SOLE’S INTRODUCTION TO
CRITICAL CARE NURSING
9TH EDITION
• AUTHOR(S)MARY MAKIC
TEST BANK
1
Reference: Ch. 1 — Overview of Critical Care Nursing —
Introduction / Clinical Judgment Measurement Model
Stem: A 68-year-old post-op CABG patient in the ICU has HR
110, BP 92/56, RR 24, SpO₂ 92% on 4 L NC, urine output 25
mL/hr, SaO₂ trending down 4% over 30 minutes. The night RN
asks you to triage priorities during rounds. Which action best
reflects immediate clinical judgment?
A. Notify the surgeon for possible bleeding.
B. Increase oxygen to 6 L via facemask and reassess SpO₂ in 10
minutes.
C. Perform immediate focused bedside assessment (airway,
,breathing, circulation) and reassess trends.
D. Contact respiratory therapy for ABG and ventilator
assessment.
Correct Answer: C
Rationale — Correct (C): A focused bedside assessment aligns
with clinical judgment measurement: synthesize vitals
(tachycardia, hypotension, rising RR, falling SpO₂, low urine
output) to determine cause (hypovolemia, bleeding, respiratory
compromise). Immediate ABC-focused reassessment is highest
priority to identify reversible causes and direct next
interventions.
Rationale — Incorrect:
A — Notifying surgeon may be necessary but premature
without targeted assessment to confirm bleeding vs. respiratory
cause.
B — Increasing oxygen without assessing causes might mask
deterioration and delays identification of shock or bleeding.
D — ABG useful, but waiting for RT delays immediate bedside
evaluation and interventions.
Teaching Point: Do a rapid ABC-focused bedside assessment
before ordering tests or calling consultants.
Citation: Makic, M. B. F. (2025). Sole’s Introduction to Critical
Care Nursing (9th ed.). Ch. 1.
2
,Reference: Ch. 1 — Professional Organizations / Certification
Stem: A newly hired ICU nurse requests guidance about
certification. She is clinically competent but anxious about
preparing for CCRN. Her unit mentor suggests attending only a
weekend review course. Which advice most supports
professional development and evidence-based certification
preparation?
A. Recommend a structured study plan including case-based
practice, mentorship, and focused review over weeks.
B. Encourage reliance on the weekend course since it provides
exam content condensed.
C. Advise postponing certification until she has 3 more years of
bedside experience.
D. Suggest purchasing multiple review question banks and
cramming the week before the exam.
Correct Answer: A
Rationale — Correct (A): Professional organizations and
certification standards emphasize sustained preparation: case-
based practice, mentorship, and progressive learning build
clinical judgment and knowledge stability, increasing validity of
certification.
Rationale — Incorrect:
B — A single weekend course alone is insufficient for deep
reasoning and application required for CCRN.
C — Unnecessary delay undermines career goals; certification
eligibility often requires fewer than 3 extra years.
, D — Cramming yields poor long-term retention and doesn’t
develop clinical judgment.
Teaching Point: Certification prep should be structured, case-
based, and mentored — not last-minute cramming.
Citation: Makic, M. B. F. (2025). Sole’s Introduction to Critical
Care Nursing (9th ed.). Ch. 1.
3
Reference: Ch. 1 — Standards / Quality and Safety Emphasis
Stem: During a safety huddle, you learn the ICU’s central line
infection rate has risen above benchmark. That morning a
patient with fever 38.6°C and new leukocytosis is 48 hours post
CVC insertion. Which action aligns with standards and
immediate safety priorities?
A. Start empiric broad-spectrum antibiotics and remove the CVC
once cultures drawn.
B. Remove the CVC immediately without obtaining cultures.
C. Obtain paired blood cultures (peripheral and central) and
notify the team while implementing CLABSI bundle measures.
