of intravascular volume; an
indirect measure of central venous pressure (CVP); Normal is 7 to 9 cm
jugular venous distention - correct answer-occurs when CVP is elevated due to fluid overload,
RV dysfunction, superior vena cava obstruction, right HF
Assessment of jugular venous pressure - correct answer-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 - correct answer-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
Indication of Arterial Line - correct answer-hemodynamic instability; assess efficacy of
vasoactive medication; frequent ABG analysis
Indication of Central Venous Catheter - correct answer-measure right heart filling pressures;
estimate fluid status; guide volume resuscitation; assess central venous O2 sat (ScvO2);
CARE EXAM 1 (2025) – PRACTICE QUESTIONS &
VERIFIED ANSWERS
AACN - correct answer-certify nurses; protect consumer by establishing high standards of
professional practice
CCRN - correct answer-certification for nurses who provide care in critically ill adult, pediatric,
or neonatal populations
PCCN - correct answer-certification for nurses who provide acute care in progressive care,
telemetry, and similar units
CNML - correct answer-certification for critical care managers and leaders
CCNS - correct answer-certification for acute and critical care clinical nurse specialists
Level A (Scale for Rating Research Evidence) - correct answer-meta-analysis or metasynthesis
studies; results consistently support specific action, intervention, or treatment
Level B (Scale for Rating Research Evidence) - correct answer-randomized and nonrandomized
controlled studies; results consistently support specific action, intervention, or treatment
Level C (Scale for Rating Research Evidence) - correct answer-qualitative, descriptive, or
correlational studies, reviews, or trials with inconsistent results
Level D (Scale for Rating Research Evidence) - correct answer-Peer-reviewed with clinical
studies to support recommendations
Level E (Scale for Rating Research Evidence) - correct answer-theory-based evidence from
expert opinions
Level M (Scale for Rating Research Evidence) - correct answer-Manufacturer's recommendation
only
Ask-Tell-Ask (Communication) - correct answer-Communication technique that assesses
concerns before providing info
Situational Awareness (Communication) - correct answer-being aware of one's surroundings
Calgary Family Assessment - correct answer-Assessment that involves structural,
developmental, and functional assessments
,Family Bundle - correct answer-Provide structure for planning and carrying out family care;
based on 5 concepts: evaluate, plan; involve; communicate; support (EPICS)
Principlism - correct answer-widely applied ethical approach based of 4 fundamental moral
principles to contemporary ethical dilemmas; respect for autonomy; beneficence;
nonmaleficence; justice
Beneficence - correct answer-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 - correct answer-states that care should not be given if it is futile in terms of improving
comfort or the medical outcome
Veracity - correct answer-states that persons are obligated to tell the truth in their communication
with others
Fidelity - correct answer-requires that one has a moral duty to be faithful to the commitments
made to others
Elements of Informed Consent - correct answer-competence (capacity); voluntariness; disclosure
of information
Living Will - correct answer-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 - correct answer-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 - correct answer-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) - correct answer-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 - correct answer-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 - correct answer-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 - correct answer-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 - correct answer-
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 - correct answer-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) - correct answer-4 to 8 L/minute
normal central venous pressure (CVP) and Right atrial pressure (RAP) (hemodynamic values) -
correct answer-2 to 6 mm Hg
Normal stroke volume (SV) (hemodynamic values) - correct answer-60 to 130 mL/beat
normal mixed venous O2 sat (SvO2) (hemodynamic values) - correct answer-60% to 75%
Normal central venous O2 sat (ScvO2) - correct answer-65% to 85%
what affects BP reading - correct answer-presence of cardiac dysrhythmias; respiratory variation;
shivering; external cuff compression; decreased peripheral perfusion
Jugular Venous Pressure - correct answer-Provides an estimate of intravascular volume; an
indirect measure of central venous pressure (CVP); Normal is 7 to 9 cm
jugular venous distention - correct answer-occurs when CVP is elevated due to fluid overload,
RV dysfunction, superior vena cava obstruction, right HF
Assessment of jugular venous pressure - correct answer-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 - correct answer-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
Indication of Arterial Line - correct answer-hemodynamic instability; assess efficacy of
vasoactive medication; frequent ABG analysis
Indication of Central Venous Catheter - correct answer-measure right heart filling pressures;
estimate fluid status; guide volume resuscitation; assess central venous O2 sat (ScvO2);
