CRITICAL CARE TEST 1 EXAM QUESTIONS
AND CORRECT VERIFIED ANSWERS
Two main professional organizations mentioned that support critical care practice. - ANSWER - American
Association of Critical-Care nurses (AACN) and Society of Critical Care Medicine (SCCM)
Which organization best supports critical care nurses out of the two mentioned? - ANSWER - The AACN's
mission is to assist acute and critical care nurses to attain knowledge and influence to deliver excellent
care using the "synergy model". The SSCM is targeted more toward the entire health care team in
critical care, so AACN would serve nurses more.
What is the mission of AACN? - ANSWER - assisting acute and critical care nurses to attain knowledge
and influence to deliver excellent care
What is the Vision of AACN? - ANSWER - a. creating a health care system driven by the needs of patients
and families in which critical care nurses make their optimal contributions (described as synergy)
What is the Values of AACN? - ANSWER - Accountability, advocacy, integrity, collaboration, leadership,
stewardship, lifelong learning, quality, innovation, and commitment
Explain the Synergy Model and how it is used in practice? - ANSWER - Patient needs (medically,
emotionally, culturally, etc.) drive the nurse competencies required for patient care - when
competencies stem from patient needs, and the characteristics of the nurse and patient match, synergy
occurs and enables optimal outcomes
- Many organizations use this model as a basis for developing frameworks for nursing practice, this is
also used to implement appropriate staffing by ensuring the best nurse is matched with the patient that
matches that nurse's competencies
What types of certifications are available for ICU nurses? - ANSWER - CCRN (nurses who provide care for
critically ill adult, pads, or neonatal populations) and PCCN (nurses who provide acute care in
progressive care, telemetry, and similar units)
,Why are critical care certifications important? - ANSWER - They validate knowledge of critical care
nursing, promotes professional excellence, and helps nurses to maintain a current base of knowledge
What 3 specific projects/organizations are in place to assist nurses in providing safe care? - ANSWER - I.
Quality and safety Education for Nurses (QSEN) project
ii. Joint Commissions National Patient Safety Goals
iii. Institute for Healthcare Improvement (IHI)
Quality and Safety Education for Nurses (QSEN) - ANSWER - defines 6 core competencies that provide a
foundation for safe nursing care - patient-centered care, teamwork and collaboration, evidence-based
practice, quality improvement, informatics, and safety
Joint Commission- National Patient Safety Goals - ANSWER - goals updated annually to ensure facilities
implement actions and protocols to address safety
- ex. improve accuracy of patient identification, improve communication among HC providers (report
critical values/test results), improve medication safety (labeling meds, contraindications, harmful side
effects), use alarms safely, reduce risk of healthcare-associated infections (hand hygiene, aseptic
techniques), identify safety risks (self-harm patients, fall risks), and prevent complications associated
with surgery and procedures
Institute for Healthcare Improvement (IHI) - ANSWER - produced an action plan for reducing healthcare-
associated infections and preventing infections with multidrug-resistant organisms - action plan includes
bundles of care to reduce harms
Explain what a Bundle of Care is? - ANSWER - Care bundles are a set of 3-5 EBP (interventions) that
when used together cause significant improvement in patient outcomes
1. All elements of the care bundle must be performed in a series of steps by 1 healthcare team within a
single time frame
, Bundles of Care Example at Bedside - ANSWER - Ex: caring for central lines, practicing meticulous hand
hygiene, using full barrier precautions during central line insertion, applying chlorhexidine to the
patient's skin as a cleansing agent, avoiding central line insertion into femoral vein, removing
unnecessary IV cats
What are some barriers to effective handoff communication? - ANSWER - 1. Physical setting-
background noise, lack of privacy, interruptions
- ex. giving report in a noisy/busy hallway causing the recipient of the handoff to miss important
information due to noise
2. Social setting- organizational hierarchy and status issues
- ex. a nurse needing to communicate a critical value to a MD but they aren't answering the page or a
new nurse feeling anxious to call the MD promptly
3. Language- differences between people of varying racial or ethnic backgrounds or geographical areas
- ex. different languages between healthcare providers or even patient-to-healthcare provider
4. Communication medium- limitations of communications via telephone, e-mail, paper, or
computerized records vs. face-to-face communication
- ex. a peer missing a page, computer glitch causing messages to fail sending
What standardized measures have been implemented to help prevent communication breakdown at
shift change? - ANSWER - I. Ask-Tell-Ask (a strategy for encouraging nurses to assess concerns before
providing more information, especially when discussing stressful issues with patient and families)
ii. Tell Me More (tool that encourages information sharing in challenging situations)
iii. SBAR (useful tool with especially physicians)
Can you give examples of things you may need to communicate during multi-professional rounds? -
ANSWER - Discharge needs, greatest safety risk, critical care "bundles", assessment and
recommendation follow-up (Head to toe status), assess needs for all meds ordered, identify central lines
and cats and tubes and if they can be removed, issues that need to be addressed (family needs, code
AND CORRECT VERIFIED ANSWERS
Two main professional organizations mentioned that support critical care practice. - ANSWER - American
Association of Critical-Care nurses (AACN) and Society of Critical Care Medicine (SCCM)
Which organization best supports critical care nurses out of the two mentioned? - ANSWER - The AACN's
mission is to assist acute and critical care nurses to attain knowledge and influence to deliver excellent
care using the "synergy model". The SSCM is targeted more toward the entire health care team in
critical care, so AACN would serve nurses more.
