Chapter 01
1. Which of the following assists the critical care nurse in ensuring that care is appropriate and based on
research? [Multiple Choice]
a. Clinical practice guidelines ✔
b. Computerized physician order entry
c. Consulting with advanced practice nurses
d. Implementing Joint Commission National Patient Safety Goals
ANS: A
Clinical practice guidelines are being implemented to ensure that care is appropriate and based on research.
Some physician order entry pathways, but not all, are based on research recommendations. Some advanced
practice nurses, but not all, are well versed in evidence-based practices. The National Patient Safety Goals are
recommendations to reduce errors using evidence-based practices.
2. Which scenarios contribute to effective handoff communication at change of shift? (Select all that apply.)
[Multiple Response]
a. The nephrology consultant physician is making rounds and asks you for an update on the patient’s status and to
assist in placing a central line for hemodialysis.
b. The noise level is high because twice as many staff members are present and everyone is giving report in the
nurses’ station.
c. The unit has decided to use a standardized checklist/tool for change-of-shift reports and patient transfers. ✔
d. You and the oncoming nurse conduct a standardized report at the patient’s bedside and review key assessment
findings. ✔
e. The off-going nurse is giving the patient medications at the same time as giving handoff report to the oncoming
nurse.
ANS: C, D
A reporting tool and bedside report improve handoff communication by ensuring standardized communication
and review of assessment findings. Conducting report at the bedside also reduces noise that commonly occurs at
the nurses’ station during a change of shift. The nephrologist has created an interruption that can impede handoff
with the next nurse. Likewise, noise in the nurses’ station can cause distractions that can impair concentration
and listening. Giving medications at the same time as handoff report could lead to serious errors both in
medication administration and in the report itself.
3. Which of the following nursing activities demonstrates implementation of the AACN Standards of Professional
,Performance? (Select all that apply.) [Multiple Response]
a. Attending a meeting of the local chapter of the American Association of Critical-Care Nurses in which a
continuing education program on sepsis is being taught ✔
b. Collaborating with a pastoral services colleague to assist in meeting spiritual needs of the patient and family ✔
c. Participating on the unit’s nurse practice council ✔
d. Posting an article from Critical Care Nurse on the management of venous thromboembolism for your
colleagues to read ✔
e. Using evidence-based strategies to prevent ventilator-associated pneumonia ✔
ANS: A, B, C, D, E
All answers are correct. Attending a program to learn about sepsis—Acquires and maintains current knowledge
and competency in patient care. Collaborating with pastoral services—Collaborates with the health care team to
provide care in a healing, humane, and caring environment. Posting information for others—Contributes to the
professional development of peers and other health care providers. Nurse practice council—Provides leadership
in the practice setting. Evidence-based practices—Uses clinical inquiry in practice.
4. Which of the following statements describes the core concept of the synergy model of practice? [Multiple Choice]
a. All nurses must be certified in order to have the synergy model implemented.
b. Family members must be included in daily interdisciplinary rounds.
c. Nurses and physicians must work collaboratively and synergistically to influence care.
d. Unique needs of patients and their families influence nursing competencies. ✔
ANS: D
The synergy model of practice is care based on the unique needs and characteristics of the patient and family
members. Although critical care certification is based on the synergy model, the model does not specifically
address certification. Inclusion of family members into the daily rounds is an example of implementation of the
synergy model. With the focus on patients and family members with nurse interaction, the synergy model does
not address physician collaboration.
5. The first critical care units were (Select all that apply.) [Multiple Response]
a. burn units.
b. coronary care units. ✔
c. recovery rooms. ✔
d. neonatal intensive care units.
,e. high-risk OB units.
ANS: B, C
Recovery rooms and coronary care units were the first units designated to care for critically ill patients. Burn,
neonatal intensive care, and high-risk OB units were established as specialty units evolved.
6. A nurse who plans care based on the patient’s gender, ethnicity, spirituality, and lifestyle is said to [Multiple
Choice]
a. be a moral advocate.
b. facilitate learning.
c. respond to diversity. ✔
d. use clinical judgment.
ANS: C
Response to diversity considers all of these aspects when planning and implementing care. A moral agent helps
resolve ethical and clinical concerns. Consideration of these factors does not necessarily facilitate learning. Clinical
judgment uses other factors as well.
7. The AACN Standards for Acute and Critical Care Nursing Practice use what framework to guide critical care
nursing practice? [Multiple Choice]
a. Evidence-based practice
b. Healthy work environment
c. National Patient Safety Goals
d. Nursing process ✔
ANS: D
The AACN Standards for Acute and Critical Care Nursing Practice delineate the nursing process as applied to
critically ill patients: collect data, determine diagnoses, identify expected outcomes, develop a plan of care,
implement interventions, and evaluate care. AACN promotes a healthy work environment, but this is not included
in its standards. The Joint Commission has established National Patient Safety Goals, but these are not the AACN
standards.
