Test Bank for Sole’s Introduction to Critical
Care Nursing 9th Edition by Makic and
Morata
1. A patient in the ICU suddenly becomes confused and agitated. The nurse suspects deli
hg hg hg hg hg hg hg hg hg hg hg hg hg hg
rium. Which of the following is the most important initial nursing action?
hg hg hg hg hg hg hg hg hg hg hg
A. Apply soft wrist restraints to prevent injury.
hg hg hg hg hg hg hg
B. Administer a dose of haloperidol as per PRN orders.
hg hg hg hg hg hg hg hg hg
C. Assess for physiological causes such as hypoxia or infection.
hg hg hg hg hg hg hg hg hg
D. Dim the lights and reduce stimulation to calm the patient.
hg hg hg hg hg hg hg hg hg hg
Correct Answer: C hg hg
Rationale: The first step in managing delirium is to assess and treat underlying physiological c
hg hg hg hg hg hg hg hg hg hg hg hg hg hg
auses (e.g., hypoxia, hypoglycemia, infection, electrolyte imbalances). Restraints and medication
hg hg hg hg hg hg hg hg hg
s are considered after environmental and non-
hg hg hg hg hg hg
pharmacological interventions and should not be used as a first- hg hg hg hg hg hg hg hg hg
line treatment without a thorough assessment.
hg hg hg hg hg
2. The family of a patient in the ICU is anxious and expresses a desire to be more involve
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
d in the patient's care. What is the best response by the nurse?
hg hg hg hg hg hg hg hg hg hg hg hg
A. "I understand, but it's best if you let us handle all the care."
hg hg hg hg hg hg hg hg hg hg hg hg hg
B. "You can stay at the bedside, but please do not touch any of the equipment."
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
C. "We encourage family participation. Let's discuss what you feel comfortable helping with, su
hg hg hg hg hg hg hg hg hg hg hg hg hg
ch as bathing or mouth care."
hg hg hg hg hg
D. "The most helpful thing you can do is talk quietly to the patient, even if they appear unresp
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
onsive."
Correct Answer: C hg hg
Rationale: Patient- and family- hg hg hg
centered care is a core principle in critical care. Encouraging family participation and involving t
hg hg hg hg hg hg hg hg hg hg hg hg hg hg
hem in care decisions promotes their well-
hg hg hg hg hg hg
being and reduces anxiety. Option C is the most proactive and inclusive approach.
hg hg hg hg hg hg hg hg hg hg hg hg
3. A nurse is caring for a patient with a pulmonary artery catheter. The waveform indicat
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
es the catheter is in the "wedge" position. Which of the following assessments is most cr
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
itical for the nurse to perform?
hg hg hg hg hg
A. Monitor the central venous pressure (CVP).
hg hg hg hg hg hg
B. Zero the transducer at the mid-axillary line.
hg hg hg hg hg hg hg
,C. Inflate the balloon slowly and monitor the tracing for a return to a pulmonary artery wavefor
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
m.
D. Assess the pulmonary artery wedge pressure (PAWP) and then deflate the balloon immediat
hg hg hg hg hg hg hg hg hg hg hg hg hg
ely.
Correct Answer: D hg hg
Rationale: The PAWP reflects left ventricular end-
hg hg hg hg hg hg
diastolic pressure (preload). The balloon must be deflated immediately after the PAWP measure
hg hg hg hg hg hg hg hg hg hg hg hg
ment is obtained to prevent pulmonary infarction. This is a critical safety step.
hg hg hg hg hg hg hg hg hg hg hg hg
Chapter 2: The Patient and Family in the ICU
hg hg hg hg hg hg hg hg
4. A patient in the ICU is being mechanically ventilated and is unable to speak. The patie
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
nt's family is frustrated and wants to know why they can't "just talk" to their loved one.
