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Chapter 1: Overview of Critical Care Nursing
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Test Bank
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MULTIPLE CHOICE FG
1. Which of the following professional organizations best supports critical care nursing practice?
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a. American Association of Critical-Care Nurses FG FG FG FG
b. American Heart Association FG FG
c. American Nurses Association FG FG
d. Society of Critical Care Medicine FG FG FG FG
ANS: F G A
The American Association of Critical-Care Nurses is the specialty organization that supports
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and represents critical care nurses. The American Heart Association supports cardiovascular
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initiatives. The American Nurses Association supports all nurses. The Society of Critical Care
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Medicine represents the multiprofessional critical care team under the direction of an
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intensivist.
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DIF: Cognitive Level: Knowledge REF: p. 4 FG FG F G F G FG
OBJ: Discuss the purposes and functions of the professional organizations that support critical
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care practice.
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MSC: NCLEX: Safe and Effective Care Environment
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2. A nurse has been working as a staff nurse in the surgical intensive care unit for 2 years and is
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FG interested in certification. Which credential would be most applicable for her to seek?
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a. ACNPC
b. CCNS
c. CCRN
d. PCCN
ANS: F G C
The CCRN certification is appropriate for nurses in bedside practice who care for critically ill
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patients. The ACNPC certification is for acute care nurse practitioners. The CCNS
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certification is for critical care clinical nurse specialists. The PCCN certification is for staff
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nurses working in progressive care, intermediate care, or step-down unit settings.
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DIF: Cognitive Level: Application REF: p. 5 FG FG F G F G FG
OBJ: Explain certification options for critical care nurses.
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N/A MSC: NCLEX: Safe and Effective Care Environment
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3. The main purpose of certification is to:
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a. assure the consumer that you will not make a mistake. FG FG FG FG FG FG FG FG FG
b. prepare for graduate school. FG FG FG
c. promote magnet status for your facility. FG FG FG FG FG
d. validate knowledge of critical care nursing. FG FG FG FG FG
ANS: F G D
, Certification assists in validating knowledge of the field, promotes excellence in the
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profession, and helps nurses to maintain their knowledge of critical care nursing. Certification
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helps to assure the consumer that the nurse has a minimum level of knowledge; however, it
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does not ensure that care will be mistake-free. Certification does not prepare one for graduate
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school; however, achieving certification demonstrates motivation for achievement and
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professionalism. Magnet facilities are rated on the number of certified nurses; however, that is
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not the purpose of certification.
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DIF: Cognitive Level: Analysis REF: pp. 4-5 FG FG F G F G FG
OBJ: Explain certification options for critical care nurses.
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N/A MSC: NCLEX: Safe and Effective Care Environment
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4. The synergy model of practice focuses on:
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a. allowing unrestricted visiting for the patient 24 hours each day. FG FG FG FG FG FG FG FG FG
b. holistic and alternative therapies. FG FG FG
c. needs of patients and their families, which drives nursing competency.
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d. patients’ needs for energy and support. FG FG FG FG FG
ANS: F G C
The synergy model of practice states that the needs of patients and families influence and
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drive competencies of nurses. Nursing practice based on the synergy model would involve
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tailored visiting to meet the patient’s and family’s needs and application of alternative
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therapies if desired by the patient, but that is not the primary focus of the model.
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DIF: Cognitive Level: Application REF: p. 5 | Fig. 1-3 FG FG F G F G FG FG FG FG
OBJ: Describe standards of professional practice for critical care nursing.
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TOP: Nursing Process Step: N/A
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5. The family of your critically ill patient tells you that they have not spoken with the physician
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FG in over 24 hours and they have some questions that they want clarified. During morning
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FG rounds, you convey this concern to the attending intensivist and arrange for her to meet with
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FG the family at 4:00 PM in the conference room. Which competency of critical care nursing
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FG does this represent?
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a. Advocacy and moral agency in solving ethical issues FG FG FG FG FG FG FG
b. Clinical judgment and clinical reasoning skills FG FG FG FG FG
c. Collaboration with patients, families, and team members FG FG FG FG FG FG
d. Facilitation of learning for patients, families, and team members FG FG FG FG FG FG FG FG
ANS: F G C
Although one might consider that all of these competencies are being addressed,
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communication and collaboration with the family and physician best exemplify the
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competency of collaboration.
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DIF: Cognitive Level: Analysis REF: p. 9 FG FG F G F G FG
OBJ: Describe standards of professional practice for critical care nursing.
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TOP: Nursing Process Step: N/A
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6. The AACN Standards for Acute and Critical Care Nursing Practice use what framework to
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FG guide critical care nursing practice?
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a. Evidence-based practice FG
b. Healthy work environment FG FG
, c. National Patient Safety Goals FG FG FG
d. Nursing process FG
ANS: F G D
The AACN Standards for Acute and Critical Care Nursing Practice delineate the nursing
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process as applied to critically ill patients: collect data, determine diagnoses, identify expected
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outcomes, develop a plan of care, implement interventions, and evaluate care. AACN
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promotes a healthy work environment, but this is not included in the Standards. The Joint
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Commission has established National Patient Safety Goals, but these are not the AACN
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Standards.