What is the mission of AACN? - ANSWER - assisting acute and critical care nurses to attain knowledge
and influence to deliver excellent care
What is the Vision of AACN? - ANSWER - a. creating a health care system driven by the needs of patients
and families in which critical care nurses make their optimal contributions (described as synergy)
What is the Values of AACN? - ANSWER - Accountability, advocacy, integrity, collaboration, leadership,
stewardship, lifelong learning, quality, innovation, and commitment
Explain the Synergy Model and how it is used in practice? - ANSWER - Patient needs (medically,
emotionally, culturally, etc.) drive the nurse competencies required for patient care - when
competencies stem from patient needs, and the characteristics of the nurse and patient match, synergy
occurs and enables optimal outcomes
- Many organizations use this model as a basis for developing frameworks for nursing practice, this is
also used to implement appropriate staffing by ensuring the best nurse is matched with the patient that
matches that nurse's competencies
What types of certifications are available for ICU nurses? - ANSWER - CCRN (nurses who provide care for
critically ill adult, pads, or neonatal populations) and PCCN (nurses who provide acute care in
progressive care, telemetry, and similar units)
,Why are critical care certifications important? - ANSWER - They validate knowledge of critical care
nursing, promotes professional excellence, and helps nurses to maintain a current base of knowledge
What 3 specific projects/organizations are in place to assist nurses in providing safe care? - ANSWER - I.
Quality and safety Education for Nurses (QSEN) project
ii. Joint Commissions National Patient Safety Goals
iii. Institute for Healthcare Improvement (IHI)
Quality and Safety Education for Nurses (QSEN) - ANSWER - defines 6 core competencies that provide a
foundation for safe nursing care - patient-centered care, teamwork and collaboration, evidence-based
practice, quality improvement, informatics, and safety
Joint Commission- National Patient Safety Goals - ANSWER - goals updated annually to ensure facilities
implement actions and protocols to address safety
- ex. improve accuracy of patient identification, improve communication among HC providers (report
critical values/test results), improve medication safety (labeling meds, contraindications, harmful side
effects), use alarms safely, reduce risk of healthcare-associated infections (hand hygiene, aseptic
techniques), identify safety risks (self-harm patients, fall risks), and prevent complications associated
with surgery and procedures
Institute for Healthcare Improvement (IHI) - ANSWER - produced an action plan for reducing healthcare-
associated infections and preventing infections with multidrug-resistant organisms - action plan includes
bundles of care to reduce harms
Explain what a Bundle of Care is? - ANSWER - Care bundles are a set of 3-5 EBP (interventions) that
when used together cause significant improvement in patient outcomes
1. All elements of the care bundle must be performed in a series of steps by 1 healthcare team within a
single time frame
, Bundles of Care Example at Bedside - ANSWER - Ex: caring for central lines, practicing meticulous hand
hygiene, using full barrier precautions during central line insertion, applying chlorhexidine to the
patient's skin as a cleansing agent, avoiding central line insertion into femoral vein, removing
unnecessary IV cats
What are some barriers to effective handoff communication? - ANSWER - 1. Physical setting-
background noise, lack of privacy, interruptions
- ex. giving report in a noisy/busy hallway causing the recipient of the handoff to miss important
information due to noise
2. Social setting- organizational hierarchy and status issues
- ex. a nurse needing to communicate a critical value to a MD but they aren't answering the page or a
new nurse feeling anxious to call the MD promptly
3. Language- differences between people of varying racial or ethnic backgrounds or geographical areas
- ex. different languages between healthcare providers or even patient-to-healthcare provider
4. Communication medium- limitations of communications via telephone, e-mail, paper, or
computerized records vs. face-to-face communication
- ex. a peer missing a page, computer glitch causing messages to fail sending
What standardized measures have been implemented to help prevent communication breakdown at
shift change? - ANSWER - I. Ask-Tell-Ask (a strategy for encouraging nurses to assess concerns before
providing more information, especially when discussing stressful issues with patient and families)
ii. Tell Me More (tool that encourages information sharing in challenging situations)
iii. SBAR (useful tool with especially physicians)
Can you give examples of things you may need to communicate during multi-professional rounds? -
ANSWER - Discharge needs, greatest safety risk, critical care "bundles", assessment and
recommendation follow-up (Head to toe status), assess needs for all meds ordered, identify central lines
and cats and tubes and if they can be removed, issues that need to be addressed (family needs, code