8. Which strategy is important in addressing issues associated with the aging workforce? (Select all that apply.)
[Multiple Response]
a. Allowing nurses to work flexible shift durations ✔
b. Encouraging older nurses to transfer to an outpatient setting that is less stressful
, c. Hiring nurse technicians who are available to assist with patient care, such as turning the patient ✔
d. Remodeling patient care rooms to include devices to assist in patient lifting ✔
e. Developing a staffing model that accurately reflects the unit’s needs.
ANS: A, C, D
Modifying the work environment to reduce physical demands is one strategy to assist the aging workforce.
Examples include overhead lifts to prevent back injuries. Twelve-hour shifts can be quite demanding; therefore,
allowing nurses flexibility in choosing shifts of shorter duration is a good option as well. Adequate staffing,
including both registered nurses and nonlicensed assistive personnel to help with nursing and nonnursing tasks, is
helpful. Encouraging experienced, knowledgeable critical care nurses to leave the critical care unit is not wise as
the unit loses the expertise of this group.
9. Which of the following professional organizations best supports critical care nursing practice? [Multiple Choice]
a. American Association of Critical-Care Nurses ✔
b. American Heart Association
c. American Nurses Association
d. Society of Critical Care Medicine
ANS: A
The American Association of Critical-Care Nurses is the specialty organization that supports and represents critical
care nurses. The American Heart Association supports cardiovascular initiatives. The American Nurses Association
supports all nurses. The Society of Critical Care Medicine represents the multiprofessional critical care team under
the direction of an intensivist.
10. The vision of the American Association of Critical-Care Nurses is a health care system driven by [Multiple Choice]
a. a healthy work environment.
b. care from a multiprofessional team under the direction of a critical care physician.
c. the needs of critically ill patients and families. ✔
d. respectful, healing, and humane environments.
ANS: C
The AACN vision is a health care system driven by the needs of critically ill patients and families where critical care
nurses make their optimum contributions. AACN promotes initiatives to support a healthy work environment as
well as respectful and healing environments, but that is not the organization’s vision. The Society of Critical Care
Medicine (SCCM) promotes care from a multiprofessional team under the direction of a critical care physician.
1. Which of the following assists the critical care nurse in ensuring that care is appropriate and based on
research? [Multiple Choice]
a. Clinical practice guidelines ✔
b. Computerized physician order entry
c. Consulting with advanced practice nurses
d. Implementing Joint Commission National Patient Safety Goals
ANS: A
Clinical practice guidelines are being implemented to ensure that care is appropriate and based on research.
Some physician order entry pathways, but not all, are based on research recommendations. Some advanced
practice nurses, but not all, are well versed in evidence-based practices. The National Patient Safety Goals are
recommendations to reduce errors using evidence-based practices.
2. Which scenarios contribute to effective handoff communication at change of shift? (Select all that apply.)
[Multiple Response]
a. The nephrology consultant physician is making rounds and asks you for an update on the patient’s status and to
assist in placing a central line for hemodialysis.
b. The noise level is high because twice as many staff members are present and everyone is giving report in the
nurses’ station.
c. The unit has decided to use a standardized checklist/tool for change-of-shift reports and patient transfers. ✔
d. You and the oncoming nurse conduct a standardized report at the patient’s bedside and review key assessment
findings. ✔
e. The off-going nurse is giving the patient medications at the same time as giving handoff report to the oncoming
nurse.
ANS: C, D
A reporting tool and bedside report improve handoff communication by ensuring standardized communication
and review of assessment findings. Conducting report at the bedside also reduces noise that commonly occurs at
the nurses’ station during a change of shift. The nephrologist has created an interruption that can impede handoff
with the next nurse. Likewise, noise in the nurses’ station can cause distractions that can impair concentration
and listening. Giving medications at the same time as handoff report could lead to serious errors both in
medication administration and in the report itself.
3. Which of the following nursing activities demonstrates implementation of the AACN Standards of Professional
,Performance? (Select all that apply.) [Multiple Response]
a. Attending a meeting of the local chapter of the American Association of Critical-Care Nurses in which a
continuing education program on sepsis is being taught ✔
b. Collaborating with a pastoral services colleague to assist in meeting spiritual needs of the patient and family ✔
c. Participating on the unit’s nurse practice council ✔
d. Posting an article from Critical Care Nurse on the management of venous thromboembolism for your
colleagues to read ✔
e. Using evidence-based strategies to prevent ventilator-associated pneumonia ✔
ANS: A, B, C, D, E
All answers are correct. Attending a program to learn about sepsis—Acquires and maintains current knowledge
and competency in patient care. Collaborating with pastoral services—Collaborates with the health care team to
provide care in a healing, humane, and caring environment. Posting information for others—Contributes to the
professional development of peers and other health care providers. Nurse practice council—Provides leadership
in the practice setting. Evidence-based practices—Uses clinical inquiry in practice.
