Chapter 01: Overview of Critical Care Nursing
MULTIPLE CHOICE
1. Which of the following professional organizations best supports critical care nursing prac-
tice?
a. American Association of Critical-Care Nurses
b. American Heart Association
c. American Nurses Association
d. Society of Critical Care Medicine - ANSWER 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 inten-
sivist.
3. The main purpose of certification is to
a. assure the consumer that you will not make a mistake.
b. prepare for graduate school.
c. promote magnet status for your facility.
d. validate knowledge of critical care nursing. - ANSWER D
Certification assists in validating knowledge of the field, promotes excellence in the profes-
sion, and helps nurses to maintain their knowledge of critical care nursing. Certification
helps to assure the consumer that the nurse has a minimum level of knowledge; however, it
does not ensure that care will be mistake-free. Certification does not prepare one for gradu-
ate school; however, achieving certification demonstrates motivation for achievement and
professionalism. Magnet facilities are rated on the number of certified nurses; however, that
is not the purpose of certification.
1
,2. A nurse has been working as a staff nurse in the surgical intensive care unit for 2 years and
is interested in certification. Which credential would be most applicable for the nurse to
seek?
a. ACNPC-AG
b. CNML
c. CCRN
d. PCCN - ANSWER C
The CCRN certification is appropriate for nurses in bedside practice who care for critically ill
patients. The ACNPC-AG certification is for acute care nurse practitioners. The CNML is for
critical care nurse managers or leaders. The PCCN certification is for staff nurses working in
progressive care, intermediate care, or step-down unit settings.
4. The synergy model of practice focuses on
a. allowing unrestricted visiting for the patient 24 hours a day.
b. holistic and alternative therapies.
c. the needs of patients and their families, which drive nursing competency.
d. patients' needs for energy and support. - ANSWER C
The synergy model of practice states that the needs of patients and families influence and
drive competencies of nurses. Nursing practice based on the synergy model would involve
tailored visiting to meet the patient's and family's needs and the application of alternative
therapies if desired by the patient, but that is not the primary focus of the model.
5. The family of your critically ill patient tells you that they have not spoken with the physi-
cian in over 24 hours and that they have some questions they want clarified. During morning
rounds, you convey this concern to the attending intensivist and arrange a meeting with the
family at 4:00 PM. Which competency of critical care nursing does this represent?
a. Advocacy and moral agency in solving ethical issues
b. Clinical judgment and clinical reasoning skills
c. Collaboration with patients, families, and team members
d. Facilitation of learning for patients, families, and team members - ANSWER C
2
,Although one might consider that all of these competencies are being addressed, communi-
cation and collaboration with the family and physician best exemplify the competency of col-
laboration.
6. The AACN Standards for Acute and Critical Care Nursing Practice use what framework to
guide critical care nursing practice?
a. Evidence-based practice
b. Healthy work environment
c. National Patient Safety Goals
d. Nursing process - ANSWER D
The AACN Standards for Acute and Critical Care Nursing Practice delineate the nursing pro-
cess as applied to critically ill patients: collect data, determine diagnoses, identify expected
outcomes, develop a plan of care, implement interventions, and evaluate care. AACN pro-
motes a healthy work environment, but this is not included in its standards. The Joint Com-
mission has established National Patient Safety Goals, but these are not the AACN standards.
7. The charge nurse is responsible for making the patient assignments on the critical care
unit. An experienced, certified nurse is assigned to care for the acutely ill patient with sepsis
who also requires continuous renal replacement therapy and mechanical ventilation. The
nurse with less than 1 year of experience is assigned to two patients who are more stable.
This assignment reflects implementation of the
a. crew resource management model.
b. National Patient Safety Goals.
c. Quality and Safety Education for Nurses (QSEN) model.
d. synergy model of practice. - ANSWER D
This assignment demonstrates nursing care to meet the needs of the patient. The synergy
model notes that the nurse competencies are matched to the patient characteristics. Crew
resource management concepts are related to team training; National Patient Safety Goals
are specified by The Joint Commission to promote safe care but do not incorporate the syn-
ergy model. The Quality and Safety Education for Nurses initiative involves targeted educa-
tion of undergraduate and graduate nursing students on quality and safety concepts.
3
, 8. The vision of the American Association of Critical-Care Nurses is a health care system
driven by
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. - ANSWER C
The AACN vision is a health care system driven by the needs of critically ill patients and fami-
lies 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.
9. The most important outcome of effective communication is to
a. demonstrate caring practices to family members.
b. ensure that patient teaching is done.
c. meet the diversity needs of patients.
d. reduce patient errors. - ANSWER D
Many errors are directly attributed to faulty communication. Effective communication has
been identified as an essential strategy to reduce patient errors and resolve issues related to
patient care delivery. Communication may demonstrate caring practices, address diversity
needs, and be used for patient/family teaching; however, the main outcome of effective
communication is patient safety.
11. The family members of a critically ill patient bring a copy of the patient's living will to the
hospital, which identifies the patient's wishes regarding health care. You discuss contents of
the living will with the patient's physician. This is an example of implementation of which of
the AACN Standards of Professional Performance?
a. Acquires and maintains current knowledge of practice
b. Acts ethically on the behalf of the patient and family
c. Considers factors related to safe patient care
d. Uses clinical inquiry and integrates research findings in practice - ANSWER B
4
MULTIPLE CHOICE
1. Which of the following professional organizations best supports critical care nursing prac-
tice?
a. American Association of Critical-Care Nurses
b. American Heart Association
c. American Nurses Association
d. Society of Critical Care Medicine - ANSWER 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 inten-
sivist.
