AACN Certification CCRN/PCCN Critical Care Exam 1 with Correct
Questions and Answers | Graded A+
AACN - Correct Answer- certify nurses; protect consumer by establishing high standards of professional
practice
CCRN - Correct Answer- certification for nurses who provide care in critically ill adult, pediatric, or
neonatal populations
PCCN - Correct Answer- certification for nurses who provide acute care in progressive care, telemetry,
and similar units
CNML - Correct Answer- certification for critical care managers and leaders
CCNS - Correct Answer- certification for acute and critical care clinical nurse specialists
Level A (Scale for Rating Research Evidence) - Correct Answer- meta-analysis or metasynthesis studies;
results consistently support specific action, intervention, or treatment
Level B (Scale for Rating Research Evidence) - Correct Answer- randomized and nonrandomized
controlled studies; results consistently support specific action, intervention, or treatment
Level C (Scale for Rating Research Evidence) - Correct Answer- qualitative, descriptive, or correlational
studies, reviews, or trials with inconsistent results
Level D (Scale for Rating Research Evidence) - Correct Answer- Peer-reviewed with clinical studies to
support recommendations
Level E (Scale for Rating Research Evidence) - Correct Answer- theory-based evidence from expert
opinions
,Level M (Scale for Rating Research Evidence) - Correct Answer- Manufacturer's recommendation only
Ask-Tell-Ask (Communication) - Correct Answer- Communication technique that assesses concerns
before providing info
Situational Awareness (Communication) - Correct Answer- being aware of one's surroundings
Calgary Family Assessment - Correct Answer- Assessment that involves structural, developmental, and
functional assessments
Family Bundle - Correct Answer- Provide structure for planning and carrying out family care; based on 5
concepts: evaluate, plan; involve; communicate; support (EPICS)
Principlism - Correct Answer- widely applied ethical approach based of 4 fundamental moral principles to
contemporary ethical dilemmas; respect for autonomy; beneficence; nonmaleficence; justice
Beneficence - Correct Answer- the duty to provide benefits to others when in a position to do so, to help
balance harms and benefits; the benefits of an action should outweigh the burdens
Futility - Correct Answer- states that care should not be given if it is futile in terms of improving comfort
or the medical outcome
Veracity - Correct Answer- states that persons are obligated to tell the truth in their communication with
others
Fidelity - Correct Answer- requires that one has a moral duty to be faithful to the commitments made to
others
,Elements of Informed Consent - Correct Answer- competence (capacity); voluntariness; disclosure of
information
Living Will - Correct Answer- a witnessed written document or oral statement voluntarily executed by a
person that expresses the person's instructions concerning life-prolonging procedure; not legally binding
in some states
Proxy - Correct Answer- a competent adult, not designated to make health care decisions for an
incapacitated person, but is authorized by state statute to make healthcare decisions for the person
Surrogate - Correct Answer- a competent adult designated by a person to make health care decisions
should that person become incapacitated
Patient Self-Determination act (End-of-life issue) - Correct Answer- requires that all healthcare facilities
that receive medicare or medicaid funding inform their patients about their right to initiate an advance
directive and the right to consent to or refuse medical treatment
Withholding, Limiting, or Withdrawing Therapy - Correct Answer- Priority should be anticipating patient
symptoms; assessment of patient response; titration of therapy to relieve emotional and physical distress;
common meds used are analgesics (ie. Morphine) and anxiolytics (ie. benzodiazepines)
Ventilator WIthdrawal - Correct Answer- Known as "terminal weaning"; consist of titration of ventilator
support to minimal levels, removal of ventilator, but not artificial airway, or complete extubation; titrate
pain meds and sedation as needed to relieve symptoms of respiratory distress
Commonly withheld therapy - Correct Answer- vasopressors; antibiotics; done when goal of treatment
shift to palliation instead of cure; address these before withdrawing or withholding ventilation
Ethical Principles for withholding and withdrawing life-sustaining treatment - Correct Answer- life-
sustaining treatment should not be withdrawn while patient is receiving paralytic agents. When paralytic
drugs are discontinued, patient must demonstrate sufficient motor activity to allow thorough clinical
assessment before withdrawal of support
, Hemodynamic Assessment - Correct Answer- Used to titrate therapies to a specific end point; detect
inadequate tissue perfusion; quantify severity of disease; and guide therapy
normal cardiac output (CO) (hemodynamic values) - Correct Answer- 4 to 8 L/minute
normal central venous pressure (CVP) and Right atrial pressure (RAP) (hemodynamic values) - Correct
Answer- 2 to 6 mm Hg
Normal stroke volume (SV) (hemodynamic values) - Correct Answer- 60 to 130 mL/beat
normal mixed venous O2 sat (SvO2) (hemodynamic values) - Correct Answer- 60% to 75%
Normal central venous O2 sat (ScvO2) - Correct Answer- 65% to 85%
what affects BP reading - Correct Answer- presence of cardiac dysrhythmias; respiratory variation;
shivering; external cuff compression; decreased peripheral perfusion
Jugular Venous Pressure - Correct Answer- Provides an estimate of intravascular volume; an indirect
measure of central venous pressure (CVP); Normal is 7 to 9 cm
jugular venous distention - Correct Answer- occurs when CVP is elevated due to fluid overload, RV
dysfunction, superior vena cava obstruction, right HF
Assessment of jugular venous pressure - Correct Answer- look for highest point of pulsation; measure the
vertical distance between this pulsation and the angle of Louis in cm; add 5 cm to this number for an