4. Which of the following statements describes the core concept of the synergy model of practice? [Multiple Choice]
a. All nurses must be certified in order to have the synergy model implemented.
b. Family members must be included in daily interdisciplinary rounds.
c. Nurses and physicians must work collaboratively and synergistically to influence care.
d. Unique needs of patients and their families influence nursing competencies. ✔
ANS: D
The synergy model of practice is care based on the unique needs and characteristics of the patient and family
members. Although critical care certification is based on the synergy model, the model does not specifically
address certification. Inclusion of family members into the daily rounds is an example of implementation of the
synergy model. With the focus on patients and family members with nurse interaction, the synergy model does
not address physician collaboration.
5. The first critical care units were (Select all that apply.) [Multiple Response]
a. burn units.
b. coronary care units. ✔
c. recovery rooms. ✔
d. neonatal intensive care units.
,e. high-risk OB units.
ANS: B, C
Recovery rooms and coronary care units were the first units designated to care for critically ill patients. Burn,
neonatal intensive care, and high-risk OB units were established as specialty units evolved.
6. A nurse who plans care based on the patient’s gender, ethnicity, spirituality, and lifestyle is said to [Multiple
Choice]
a. be a moral advocate.
b. facilitate learning.
c. respond to diversity. ✔
d. use clinical judgment.
ANS: C
Response to diversity considers all of these aspects when planning and implementing care. A moral agent helps
resolve ethical and clinical concerns. Consideration of these factors does not necessarily facilitate learning. Clinical
judgment uses other factors as well.
7. The AACN Standards for Acute and Critical Care Nursing Practice use what framework to guide critical care
nursing practice? [Multiple Choice]
a. Evidence-based practice
b. Healthy work environment
c. National Patient Safety Goals
d. Nursing process ✔
ANS: D
The AACN Standards for Acute and Critical Care Nursing Practice delineate the nursing process as applied to
critically ill patients: collect data, determine diagnoses, identify expected outcomes, develop a plan of care,
implement interventions, and evaluate care. AACN promotes a healthy work environment, but this is not included
in its standards. The Joint Commission has established National Patient Safety Goals, but these are not the AACN
standards.
8. Which strategy is important in addressing issues associated with the aging workforce? (Select all that apply.)
[Multiple Response]
a. Allowing nurses to work flexible shift durations ✔
b. Encouraging older nurses to transfer to an outpatient setting that is less stressful
, c. Hiring nurse technicians who are available to assist with patient care, such as turning the patient ✔
d. Remodeling patient care rooms to include devices to assist in patient lifting ✔
e. Developing a staffing model that accurately reflects the unit’s needs.
ANS: A, C, D
Modifying the work environment to reduce physical demands is one strategy to assist the aging workforce.
Examples include overhead lifts to prevent back injuries. Twelve-hour shifts can be quite demanding; therefore,
allowing nurses flexibility in choosing shifts of shorter duration is a good option as well. Adequate staffing,
including both registered nurses and nonlicensed assistive personnel to help with nursing and nonnursing tasks, is
helpful. Encouraging experienced, knowledgeable critical care nurses to leave the critical care unit is not wise as
the unit loses the expertise of this group.
9. Which of the following professional organizations best supports critical care nursing practice? [Multiple Choice]
a. American Association of Critical-Care Nurses ✔
b. American Heart Association
c. American Nurses Association
d. Society of Critical Care Medicine
ANS: A
The American Association of Critical-Care Nurses is the specialty organization that supports and represents critical
care nurses. The American Heart Association supports cardiovascular initiatives. The American Nurses Association
supports all nurses. The Society of Critical Care Medicine represents the multiprofessional critical care team under
the direction of an intensivist.
10. The vision of the American Association of Critical-Care Nurses is a health care system driven by [Multiple Choice]
a. a healthy work environment.
b. care from a multiprofessional team under the direction of a critical care physician.
c. the needs of critically ill patients and families. ✔
d. respectful, healing, and humane environments.
ANS: C
The AACN vision is a health care system driven by the needs of critically ill patients and families where critical care
nurses make their optimum contributions. AACN promotes initiatives to support a healthy work environment as
well as respectful and healing environments, but that is not the organization’s vision. The Society of Critical Care
Medicine (SCCM) promotes care from a multiprofessional team under the direction of a critical care physician.
