SOLE’S INTRODUCTION TO
CRITICAL CARE NURSING
9TH EDITION
• AUTHOR(S)MARY MAKIC
TEST BANK
1.
Reference
Ch. 1 — Introduction — Role and Scope of the Critical Care
Nurse
Stem
A 62-year-old post-op abdominal surgery patient in the step-
down unit develops sudden tachycardia to 125 bpm, BP 86/54
mm Hg, cool clammy skin, and decreased urine output over 30
minutes. The bedside RN calls the critical care team; while
waiting, which action should the critical care nurse prioritize
first?
,Options
A. Notify the surgeon immediately and request transfer back to
the OR.
B. Initiate rapid bedside assessment including airway, breathing,
circulation (ABCs) and apply supplemental oxygen.
C. Start a 500-mL rapid infusion of lactated Ringer’s without
further assessment.
D. Draw blood for a complete metabolic panel and lactate level.
Correct answer
B
Rationale — Correct (B)
Immediate bedside assessment using ABCs and providing
supplemental oxygen addresses the most time-sensitive threats
and guides further interventions. In a rapidly hypotensive,
tachycardic patient with oliguria and cool skin, stabilizing
oxygenation and assessing airway and circulation identifies
reversible causes and prioritizes resuscitation. This aligns with
critical care scope—rapid assessment before definitive
diagnostics or non-assessed fluid bolus.
Rationale — Incorrect (A)
Contacting the surgeon is important but not the first action;
urgent stabilization can change immediate risk and guide the
surgeon’s recommendations.
Rationale — Incorrect (C)
Blind fluid bolus without assessment risks fluid overload (e.g.,
,cardiogenic shock) or delaying identification of hemorrhage or
other causes.
Rationale — Incorrect (D)
Labs are valuable but will not immediately stabilize the patient;
they must follow urgent assessment/interventions.
Teaching point
Immediate ABC assessment with oxygen identifies reversible
threats and guides resuscitation.
Citation
Makic, M. B. F. (2025). Sole’s Introduction to Critical Care
Nursing (9th ed.). Ch. 1.
2.
Reference
Ch. 1 — Critical Care Nursing — Professional Roles & Teamwork
Stem
An ICU nurse notices the newly assigned RN is unfamiliar with
the unit’s sepsis protocol during an acutely febrile patient’s
early sepsis screen. The charge asks you to assign the new RN
several unstable patients. What is the most appropriate action?
Options
A. Accept assignment but offer to help the new RN as needed.
B. Inform charge you cannot accept the assignment because of
staffing ratios.
, C. Refuse and document the charge nurse's poor decision to
avoid liability.
D. Discuss concerns with charge nurse, request reassignment or
higher supervision for the new RN.
Correct answer
D
Rationale — Correct (D)
Patient safety requires appropriate skill-assignment. The critical
care nurse should raise concerns with charge, requesting
reassignment or direct supervision to match competencies to
patient acuity. This protects patients and supports novice staff
without immediate refusal.
Rationale — Incorrect (A)
Volunteering help is collegial, but accepting unstable
assignment without formal supervision may compromise safety
and accountability.
Rationale — Incorrect (B)
Stating an inability to accept due to ratios is vague and avoids
collaborative problem-solving; it skips escalation to ensure
supervision.
Rationale — Incorrect (C)
Refusing and documenting as punitive is adversarial and
bypasses constructive safety processes; begin with dialogue and
escalation.
CRITICAL CARE NURSING
9TH EDITION
• AUTHOR(S)MARY MAKIC
TEST BANK
1.
Reference
Ch. 1 — Introduction — Role and Scope of the Critical Care
Nurse
Stem
A 62-year-old post-op abdominal surgery patient in the step-
down unit develops sudden tachycardia to 125 bpm, BP 86/54
mm Hg, cool clammy skin, and decreased urine output over 30
minutes. The bedside RN calls the critical care team; while
waiting, which action should the critical care nurse prioritize
first?
,Options
A. Notify the surgeon immediately and request transfer back to
the OR.
B. Initiate rapid bedside assessment including airway, breathing,
circulation (ABCs) and apply supplemental oxygen.
C. Start a 500-mL rapid infusion of lactated Ringer’s without
further assessment.
D. Draw blood for a complete metabolic panel and lactate level.
Correct answer
B
Rationale — Correct (B)
Immediate bedside assessment using ABCs and providing
supplemental oxygen addresses the most time-sensitive threats
and guides further interventions. In a rapidly hypotensive,
tachycardic patient with oliguria and cool skin, stabilizing
oxygenation and assessing airway and circulation identifies
reversible causes and prioritizes resuscitation. This aligns with
critical care scope—rapid assessment before definitive
diagnostics or non-assessed fluid bolus.
Rationale — Incorrect (A)
Contacting the surgeon is important but not the first action;
urgent stabilization can change immediate risk and guide the
surgeon’s recommendations.
Rationale — Incorrect (C)
Blind fluid bolus without assessment risks fluid overload (e.g.,
,cardiogenic shock) or delaying identification of hemorrhage or
other causes.
Rationale — Incorrect (D)
Labs are valuable but will not immediately stabilize the patient;
they must follow urgent assessment/interventions.
Teaching point
Immediate ABC assessment with oxygen identifies reversible
threats and guides resuscitation.
Citation
Makic, M. B. F. (2025). Sole’s Introduction to Critical Care
Nursing (9th ed.). Ch. 1.
2.
Reference
Ch. 1 — Critical Care Nursing — Professional Roles & Teamwork
Stem
An ICU nurse notices the newly assigned RN is unfamiliar with
the unit’s sepsis protocol during an acutely febrile patient’s
early sepsis screen. The charge asks you to assign the new RN
several unstable patients. What is the most appropriate action?
Options
A. Accept assignment but offer to help the new RN as needed.
B. Inform charge you cannot accept the assignment because of
staffing ratios.
, C. Refuse and document the charge nurse's poor decision to
avoid liability.
D. Discuss concerns with charge nurse, request reassignment or
higher supervision for the new RN.
Correct answer
D
Rationale — Correct (D)
Patient safety requires appropriate skill-assignment. The critical
care nurse should raise concerns with charge, requesting
reassignment or direct supervision to match competencies to
patient acuity. This protects patients and supports novice staff
without immediate refusal.
Rationale — Incorrect (A)
Volunteering help is collegial, but accepting unstable
assignment without formal supervision may compromise safety
and accountability.
Rationale — Incorrect (B)
Stating an inability to accept due to ratios is vague and avoids
collaborative problem-solving; it skips escalation to ensure
supervision.
Rationale — Incorrect (C)
Refusing and documenting as punitive is adversarial and
bypasses constructive safety processes; begin with dialogue and
escalation.
