Exam Question And Answers 2025
Immediate Assessment - correct answers ✅✅A - airway
B - breathing
C - circulation, cerebral perfusion, chief complaint
D - drugs and diagnostic tests
E - equipment
Patient Safety Considerations - correct answers ✅✅Risk for
pressure injury
Delirium
Infection
Falls
Airway - correct answers ✅✅Patency - Having the patient speak,
watching the patient's chest rise and fall, or both
Position of artificial airway (if present)
ET tubes - correct answers ✅✅Endotracheal tube
Note the size and position of the airway
Note the marking closest to the teeth, lips, or nares to assist with
future comparisons for proper placement
Suction the upper airway, either through the oral cavity or
artificial airway to ensure that the airway is free from secretions
Observe and document the amount, color, and consistency of any
secretions removed
Breathing - correct answers ✅✅Quantity and quality of
respirations (rate, depth, pattern, symmetry, effort, use of
accessory muscles)
Breath sounds
, AACN Essentials of Critical Care Nursing
Exam Question And Answers 2025
Presence of spontaneous breathing
Observation of rate, depth, pattern, and symmetry of breathing
The effort of breathing
Use of accessory muscles
Breathing synchrony with the ventilator
Circulation and Cerebral Perfusion - correct answers ✅✅ECG
Rate, rhythm, and presence of ectopy
Blood pressure
Peripheral pulses and capillary refill
Skin, color, temperature, moisture
Presence of bleeding
Level of consciousness, responsiveness
Quickly palpating a pulse and viewing ECG
Color, temperature, and moisture of the skin, capillary refill
Chief Complaint - correct answers ✅✅Primary body system
Associated symptoms
Drugs and Diagnostic Tests - correct answers ✅✅Drugs prior to
admission (prescribed, otc, illicit)
Current medications
Review diagnostic test results
Equipment - correct answers ✅✅Patency of vascular and
drainage systems
Appropriate functioning and labeling of equipment connected to
patient