AACN CERTIFICATION CCRN|PCCN CRITICAL CARE EXAM|VERIFIED
QUESTIONS AND ANSWERS|GRADED A+ |LATEST 2026/2027
AACN - ANSWER✔ certify nurses; protect consumer by establishing high standards of professional
practice
CCRN - ANSWER✔ certification for nurses who provide care in critically ill adult, pediatric, or neonatal
populations
PCCN - ANSWER✔ certification for nurses who provide acute care in progressive care, telemetry, and
similar units
CNML - ANSWER✔ certification for critical care managers and leaders
CCNS - ANSWER✔ certification for acute and critical care clinical nurse specialists
Level A (Scale for Rating Research Evidence) - ANSWER✔ meta-analysis or metasynthesis studies;
results consistently support specific action, intervention, or treatment
Level B (Scale for Rating Research Evidence) - ANSWER✔ randomized and nonrandomized controlled
studies; results consistently support specific action, intervention, or treatment
Level C (Scale for Rating Research Evidence) - ANSWER✔ qualitative, descriptive, or correlational
studies, reviews, or trials with inconsistent results
Level D (Scale for Rating Research Evidence) - ANSWER✔ Peer-reviewed with clinical studies to
support recommendations
Level E (Scale for Rating Research Evidence) - ANSWER✔ theory-based evidence from expert opinions
,Level M (Scale for Rating Research Evidence) - ANSWER✔ Manufacturer's recommendation only
Ask-Tell-Ask (Communication) - ANSWER✔ Communication technique that assesses concerns before
providing info
Situational Awareness (Communication) - ANSWER✔ being aware of one's surroundings
Calgary Family Assessment - ANSWER✔ Assessment that involves structural, developmental, and
functional assessments
Family Bundle - ANSWER✔ Provide structure for planning and carrying out family care; based on 5
concepts: evaluate, plan; involve; communicate; support (EPICS)
Principlism - ANSWER✔ widely applied ethical approach based of 4 fundamental moral principles to
contemporary ethical dilemmas; respect for autonomy; beneficence; nonmaleficence; justice
Beneficence - 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 - ANSWER✔ states that care should not be given if it is futile in terms of improving comfort or
the medical outcome
Veracity - ANSWER✔ states that persons are obligated to tell the truth in their communication with
others
Fidelity - ANSWER✔ requires that one has a moral duty to be faithful to the commitments made to
others
Elements of Informed Consent - ANSWER✔ competence (capacity); voluntariness; disclosure of
information
,Living Will - 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 - 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 - 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) - 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 - 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 - 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 - 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 - 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 - 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) - ANSWER✔ 4 to 8 L/minute
normal central venous pressure (CVP) and Right atrial pressure (RAP) (hemodynamic values) -
ANSWER✔ 2 to 6 mm Hg
Normal stroke volume (SV) (hemodynamic values) - ANSWER✔ 60 to 130 mL/beat
normal mixed venous O2 sat (SvO2) (hemodynamic values) - ANSWER✔ 60% to 75%
Normal central venous O2 sat (ScvO2) - ANSWER✔ 65% to 85%
what affects BP reading - ANSWER✔ presence of cardiac dysrhythmias; respiratory variation;
shivering; external cuff compression; decreased peripheral perfusion
Jugular Venous Pressure - ANSWER✔ Provides an estimate of intravascular volume; an indirect
measure of central venous pressure (CVP); Normal is 7 to 9 cm
jugular venous distention - ANSWER✔ occurs when CVP is elevated due to fluid overload, RV
dysfunction, superior vena cava obstruction, right HF
Assessment of jugular venous pressure - 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 - 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 - ANSWER✔ hemodynamic instability; assess efficacy of vasoactive
medication; frequent ABG analysis
QUESTIONS AND ANSWERS|GRADED A+ |LATEST 2026/2027
AACN - ANSWER✔ certify nurses; protect consumer by establishing high standards of professional
practice
CCRN - ANSWER✔ certification for nurses who provide care in critically ill adult, pediatric, or neonatal
populations
PCCN - ANSWER✔ certification for nurses who provide acute care in progressive care, telemetry, and
similar units
CNML - ANSWER✔ certification for critical care managers and leaders
CCNS - ANSWER✔ certification for acute and critical care clinical nurse specialists
Level A (Scale for Rating Research Evidence) - ANSWER✔ meta-analysis or metasynthesis studies;
results consistently support specific action, intervention, or treatment
Level B (Scale for Rating Research Evidence) - ANSWER✔ randomized and nonrandomized controlled
studies; results consistently support specific action, intervention, or treatment
Level C (Scale for Rating Research Evidence) - ANSWER✔ qualitative, descriptive, or correlational
studies, reviews, or trials with inconsistent results
Level D (Scale for Rating Research Evidence) - ANSWER✔ Peer-reviewed with clinical studies to
support recommendations
Level E (Scale for Rating Research Evidence) - ANSWER✔ theory-based evidence from expert opinions
,Level M (Scale for Rating Research Evidence) - ANSWER✔ Manufacturer's recommendation only
Ask-Tell-Ask (Communication) - ANSWER✔ Communication technique that assesses concerns before
providing info
Situational Awareness (Communication) - ANSWER✔ being aware of one's surroundings
Calgary Family Assessment - ANSWER✔ Assessment that involves structural, developmental, and
functional assessments
Family Bundle - ANSWER✔ Provide structure for planning and carrying out family care; based on 5
concepts: evaluate, plan; involve; communicate; support (EPICS)
Principlism - ANSWER✔ widely applied ethical approach based of 4 fundamental moral principles to
contemporary ethical dilemmas; respect for autonomy; beneficence; nonmaleficence; justice
Beneficence - 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 - ANSWER✔ states that care should not be given if it is futile in terms of improving comfort or
the medical outcome
Veracity - ANSWER✔ states that persons are obligated to tell the truth in their communication with
others
Fidelity - ANSWER✔ requires that one has a moral duty to be faithful to the commitments made to
others
Elements of Informed Consent - ANSWER✔ competence (capacity); voluntariness; disclosure of
information
,Living Will - 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 - 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 - 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) - 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 - 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 - 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 - 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 - 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 - 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) - ANSWER✔ 4 to 8 L/minute
normal central venous pressure (CVP) and Right atrial pressure (RAP) (hemodynamic values) -
ANSWER✔ 2 to 6 mm Hg
Normal stroke volume (SV) (hemodynamic values) - ANSWER✔ 60 to 130 mL/beat
normal mixed venous O2 sat (SvO2) (hemodynamic values) - ANSWER✔ 60% to 75%
Normal central venous O2 sat (ScvO2) - ANSWER✔ 65% to 85%
what affects BP reading - ANSWER✔ presence of cardiac dysrhythmias; respiratory variation;
shivering; external cuff compression; decreased peripheral perfusion
Jugular Venous Pressure - ANSWER✔ Provides an estimate of intravascular volume; an indirect
measure of central venous pressure (CVP); Normal is 7 to 9 cm
jugular venous distention - ANSWER✔ occurs when CVP is elevated due to fluid overload, RV
dysfunction, superior vena cava obstruction, right HF
Assessment of jugular venous pressure - 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 - 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 - ANSWER✔ hemodynamic instability; assess efficacy of vasoactive
medication; frequent ABG analysis