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DIF: Cognitive Level: Analysis REF: p. 5 | Box 1-2 FG FG F G F G FG FG FG FG
OBJ: Describe standards of professional practice for critical care nursing.
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TOP: Nursing Process Step: N/A
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7. The charge nurse is responsible for making the patient assignments on the critical care unit.
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She assigns the experienced, certified nurse to care for the acutely ill patient with sepsis who
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also requires continuous renal replacement therapy and mechanical ventilation. She assigns
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the nurse with less than 1 year of experience to two patients who are more stable. This
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assignment reflects implementation of the:
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a. crew resource management model FG FG FG
b. National Patient Safety Goals FG FG FG
c. Quality and Safety Education for Nurses (QSEN) model FG FG FG FG FG FG FG
d. synergy model of practice FG FG FG
ANS: F G D
This assignment demonstrates nursing care to meet the needs of the patient. The synergy
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model notes that the nurse competencies are matched to the patient characteristics. Crew
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resource management concepts related to team training, National Patient Safety Goals are
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specified by The Joint Commission to promote safe care but do not incorporate the synergy
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model. The Quality and Safety Education for Nurses initiative involves targeted education to
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undergraduate and graduate nursing students to learn quality and safety concepts.
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DIF: Cognitive Level: Analysis REF: p. 5 | Fig. 1-3 FG FG F G F G FG FG FG FG
OBJ: Describe standards of professional practice for critical care nursing.
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TOP: Nursing Process Step: N/A
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8. The vision of the American Association of Critical-Care Nurses is a healthcare system driven
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a. a healthy work environment.
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b. care from a multiprofessional team under the direction of a critical care physician.
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c. the needs of critically ill patients and families.
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d. respectful, healing, and humane environments. FG FG FG FG
ANS: F G C
The AACN vision is a healthcare system driven by the needs of critically ill patients and
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families where critical care nurses make their optimum contributions. AACN promotes
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initiatives to support a healthy work environment as well as respectful and healing
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environments, but that is not the organization’s vision. The SCCM promotes care from a
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multiprofessional team under the direction of a critical care physician.
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DIF: Cognitive Level: Knowledge FG FG REF: F G F G p. 4 FG
, OBJ: Discuss the purposes and functions of the professional organizations that support critical
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care practice.
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MSC: NCLEX: Safe and Effective Care Environment
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9. The most important outcome of effective communication is to:
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a. demonstrate caring practices to family members. FG FG FG FG FG
b. ensure that patient teaching is done. FG FG FG FG FG
c. meet the diversity needs of patients. FG FG FG FG FG
d. reduce patient errors. FG FG
ANS: F G D
Many errors are directly attributed to faulty communication. Effective communication has
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been identified as an essential strategy to reduce patient errors and resolve issues related to
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patient care delivery. Communication may demonstrate caring practices, be used for
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patient/family teaching, and address diversity needs; however, the main outcome of effective
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communication is patient safety.
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DIF: Cognitive Level: Knowledge REF: pp. 8-9 FG FG F G F G FG
OBJ: Describe quality and safety initiatives related to critical care nursing.
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TOP: Nursing Process Step: N/A
F G MSC: NCLEX: Safe and Effective Care Environment FG FG FG F G FG FG FG FG FG
10. You are caring for a critically ill patient whose urine output has been low for 2 consecutive
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hours. After a thorough patient assessment, you call the intensivist with the following report.
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Dr. Smith, I’m calling about Mrs. P., your 65-year-old patient in CCU 10. Her urine output
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for the past 2 hours totaled only 40 mL. She arrived from surgery to repair an aortic
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aneurysm 4 hours ago and remains on mechanical ventilation. In the past 2 hours, her heart
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rate has increased from 80 to 100 beats per minute and her blood pressure has decreased
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from 128/82 to 100/70 mm Hg. She is being given an infusion of normal saline at 100 mL per
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hour. Her right atrial pressure through the subclavian central line is low at 3 mm Hg. Her
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urine is concentrated. Her BUN and creatinine levels have been stable and in normal
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range. Her abdominal dressing is dry with no indication of bleeding. My assessment
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suggests that Mrs. P. is hypovolemic and I would like you to consider increasing her fluids
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or giving her a fluid challenge. Using the SBAR model for communication, the information
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the nurse gives about the patient’s history and vital signs is:
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a. Situation
b. Background
c. Assessment
d. Recommendation
ANS: F G B
The history and vital signs are part of the background. Information regarding the low urine
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output is the situation. Information regarding possible hypovolemia is part of the nurse’s
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assessment, and the suggestion for fluids is the recommendation.
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DIF: Cognitive Level: Analysis REF: pp. 8-9 FG FG F G F G FG
OBJ: Describe quality and safety initiatives related to critical care nursing.
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TOP: Nursing Process Step: Assessment MSC: NCLEX: Safe and Effective Care Environment
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