Critical Care Exam 1 Questions and Correct
Answers.
AACN - ANS certify nurses; protect consumer by establishing high standards of
professional practice
CCRN - ANS certification for nurses who provide care in critically ill adult, pediatric, or
neonatal populations
PCCN - ANS certification for nurses who provide acute care in progressive care,
telemetry, and similar units
CNML - ANS certification for critical care managers and leaders
CCNS - ANS certification for acute and critical care clinical nurse specialists
Level A (Scale for Rating Research Evidence) - ANS meta-analysis or metasynthesis
studies; results consistently support specific action, intervention, or treatment
Level B (Scale for Rating Research Evidence) - ANS randomized and nonrandomized
controlled studies; results consistently support specific action, intervention, or treatment
Level C (Scale for Rating Research Evidence) - ANS qualitative, descriptive, or
correlational studies, reviews, or trials with inconsistent results
Level D (Scale for Rating Research Evidence) - ANS Peer-reviewed with clinical studies
to support recommendations
Level E (Scale for Rating Research Evidence) - ANS theory-based evidence from expert
opinions
Level M (Scale for Rating Research Evidence) - ANS Manufacturer's recommendation
only
Ask-Tell-Ask (Communication) - ANS Communication technique that assesses concerns
before providing info
,Situational Awareness (Communication) - ANS being aware of one's surroundings
Calgary Family Assessment - ANS Assessment that involves structural, developmental,
and functional assessments
Family Bundle - ANS Provide structure for planning and carrying out family care; based
on 5 concepts: evaluate, plan; involve; communicate; support (EPICS)
Principlism - ANS widely applied ethical approach based of 4 fundamental moral
principles to contemporary ethical dilemmas; respect for autonomy; beneficence;
nonmaleficence; justice
Beneficence - ANS 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 - ANS states that care should not be given if it is futile in terms of improving
comfort or the medical outcome
Veracity - ANS states that persons are obligated to tell the truth in their communication
with others
Fidelity - ANS requires that one has a moral duty to be faithful to the commitments made
to others
Elements of Informed Consent - ANS competence (capacity); voluntariness; disclosure of
information
Living Will - ANS 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 - ANS 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 - ANS 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) - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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) - ANS 4 to 8 L/minute
normal central venous pressure (CVP) and Right atrial pressure (RAP) (hemodynamic
values) - ANS 2 to 6 mm Hg
Normal stroke volume (SV) (hemodynamic values) - ANS 60 to 130 mL/beat
normal mixed venous O2 sat (SvO2) (hemodynamic values) - ANS 60% to 75%
Normal central venous O2 sat (ScvO2) - ANS 65% to 85%
Answers.
AACN - ANS certify nurses; protect consumer by establishing high standards of
professional practice
CCRN - ANS certification for nurses who provide care in critically ill adult, pediatric, or
neonatal populations
PCCN - ANS certification for nurses who provide acute care in progressive care,
telemetry, and similar units
CNML - ANS certification for critical care managers and leaders
CCNS - ANS certification for acute and critical care clinical nurse specialists
Level A (Scale for Rating Research Evidence) - ANS meta-analysis or metasynthesis
studies; results consistently support specific action, intervention, or treatment
Level B (Scale for Rating Research Evidence) - ANS randomized and nonrandomized
controlled studies; results consistently support specific action, intervention, or treatment
Level C (Scale for Rating Research Evidence) - ANS qualitative, descriptive, or
correlational studies, reviews, or trials with inconsistent results
Level D (Scale for Rating Research Evidence) - ANS Peer-reviewed with clinical studies
to support recommendations
Level E (Scale for Rating Research Evidence) - ANS theory-based evidence from expert
opinions
Level M (Scale for Rating Research Evidence) - ANS Manufacturer's recommendation
only
Ask-Tell-Ask (Communication) - ANS Communication technique that assesses concerns
before providing info
,Situational Awareness (Communication) - ANS being aware of one's surroundings
Calgary Family Assessment - ANS Assessment that involves structural, developmental,
and functional assessments
Family Bundle - ANS Provide structure for planning and carrying out family care; based
on 5 concepts: evaluate, plan; involve; communicate; support (EPICS)
Principlism - ANS widely applied ethical approach based of 4 fundamental moral
principles to contemporary ethical dilemmas; respect for autonomy; beneficence;
nonmaleficence; justice
Beneficence - ANS 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 - ANS states that care should not be given if it is futile in terms of improving
comfort or the medical outcome
Veracity - ANS states that persons are obligated to tell the truth in their communication
with others
Fidelity - ANS requires that one has a moral duty to be faithful to the commitments made
to others
Elements of Informed Consent - ANS competence (capacity); voluntariness; disclosure of
information
Living Will - ANS 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 - ANS 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 - ANS 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) - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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 - ANS 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) - ANS 4 to 8 L/minute
normal central venous pressure (CVP) and Right atrial pressure (RAP) (hemodynamic
values) - ANS 2 to 6 mm Hg
Normal stroke volume (SV) (hemodynamic values) - ANS 60 to 130 mL/beat
normal mixed venous O2 sat (SvO2) (hemodynamic values) - ANS 60% to 75%
Normal central venous O2 sat (ScvO2) - ANS 65% to 85%