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
What is the best nursing intervention?
hg hg hg hg hg
A. Explain that the ventilator tube prevents speech and provide the family with alternative com
hg hg hg hg hg hg hg hg hg hg hg hg hg hg
munication aids like a communication board. hg hg hg hg hg
B. Suggest that they write a letter to the patient to be read aloud at the bedside.
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
C. Tell them to wait until the patient is extubated.
hg hg hg hg hg hg hg hg hg
D. Explain that the patient is sedated and cannot communicate anyway.
hg hg hg hg hg hg hg hg hg hg
Correct Answer: A hg hg
Rationale: The nurse's role includes facilitating communication. Alternative methods, such as c
hg hg hg hg hg hg hg hg hg hg hg
ommunication boards, picture cards, or a whiteboard, should be provided to the patient and fa
hg hg hg hg hg hg hg hg hg hg hg hg hg hg
mily. This empowers the patient and reduces family frustration.
hg hg hg hg hg hg hg hg
5. A patient's family is grieving and asks the nurse, "Why did this happen to them?" Wh
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
at is the nurse's most appropriate response?
hg hg hg hg hg hg
A. "I know this is hard. Let's focus on what we can do now to help your loved one."
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
B. "That is a question that is often asked. I don't have the answer, but I am here to listen."
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
C. "The doctor will be by later to explain everything."
hg hg hg hg hg hg hg hg hg
D. "Try not to dwell on the 'why.' It will only make you more upset."
hg hg hg hg hg hg hg hg hg hg hg hg hg hg
Correct Answer: B hg hg
Rationale: This therapeutic communication technique acknowledges the family's feelings and p
hg hg hg hg hg hg hg hg hg hg
ain without providing false reassurance or blocking their expression of emotions. Active listenin
hg hg hg hg hg hg hg hg hg hg hg hg
g is a key component of supporting grieving families.
hg hg hg hg hg hg hg hg
Chapter 3: Ethical and Legal Issues in Critical Care Nursing
hg hg hg hg hg hg hg hg hg
,6. A patient has a valid living will that states "no life-
hg hg hg hg hg hg hg hg hg hg hg
sustaining treatment." The patient is now in the ICU with a severe stroke and respiratory
hg hg hg hg hg hg hg hg hg hg hg hg hg hg h
failure. The physician orders intubation and mechanical ventilation. What is the most ap
g hg hg hg hg hg hg hg hg hg hg hg hg
propriate initial action by the nurse? hg hg hg hg hg
A. Prepare the patient for intubation as ordered.
hg hg hg hg hg hg hg
B. Call the hospital's ethics committee to review the case.
hg hg hg hg hg hg hg hg hg
C. Discuss the living will with the physician and advocate for the patient's wishes.
hg hg hg hg hg hg hg hg hg hg hg hg hg
D. Contact the patient's family to get their consent for intubation.
hg hg hg hg hg hg hg hg hg hg
Correct Answer: C hg hg
Rationale: The nurse acts as a patient advocate. The nurse must first clarify the patient's wishe
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
s as documented in the living will with the physician, who holds the legal authority to withhold
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
or withdraw treatment. The nurse's role is to ensure the healthcare team is aware of and respec
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
ts the patient's advanced directive.
hg hg hg hg
7. A terminally ill patient in the ICU is experiencing severe pain that is unresponsive to st
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
andard doses of opioids. The physician is considering increasing the dose to a level that
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
could potentially hasten death. This is an example of which ethical principle?
hg hg hg hg hg hg hg hg hg hg hg
A. Beneficence
hg
B. The Doctrine of Double Effect
hg hg hg hg hg
C. Autonomy
hg
D. Justicehg
Correct Answer: B hg hg
Rationale: The Doctrine of Double Effect allows for an action that has a good effect (pain relief
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
) but may also have a foreseeable bad effect (respiratory depression leading to death) as long
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
as the bad effect is not the intended outcome. The primary intention is to relieve suffering.
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
Chapter 4: Monitoring and Technology in Critical Care
hg hg hg hg hg hg hg
8. A nurse is interpreting a patient's cardiac rhythm. The monitor shows a regular rhyth
hg hg hg hg hg hg hg hg hg hg hg hg hg hg
m with a rate of 110 bpm, narrow QRS complexes, and no visible P waves. The nurse cor
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
rectly identifies this rhythm as:
hg hg hg hg
A. Sinus Tachycardia
hg hg
B. Atrial Fibrillation
hg hg
C. Ventricular Tachycardia
hg hg
D. Junctional Tachycardia
hg hg
Correct Answer: B hg hg
Rationale: Atrial Fibrillation is characterized by an irregularly irregular rhythm, no discernible P
hg hg hg hg hg hg hg hg hg hg hg hg hg
, waves, and a narrow QRS complex (if ventricular conduction is normal). While the rate is fast, it
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
is still Atrial Fibrillation.