estimation of CVP
Questions and Answers | Graded A+
AACN - Correct Answer- certify nurses; protect consumer by establishing high standards of professional
practice
CCRN - Correct Answer- certification for nurses who provide care in critically ill adult, pediatric, or
neonatal populations
PCCN - Correct Answer- certification for nurses who provide acute care in progressive care, telemetry,
and similar units
CNML - Correct Answer- certification for critical care managers and leaders
CCNS - Correct Answer- certification for acute and critical care clinical nurse specialists
Level A (Scale for Rating Research Evidence) - Correct Answer- meta-analysis or metasynthesis studies;
results consistently support specific action, intervention, or treatment
Level B (Scale for Rating Research Evidence) - Correct Answer- randomized and nonrandomized
controlled studies; results consistently support specific action, intervention, or treatment
Level C (Scale for Rating Research Evidence) - Correct Answer- qualitative, descriptive, or correlational
studies, reviews, or trials with inconsistent results
Level D (Scale for Rating Research Evidence) - Correct Answer- Peer-reviewed with clinical studies to
support recommendations
Level E (Scale for Rating Research Evidence) - Correct Answer- theory-based evidence from expert
opinions
,Level M (Scale for Rating Research Evidence) - Correct Answer- Manufacturer's recommendation only
Ask-Tell-Ask (Communication) - Correct Answer- Communication technique that assesses concerns
before providing info
Situational Awareness (Communication) - Correct Answer- being aware of one's surroundings
Calgary Family Assessment - Correct Answer- Assessment that involves structural, developmental, and
functional assessments
Family Bundle - Correct Answer- Provide structure for planning and carrying out family care; based on 5
concepts: evaluate, plan; involve; communicate; support (EPICS)
Principlism - Correct Answer- widely applied ethical approach based of 4 fundamental moral principles to
contemporary ethical dilemmas; respect for autonomy; beneficence; nonmaleficence; justice
Beneficence - Correct Answer- the duty to provide benefits to others when in a position to do so, to help
balance harms and benefits; the benefits of an action should outweigh the burdens
Futility - Correct Answer- states that care should not be given if it is futile in terms of improving comfort
or the medical outcome
Veracity - Correct Answer- states that persons are obligated to tell the truth in their communication with
others
Fidelity - Correct Answer- requires that one has a moral duty to be faithful to the commitments made to
others
,Elements of Informed Consent - Correct Answer- competence (capacity); voluntariness; disclosure of
information
Living Will - Correct Answer- a witnessed written document or oral statement voluntarily executed by a
person that expresses the person's instructions concerning life-prolonging procedure; not legally binding
in some states
Proxy - Correct Answer- a competent adult, not designated to make health care decisions for an
incapacitated person, but is authorized by state statute to make healthcare decisions for the person
Surrogate - Correct Answer- a competent adult designated by a person to make health care decisions
should that person become incapacitated
Patient Self-Determination act (End-of-life issue) - Correct Answer- requires that all healthcare facilities
that receive medicare or medicaid funding inform their patients about their right to initiate an advance
directive and the right to consent to or refuse medical treatment
Withholding, Limiting, or Withdrawing Therapy - Correct Answer- Priority should be anticipating patient
symptoms; assessment of patient response; titration of therapy to relieve emotional and physical distress;
common meds used are analgesics (ie. Morphine) and anxiolytics (ie. benzodiazepines)
Ventilator WIthdrawal - Correct Answer- Known as "terminal weaning"; consist of titration of ventilator
support to minimal levels, removal of ventilator, but not artificial airway, or complete extubation; titrate
pain meds and sedation as needed to relieve symptoms of respiratory distress
Commonly withheld therapy - Correct Answer- vasopressors; antibiotics; done when goal of treatment
shift to palliation instead of cure; address these before withdrawing or withholding ventilation
Ethical Principles for withholding and withdrawing life-sustaining treatment - Correct Answer- life-
sustaining treatment should not be withdrawn while patient is receiving paralytic agents. When paralytic
drugs are discontinued, patient must demonstrate sufficient motor activity to allow thorough clinical
assessment before withdrawal of support
, Hemodynamic Assessment - Correct Answer- Used to titrate therapies to a specific end point; detect
inadequate tissue perfusion; quantify severity of disease; and guide therapy
normal cardiac output (CO) (hemodynamic values) - Correct Answer- 4 to 8 L/minute
normal central venous pressure (CVP) and Right atrial pressure (RAP) (hemodynamic values) - Correct
Answer- 2 to 6 mm Hg
Normal stroke volume (SV) (hemodynamic values) - Correct Answer- 60 to 130 mL/beat
normal mixed venous O2 sat (SvO2) (hemodynamic values) - Correct Answer- 60% to 75%
Normal central venous O2 sat (ScvO2) - Correct Answer- 65% to 85%
what affects BP reading - Correct Answer- presence of cardiac dysrhythmias; respiratory variation;
shivering; external cuff compression; decreased peripheral perfusion
Jugular Venous Pressure - Correct Answer- Provides an estimate of intravascular volume; an indirect
measure of central venous pressure (CVP); Normal is 7 to 9 cm
jugular venous distention - Correct Answer- occurs when CVP is elevated due to fluid overload, RV
dysfunction, superior vena cava obstruction, right HF
Assessment of jugular venous pressure - Correct Answer- look for highest point of pulsation; measure the
vertical distance between this pulsation and the angle of Louis in cm; add 5 cm to this number for an
estimation of CVP
