SOLE’S INTRODUCTION TO
CRITICAL CARE NURSING
9TH EDITION
• AUTHOR(S)MARY MAKIC
TEST BANK
1
Reference
Part I, Ch. 1 — Overview of Critical Care Nursing — Quality &
Safety Systems
Stem
A charge nurse on a 12-bed ICU notes a rising number of
medication administration errors during night shift handoffs.
Unit staffing is at 85% of budgeted FTEs, and a new provider
team rotates every two weeks. Which system-level action
should the charge nurse prioritize to reduce errors
immediately?
,A. Institute mandatory online medication refresher modules for
all night staff.
B. Implement a standardized bedside handoff tool (SBAR +
medication review) at shift change.
C. Request hiring of two additional RNs to meet budgeted
staffing.
D. Begin monthly morbidity and mortality (M&M) chart reviews.
Correct Answer: B
Rationale — Correct (B)
Standardized bedside handoffs that include medication review
directly address the proximate cause (handoff communication)
and immediately reduce transcription/omission errors by
ensuring verification at the point of care. This aligns with safety
system practices and evidence-based handoff strategies in
critical care.
Rationale — Incorrect
A. Education is useful but does not correct real-time
communication failures and is slower to impact error rates.
C. Hiring may be needed but is not an immediate feasible fix
and doesn't target handoff process.
D. M&M reviews inform long-term improvement but are
retrospective and do not immediately prevent errors.
Teaching Point:
Standardize bedside handoffs including medication verification
to reduce immediate error risk.
,Citation:
Makic, M. B. F. (2025). Sole’s Introduction to Critical Care
Nursing (9th ed.). Ch. 1.
2
Reference
Part I, Ch. 1 — Standards & Clinical Judgment Measurement
Model
Stem
A newly hired ICU nurse is assigned a patient with early septic
shock. During orientation, the preceptor asks the nurse to
prioritize interventions. According to clinical judgment
frameworks, which initial action demonstrates the highest-
priority nursing judgment?
A. Review the patient’s 24-hour input/output totals.
B. Assess current hemodynamics and oxygenation (vitals,
lactate, SpO₂).
C. Call the physician to request broad-spectrum antibiotics.
D. Document baseline neurological status.
Correct Answer: B
Rationale — Correct (B)
Clinical judgment frameworks prioritize identification of
immediate physiologic instability. Assessing hemodynamics and
oxygenation yields data necessary to triage interventions
(fluids, vasopressors, oxygen), and informs timely antibiotic
, decisions. It's the immediate assessment step in the clinical
reasoning loop.
Rationale — Incorrect
A. Fluid balance is relevant but less immediate than real-time
hemodynamic and oxygenation status.
C. Calling for antibiotics is critical but should follow assessment
to provide targeted information (or be initiated in parallel if
protocols allow).
D. Neurologic baseline is useful but lower priority compared to
resuscitation needs.
Teaching Point:
Assess vitals and perfusion first to guide priority resuscitation in
early shock.
Citation:
Makic, M. B. F. (2025). Sole’s Introduction to Critical Care
Nursing (9th ed.). Ch. 1.
3
Reference
Part I, Ch. 1 — Professional Organizations & Certification
Stem
An ICU nurse is considering CCRN certification to advance
professionally. The nurse asks which benefit is most directly tied
to improved patient outcomes at the unit level.
CRITICAL CARE NURSING
9TH EDITION
• AUTHOR(S)MARY MAKIC
TEST BANK
1
Reference
Part I, Ch. 1 — Overview of Critical Care Nursing — Quality &
Safety Systems
Stem
A charge nurse on a 12-bed ICU notes a rising number of
medication administration errors during night shift handoffs.
Unit staffing is at 85% of budgeted FTEs, and a new provider
team rotates every two weeks. Which system-level action
should the charge nurse prioritize to reduce errors
immediately?
,A. Institute mandatory online medication refresher modules for
all night staff.
B. Implement a standardized bedside handoff tool (SBAR +
medication review) at shift change.
C. Request hiring of two additional RNs to meet budgeted
staffing.
D. Begin monthly morbidity and mortality (M&M) chart reviews.
Correct Answer: B
Rationale — Correct (B)
Standardized bedside handoffs that include medication review
directly address the proximate cause (handoff communication)
and immediately reduce transcription/omission errors by
ensuring verification at the point of care. This aligns with safety
system practices and evidence-based handoff strategies in
critical care.
Rationale — Incorrect
A. Education is useful but does not correct real-time
communication failures and is slower to impact error rates.
C. Hiring may be needed but is not an immediate feasible fix
and doesn't target handoff process.
D. M&M reviews inform long-term improvement but are
retrospective and do not immediately prevent errors.
Teaching Point:
Standardize bedside handoffs including medication verification
to reduce immediate error risk.
,Citation:
Makic, M. B. F. (2025). Sole’s Introduction to Critical Care
Nursing (9th ed.). Ch. 1.
2
Reference
Part I, Ch. 1 — Standards & Clinical Judgment Measurement
Model
Stem
A newly hired ICU nurse is assigned a patient with early septic
shock. During orientation, the preceptor asks the nurse to
prioritize interventions. According to clinical judgment
frameworks, which initial action demonstrates the highest-
priority nursing judgment?
A. Review the patient’s 24-hour input/output totals.
B. Assess current hemodynamics and oxygenation (vitals,
lactate, SpO₂).
C. Call the physician to request broad-spectrum antibiotics.
D. Document baseline neurological status.
Correct Answer: B
Rationale — Correct (B)
Clinical judgment frameworks prioritize identification of
immediate physiologic instability. Assessing hemodynamics and
oxygenation yields data necessary to triage interventions
(fluids, vasopressors, oxygen), and informs timely antibiotic
, decisions. It's the immediate assessment step in the clinical
reasoning loop.
Rationale — Incorrect
A. Fluid balance is relevant but less immediate than real-time
hemodynamic and oxygenation status.
C. Calling for antibiotics is critical but should follow assessment
to provide targeted information (or be initiated in parallel if
protocols allow).
D. Neurologic baseline is useful but lower priority compared to
resuscitation needs.
Teaching Point:
Assess vitals and perfusion first to guide priority resuscitation in
early shock.
Citation:
Makic, M. B. F. (2025). Sole’s Introduction to Critical Care
Nursing (9th ed.). Ch. 1.
3
Reference
Part I, Ch. 1 — Professional Organizations & Certification
Stem
An ICU nurse is considering CCRN certification to advance
professionally. The nurse asks which benefit is most directly tied
to improved patient outcomes at the unit level.