hg hg hg
9. When caring for a patient with an arterial line, the nurse obtains a blood pressure rea
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
ding that is significantly different from the non-
hg hg hg hg hg hg hg
invasive cuff reading. What is the priority action?
hg hg hg hg hg hg hg
A. Document the difference and inform the physician.
hg hg hg hg hg hg hg
B. Re-zero the transducer and level the system at the phlebostatic axis.
hg hg hg hg hg hg hg hg hg hg hg
C. Increase the infusion rate of the flush solution.
hg hg hg hg hg hg hg hg
D. Check the patient for signs of hypovolemia.
hg hg hg hg hg hg hg
Correct Answer: B hg hg
Rationale: The most common cause for inaccurate readings from an arterial line is improper ze
hg hg hg hg hg hg hg hg hg hg hg hg hg hg
roing and leveling of the transducer. The transducer must be zeroed to atmospheric pressure a
hg hg hg hg hg hg hg hg hg hg hg hg hg hg
nd leveled at the phlebostatic axis (the fourth intercostal space, mid-
hg hg hg hg hg hg hg hg hg hg
axillary line) to ensure accuracy. This is the first and most critical troubleshooting step.
hg hg hg hg hg hg hg hg hg hg hg hg hg
Chapter 5: Cardiovascular System hg hg hg
10. A patient is experiencing acute myocardial infarction (MI). The nurse expects which o
hg hg hg hg hg hg hg hg hg hg hg hg hg
f the following laboratory findings to be most specific and earliest to rise?
hg hg hg hg hg hg hg hg hg hg hg hg
A. Creatine Kinase-MB (CK-MB)
hg hg hg
B. Lactate Dehydrogenase (LDH)
hg hg hg
C. Myoglobin
hg
D. Troponin T or I
hg hg hg hg
Correct Answer: D hg hg
Rationale: Cardiac troponins (T and I) are the most specific and sensitive biomarkers for myoca
hg hg hg hg hg hg hg hg hg hg hg hg hg hg
rdial injury. They begin to rise within 3-4 hours of symptom onset and remain elevated for 7-
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
10 days, making them ideal for early and late diagnosis.
hg hg hg hg hg hg hg hg hg
11. A patient is diagnosed with heart failure and has an ejection fraction of 25%. Which
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
of the following medications is a first-
hg hg hg hg hg hg
line therapy that has been shown to reduce mortality in this condition?
hg hg hg hg hg hg hg hg hg hg hg
A. Dopamine
hg
B. Digoxin
hg
C. Metoprolol
hg
D. Nifedipine
hg
Care Nursing 9th Edition by Makic and
Morata
1. A patient in the ICU suddenly becomes confused and agitated. The nurse suspects deli
hg hg hg hg hg hg hg hg hg hg hg hg hg hg
rium. Which of the following is the most important initial nursing action?
hg hg hg hg hg hg hg hg hg hg hg
A. Apply soft wrist restraints to prevent injury.
hg hg hg hg hg hg hg
B. Administer a dose of haloperidol as per PRN orders.
hg hg hg hg hg hg hg hg hg
C. Assess for physiological causes such as hypoxia or infection.
hg hg hg hg hg hg hg hg hg
D. Dim the lights and reduce stimulation to calm the patient.
hg hg hg hg hg hg hg hg hg hg
Correct Answer: C hg hg
Rationale: The first step in managing delirium is to assess and treat underlying physiological c
hg hg hg hg hg hg hg hg hg hg hg hg hg hg
auses (e.g., hypoxia, hypoglycemia, infection, electrolyte imbalances). Restraints and medication
hg hg hg hg hg hg hg hg hg
s are considered after environmental and non-
hg hg hg hg hg hg
pharmacological interventions and should not be used as a first- hg hg hg hg hg hg hg hg hg
line treatment without a thorough assessment.
hg hg hg hg hg
2. The family of a patient in the ICU is anxious and expresses a desire to be more involve
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
d in the patient's care. What is the best response by the nurse?
hg hg hg hg hg hg hg hg hg hg hg hg
A. "I understand, but it's best if you let us handle all the care."
hg hg hg hg hg hg hg hg hg hg hg hg hg
B. "You can stay at the bedside, but please do not touch any of the equipment."
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
C. "We encourage family participation. Let's discuss what you feel comfortable helping with, su
hg hg hg hg hg hg hg hg hg hg hg hg hg
ch as bathing or mouth care."
hg hg hg hg hg
D. "The most helpful thing you can do is talk quietly to the patient, even if they appear unresp
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
onsive."