D. Assume the fever is postoperative and document trends only.
Correct Answer: C
Rationale — Correct (C): Standards and safety emphasize
evidence-based CLABSI bundles and correct diagnostic steps:
obtain paired cultures to identify source (central vs peripheral)
and implement prevention measures while notifying team for
CRITICAL CARE NURSING
9TH EDITION
• AUTHOR(S)MARY MAKIC
TEST BANK
1
Reference: Ch. 1 — Overview of Critical Care Nursing —
Introduction / Clinical Judgment Measurement Model
Stem: A 68-year-old post-op CABG patient in the ICU has HR
110, BP 92/56, RR 24, SpO₂ 92% on 4 L NC, urine output 25
mL/hr, SaO₂ trending down 4% over 30 minutes. The night RN
asks you to triage priorities during rounds. Which action best
reflects immediate clinical judgment?
A. Notify the surgeon for possible bleeding.
B. Increase oxygen to 6 L via facemask and reassess SpO₂ in 10
minutes.
C. Perform immediate focused bedside assessment (airway,
,breathing, circulation) and reassess trends.
D. Contact respiratory therapy for ABG and ventilator
assessment.
Correct Answer: C
Rationale — Correct (C): A focused bedside assessment aligns
with clinical judgment measurement: synthesize vitals
(tachycardia, hypotension, rising RR, falling SpO₂, low urine
output) to determine cause (hypovolemia, bleeding, respiratory
compromise). Immediate ABC-focused reassessment is highest
priority to identify reversible causes and direct next
interventions.
Rationale — Incorrect:
A — Notifying surgeon may be necessary but premature
without targeted assessment to confirm bleeding vs. respiratory
cause.
B — Increasing oxygen without assessing causes might mask
deterioration and delays identification of shock or bleeding.
D — ABG useful, but waiting for RT delays immediate bedside
evaluation and interventions.
Teaching Point: Do a rapid ABC-focused bedside assessment
before ordering tests or calling consultants.
Citation: Makic, M. B. F. (2025). Sole’s Introduction to Critical
Care Nursing (9th ed.). Ch. 1.
2
,Reference: Ch. 1 — Professional Organizations / Certification
Stem: A newly hired ICU nurse requests guidance about
certification. She is clinically competent but anxious about
preparing for CCRN. Her unit mentor suggests attending only a
weekend review course. Which advice most supports
professional development and evidence-based certification
preparation?
A. Recommend a structured study plan including case-based
practice, mentorship, and focused review over weeks.
B. Encourage reliance on the weekend course since it provides
exam content condensed.
C. Advise postponing certification until she has 3 more years of
bedside experience.
D. Suggest purchasing multiple review question banks and
cramming the week before the exam.
Correct Answer: A
Rationale — Correct (A): Professional organizations and
certification standards emphasize sustained preparation: case-
based practice, mentorship, and progressive learning build
clinical judgment and knowledge stability, increasing validity of
certification.
Rationale — Incorrect:
B — A single weekend course alone is insufficient for deep
reasoning and application required for CCRN.
C — Unnecessary delay undermines career goals; certification
eligibility often requires fewer than 3 extra years.
, D — Cramming yields poor long-term retention and doesn’t
develop clinical judgment.
Teaching Point: Certification prep should be structured, case-
based, and mentored — not last-minute cramming.
Citation: Makic, M. B. F. (2025). Sole’s Introduction to Critical
Care Nursing (9th ed.). Ch. 1.
3
Reference: Ch. 1 — Standards / Quality and Safety Emphasis
Stem: During a safety huddle, you learn the ICU’s central line
infection rate has risen above benchmark. That morning a
patient with fever 38.6°C and new leukocytosis is 48 hours post
CVC insertion. Which action aligns with standards and
immediate safety priorities?
A. Start empiric broad-spectrum antibiotics and remove the CVC
once cultures drawn.
B. Remove the CVC immediately without obtaining cultures.
C. Obtain paired blood cultures (peripheral and central) and
notify the team while implementing CLABSI bundle measures.
D. Assume the fever is postoperative and document trends only.
Correct Answer: C
Rationale — Correct (C): Standards and safety emphasize
evidence-based CLABSI bundles and correct diagnostic steps:
obtain paired cultures to identify source (central vs peripheral)
and implement prevention measures while notifying team for