3. The main purpose of certification is to
a. assure the consumer that you will not make a mistake.
b. prepare for graduate school.
c. promote magnet status for your facility.
d. validate knowledge of critical care nursing. - ANSWER D
Certification assists in validating knowledge of the field, promotes excellence in the profes-
sion, and helps nurses to maintain their knowledge of critical care nursing. Certification
helps to assure the consumer that the nurse has a minimum level of knowledge; however, it
does not ensure that care will be mistake-free. Certification does not prepare one for gradu-
ate school; however, achieving certification demonstrates motivation for achievement and
professionalism. Magnet facilities are rated on the number of certified nurses; however, that
is not the purpose of certification.
1
,2. A nurse has been working as a staff nurse in the surgical intensive care unit for 2 years and
is interested in certification. Which credential would be most applicable for the nurse to
seek?
a. ACNPC-AG
b. CNML
c. CCRN
d. PCCN - ANSWER C
The CCRN certification is appropriate for nurses in bedside practice who care for critically ill
patients. The ACNPC-AG certification is for acute care nurse practitioners. The CNML is for
critical care nurse managers or leaders. The PCCN certification is for staff nurses working in
progressive care, intermediate care, or step-down unit settings.
4. The synergy model of practice focuses on
a. allowing unrestricted visiting for the patient 24 hours a day.
b. holistic and alternative therapies.
c. the needs of patients and their families, which drive nursing competency.
d. patients' needs for energy and support. - ANSWER C
The synergy model of practice states that the needs of patients and families influence and
drive competencies of nurses. Nursing practice based on the synergy model would involve
tailored visiting to meet the patient's and family's needs and the application of alternative
therapies if desired by the patient, but that is not the primary focus of the model.
5. The family of your critically ill patient tells you that they have not spoken with the physi-
cian in over 24 hours and that they have some questions they want clarified. During morning
rounds, you convey this concern to the attending intensivist and arrange a meeting with the
family at 4:00 PM. Which competency of critical care nursing does this represent?
a. Advocacy and moral agency in solving ethical issues
b. Clinical judgment and clinical reasoning skills
c. Collaboration with patients, families, and team members
d. Facilitation of learning for patients, families, and team members - ANSWER C
2
,Although one might consider that all of these competencies are being addressed, communi-
cation and collaboration with the family and physician best exemplify the competency of col-
laboration.
6. The AACN Standards for Acute and Critical Care Nursing Practice use what framework to
guide critical care nursing practice?
a. Evidence-based practice
b. Healthy work environment
c. National Patient Safety Goals
d. Nursing process - ANSWER D
The AACN Standards for Acute and Critical Care Nursing Practice delineate the nursing pro-
cess as applied to critically ill patients: collect data, determine diagnoses, identify expected
outcomes, develop a plan of care, implement interventions, and evaluate care. AACN pro-
motes a healthy work environment, but this is not included in its standards. The Joint Com-
mission has established National Patient Safety Goals, but these are not the AACN standards.
7. The charge nurse is responsible for making the patient assignments on the critical care
unit. An experienced, certified nurse is assigned to care for the acutely ill patient with sepsis
who also requires continuous renal replacement therapy and mechanical ventilation. The
nurse with less than 1 year of experience is assigned to two patients who are more stable.
This assignment reflects implementation of the
a. crew resource management model.
b. National Patient Safety Goals.
c. Quality and Safety Education for Nurses (QSEN) model.
d. synergy model of practice. - ANSWER D
This assignment demonstrates nursing care to meet the needs of the patient. The synergy
model notes that the nurse competencies are matched to the patient characteristics. Crew
resource management concepts are related to team training; National Patient Safety Goals
are specified by The Joint Commission to promote safe care but do not incorporate the syn-
ergy model. The Quality and Safety Education for Nurses initiative involves targeted educa-
tion of undergraduate and graduate nursing students on quality and safety concepts.
3
, 8. The vision of the American Association of Critical-Care Nurses is a health care system
driven by
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. - ANSWER C
The AACN vision is a health care system driven by the needs of critically ill patients and fami-
lies 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.
9. The most important outcome of effective communication is to
a. demonstrate caring practices to family members.
b. ensure that patient teaching is done.
c. meet the diversity needs of patients.
d. reduce patient errors. - ANSWER D
Many errors are directly attributed to faulty communication. Effective communication has
been identified as an essential strategy to reduce patient errors and resolve issues related to
patient care delivery. Communication may demonstrate caring practices, address diversity
needs, and be used for patient/family teaching; however, the main outcome of effective
communication is patient safety.
11. The family members of a critically ill patient bring a copy of the patient's living will to the
hospital, which identifies the patient's wishes regarding health care. You discuss contents of
the living will with the patient's physician. This is an example of implementation of which of
the AACN Standards of Professional Performance?
a. Acquires and maintains current knowledge of practice
b. Acts ethically on the behalf of the patient and family
c. Considers factors related to safe patient care
d. Uses clinical inquiry and integrates research findings in practice - ANSWER B
4