Correct Answer: C hg hg
Rationale: Patient- and family- hg hg hg
centered care is a core principle in critical care. Encouraging family participation and involving t
hg hg hg hg hg hg hg hg hg hg hg hg hg hg
hem in care decisions promotes their well-
hg hg hg hg hg hg
being and reduces anxiety. Option C is the most proactive and inclusive approach.
hg hg hg hg hg hg hg hg hg hg hg hg
3. A nurse is caring for a patient with a pulmonary artery catheter. The waveform indicat
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
es the catheter is in the "wedge" position. Which of the following assessments is most cr
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
itical for the nurse to perform?
hg hg hg hg hg
A. Monitor the central venous pressure (CVP).
hg hg hg hg hg hg
B. Zero the transducer at the mid-axillary line.
hg hg hg hg hg hg hg
,C. Inflate the balloon slowly and monitor the tracing for a return to a pulmonary artery wavefor
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
m.
D. Assess the pulmonary artery wedge pressure (PAWP) and then deflate the balloon immediat
hg hg hg hg hg hg hg hg hg hg hg hg hg
ely.
Correct Answer: D hg hg
Rationale: The PAWP reflects left ventricular end-
hg hg hg hg hg hg
diastolic pressure (preload). The balloon must be deflated immediately after the PAWP measure
hg hg hg hg hg hg hg hg hg hg hg hg
ment is obtained to prevent pulmonary infarction. This is a critical safety step.
hg hg hg hg hg hg hg hg hg hg hg hg
Chapter 2: The Patient and Family in the ICU
hg hg hg hg hg hg hg hg
4. A patient in the ICU is being mechanically ventilated and is unable to speak. The patie
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
nt's family is frustrated and wants to know why they can't "just talk" to their loved one.
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
What is the best nursing intervention?
hg hg hg hg hg
A. Explain that the ventilator tube prevents speech and provide the family with alternative com
hg hg hg hg hg hg hg hg hg hg hg hg hg hg
munication aids like a communication board. hg hg hg hg hg
B. Suggest that they write a letter to the patient to be read aloud at the bedside.
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
C. Tell them to wait until the patient is extubated.
hg hg hg hg hg hg hg hg hg
D. Explain that the patient is sedated and cannot communicate anyway.
hg hg hg hg hg hg hg hg hg hg
Correct Answer: A hg hg
Rationale: The nurse's role includes facilitating communication. Alternative methods, such as c
hg hg hg hg hg hg hg hg hg hg hg
ommunication boards, picture cards, or a whiteboard, should be provided to the patient and fa
hg hg hg hg hg hg hg hg hg hg hg hg hg hg
mily. This empowers the patient and reduces family frustration.
hg hg hg hg hg hg hg hg
5. A patient's family is grieving and asks the nurse, "Why did this happen to them?" Wh
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
at is the nurse's most appropriate response?
hg hg hg hg hg hg
A. "I know this is hard. Let's focus on what we can do now to help your loved one."
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
B. "That is a question that is often asked. I don't have the answer, but I am here to listen."
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
C. "The doctor will be by later to explain everything."
hg hg hg hg hg hg hg hg hg
D. "Try not to dwell on the 'why.' It will only make you more upset."
hg hg hg hg hg hg hg hg hg hg hg hg hg hg
Correct Answer: B hg hg
Rationale: This therapeutic communication technique acknowledges the family's feelings and p
hg hg hg hg hg hg hg hg hg hg
ain without providing false reassurance or blocking their expression of emotions. Active listenin
hg hg hg hg hg hg hg hg hg hg hg hg
g is a key component of supporting grieving families.
