SOLE’S INTRODUCTION TO
CRITICAL CARE NURSING
9TH EDITION
• AUTHOR(S)MARY MAKIC
TEST BANK
Q1
Reference: Ch. 1 — Overview of Critical Care Nursing —
Collaborative plan of care
Stem: A 62-year-old postop CABG patient in the ICU develops a
new-onset fever (38.9°C), rising WBC, and increased sedation
requirements. The bedside nurse notes no recent ventilator
disconnections and that central line dressings were changed 24
hours ago. The interdisciplinary team is meeting to revise the
daily plan of care. What should the nurse prioritize presenting
to the team?
Options:
A. Suggest switching to a broader-spectrum antibiotic
,immediately.
B. Recommend a focused bedside assessment for catheter-
related infection and collect blood cultures.
C. Request canceling the next physiotherapy session to reduce
work of breathing.
D. Propose transfer to telemetry for continued monitoring.
Correct Answer: B
Rationale — Correct (B): Collecting cultures and performing a
focused assessment addresses the most likely source
(catheter/line or pulmonary) and preserves diagnostic accuracy
before escalating antibiotics; aligns with evidence-based sepsis
evaluation and team decision-making.
Rationale — Incorrect:
A — Premature; antibiotic escalation without cultures reduces
diagnostic clarity and may promote resistance.
C — Lower priority; while activity modifies respiratory demand,
it doesn't address possible infection source causing
deterioration.
D — Inappropriate; telemetry lacks ICU resources if sepsis or
line infection suspected.
Teaching Point: Prioritize diagnostics (cultures, focused exam)
before empiric escalation when possible.
Citation: Makic, M. B. F. (2025). Sole’s Introduction to Critical
Care Nursing (9th ed.). Ch. 1.
Q2
,Reference: Ch. 1 — Professional Organizations — Standards &
advocacy
Stem: The ICU nursing manager is updating unit policies to align
with a new professional organization guideline that affects
ventilator-associated pneumonia prevention. Which rationale
should the staff nurse include when explaining this change to
bedside nurses?
Options:
A. Professional organization guidelines are optional suggestions
without regulatory weight.
B. Aligning unit practice with guidelines improves patient
outcomes and supports accreditation readiness.
C. Local custom always supersedes external professional
recommendations.
D. Changing policies now will reduce documentation workload
for nurses.
Correct Answer: B
Rationale — Correct (B): Professional guidelines synthesize best
evidence and improve outcomes when implemented; they also
support accreditation and quality metrics that affect unit
performance.
Rationale — Incorrect:
A — Misleading; while not laws, guidelines influence standards
of care and accreditation.
C — Incorrect; local custom should be reconciled with evidence-
based standards.
D — False; guideline implementation often initially increases
, workload for training/documentation.
Teaching Point: Evidence-based professional guidelines
enhance outcomes and accreditation readiness.
Citation: Makic, M. B. F. (2025). Sole’s Introduction to Critical
Care Nursing (9th ed.). Ch. 1.
Q3
Reference: Ch. 1 — Certification — Clinical competency &
staffing
Stem: A new charge nurse is scheduling staff for a high-acuity
shift with two ECMO patients. One experienced RN is
uncertified in critical care but has 10 years of ICU experience;
two RNs hold recent CCRN certification but are each three
months into orientation. Which staffing assignment most
reflects best practice for patient safety?
Options:
A. Assign the experienced uncertified RN as primary for one
ECMO patient; pair each CCRN novice as primary for the other
ECMO patient.
B. Assign the experienced uncertified RN as primary for both
ECMO patients.
C. Pair the experienced RN with one CCRN-orientee as a team
for one ECMO patient and assign the other CCRN-orientee with
the charge nurse for the second ECMO patient.
D. Cancel both ECMO therapies due to insufficient
credentialing.
CRITICAL CARE NURSING
9TH EDITION
• AUTHOR(S)MARY MAKIC
TEST BANK
Q1
Reference: Ch. 1 — Overview of Critical Care Nursing —
Collaborative plan of care
Stem: A 62-year-old postop CABG patient in the ICU develops a
new-onset fever (38.9°C), rising WBC, and increased sedation
requirements. The bedside nurse notes no recent ventilator
disconnections and that central line dressings were changed 24
hours ago. The interdisciplinary team is meeting to revise the
daily plan of care. What should the nurse prioritize presenting
to the team?
Options:
A. Suggest switching to a broader-spectrum antibiotic
,immediately.
B. Recommend a focused bedside assessment for catheter-
related infection and collect blood cultures.
C. Request canceling the next physiotherapy session to reduce
work of breathing.
D. Propose transfer to telemetry for continued monitoring.
Correct Answer: B
Rationale — Correct (B): Collecting cultures and performing a
focused assessment addresses the most likely source
(catheter/line or pulmonary) and preserves diagnostic accuracy
before escalating antibiotics; aligns with evidence-based sepsis
evaluation and team decision-making.
Rationale — Incorrect:
A — Premature; antibiotic escalation without cultures reduces
diagnostic clarity and may promote resistance.
C — Lower priority; while activity modifies respiratory demand,
it doesn't address possible infection source causing
deterioration.
D — Inappropriate; telemetry lacks ICU resources if sepsis or
line infection suspected.
Teaching Point: Prioritize diagnostics (cultures, focused exam)
before empiric escalation when possible.
Citation: Makic, M. B. F. (2025). Sole’s Introduction to Critical
Care Nursing (9th ed.). Ch. 1.
Q2
,Reference: Ch. 1 — Professional Organizations — Standards &
advocacy
Stem: The ICU nursing manager is updating unit policies to align
with a new professional organization guideline that affects
ventilator-associated pneumonia prevention. Which rationale
should the staff nurse include when explaining this change to
bedside nurses?
Options:
A. Professional organization guidelines are optional suggestions
without regulatory weight.
B. Aligning unit practice with guidelines improves patient
outcomes and supports accreditation readiness.
C. Local custom always supersedes external professional
recommendations.
D. Changing policies now will reduce documentation workload
for nurses.
Correct Answer: B
Rationale — Correct (B): Professional guidelines synthesize best
evidence and improve outcomes when implemented; they also
support accreditation and quality metrics that affect unit
performance.
Rationale — Incorrect:
A — Misleading; while not laws, guidelines influence standards
of care and accreditation.
C — Incorrect; local custom should be reconciled with evidence-
based standards.
D — False; guideline implementation often initially increases
, workload for training/documentation.
Teaching Point: Evidence-based professional guidelines
enhance outcomes and accreditation readiness.
Citation: Makic, M. B. F. (2025). Sole’s Introduction to Critical
Care Nursing (9th ed.). Ch. 1.
Q3
Reference: Ch. 1 — Certification — Clinical competency &
staffing
Stem: A new charge nurse is scheduling staff for a high-acuity
shift with two ECMO patients. One experienced RN is
uncertified in critical care but has 10 years of ICU experience;
two RNs hold recent CCRN certification but are each three
months into orientation. Which staffing assignment most
reflects best practice for patient safety?
Options:
A. Assign the experienced uncertified RN as primary for one
ECMO patient; pair each CCRN novice as primary for the other
ECMO patient.
B. Assign the experienced uncertified RN as primary for both
ECMO patients.
C. Pair the experienced RN with one CCRN-orientee as a team
for one ECMO patient and assign the other CCRN-orientee with
the charge nurse for the second ECMO patient.
D. Cancel both ECMO therapies due to insufficient
credentialing.