hg hg hg hg hg hg hg hg
Chapter 3: Ethical and Legal Issues in Critical Care Nursing
hg hg hg hg hg hg hg hg hg
,6. A patient has a valid living will that states "no life-
hg hg hg hg hg hg hg hg hg hg hg
sustaining treatment." The patient is now in the ICU with a severe stroke and respiratory
hg hg hg hg hg hg hg hg hg hg hg hg hg hg h
failure. The physician orders intubation and mechanical ventilation. What is the most ap
g hg hg hg hg hg hg hg hg hg hg hg hg
propriate initial action by the nurse? hg hg hg hg hg
A. Prepare the patient for intubation as ordered.
hg hg hg hg hg hg hg
B. Call the hospital's ethics committee to review the case.
hg hg hg hg hg hg hg hg hg
C. Discuss the living will with the physician and advocate for the patient's wishes.
hg hg hg hg hg hg hg hg hg hg hg hg hg
D. Contact the patient's family to get their consent for intubation.
hg hg hg hg hg hg hg hg hg hg
Correct Answer: C hg hg
Rationale: The nurse acts as a patient advocate. The nurse must first clarify the patient's wishe
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
s as documented in the living will with the physician, who holds the legal authority to withhold
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
or withdraw treatment. The nurse's role is to ensure the healthcare team is aware of and respec
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
ts the patient's advanced directive.
hg hg hg hg
7. A terminally ill patient in the ICU is experiencing severe pain that is unresponsive to st
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
andard doses of opioids. The physician is considering increasing the dose to a level that
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
could potentially hasten death. This is an example of which ethical principle?
hg hg hg hg hg hg hg hg hg hg hg
A. Beneficence
hg
B. The Doctrine of Double Effect
hg hg hg hg hg
C. Autonomy
hg
D. Justicehg
Correct Answer: B hg hg
Rationale: The Doctrine of Double Effect allows for an action that has a good effect (pain relief
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
) but may also have a foreseeable bad effect (respiratory depression leading to death) as long
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
as the bad effect is not the intended outcome. The primary intention is to relieve suffering.
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
Chapter 4: Monitoring and Technology in Critical Care
hg hg hg hg hg hg hg
8. A nurse is interpreting a patient's cardiac rhythm. The monitor shows a regular rhyth
hg hg hg hg hg hg hg hg hg hg hg hg hg hg
m with a rate of 110 bpm, narrow QRS complexes, and no visible P waves. The nurse cor
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
rectly identifies this rhythm as:
hg hg hg hg
A. Sinus Tachycardia
hg hg
B. Atrial Fibrillation
hg hg
C. Ventricular Tachycardia
hg hg
D. Junctional Tachycardia
hg hg
Correct Answer: B hg hg
Rationale: Atrial Fibrillation is characterized by an irregularly irregular rhythm, no discernible P
hg hg hg hg hg hg hg hg hg hg hg hg hg
, waves, and a narrow QRS complex (if ventricular conduction is normal). While the rate is fast, it
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
is still Atrial Fibrillation.
hg hg hg
9. When caring for a patient with an arterial line, the nurse obtains a blood pressure rea
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
ding that is significantly different from the non-
hg hg hg hg hg hg hg
invasive cuff reading. What is the priority action?
hg hg hg hg hg hg hg
A. Document the difference and inform the physician.
hg hg hg hg hg hg hg
B. Re-zero the transducer and level the system at the phlebostatic axis.
hg hg hg hg hg hg hg hg hg hg hg
C. Increase the infusion rate of the flush solution.
hg hg hg hg hg hg hg hg
D. Check the patient for signs of hypovolemia.
hg hg hg hg hg hg hg
Correct Answer: B hg hg
Rationale: The most common cause for inaccurate readings from an arterial line is improper ze
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roing and leveling of the transducer. The transducer must be zeroed to atmospheric pressure a
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nd leveled at the phlebostatic axis (the fourth intercostal space, mid-
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axillary line) to ensure accuracy. This is the first and most critical troubleshooting step.
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Chapter 5: Cardiovascular System hg hg hg
10. A patient is experiencing acute myocardial infarction (MI). The nurse expects which o
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f the following laboratory findings to be most specific and earliest to rise?
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A. Creatine Kinase-MB (CK-MB)
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B. Lactate Dehydrogenase (LDH)
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C. Myoglobin
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D. Troponin T or I
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Correct Answer: D hg hg
Rationale: Cardiac troponins (T and I) are the most specific and sensitive biomarkers for myoca
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rdial injury. They begin to rise within 3-4 hours of symptom onset and remain elevated for 7-
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10 days, making them ideal for early and late diagnosis.
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11. A patient is diagnosed with heart failure and has an ejection fraction of 25%. Which
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of the following medications is a first-
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line therapy that has been shown to reduce mortality in this condition?
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A. Dopamine
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B. Digoxin
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C. Metoprolol
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D. Nifedipine
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