AACN Certification CCRN/PCCN
Critical Care Exam 1Questions And
Answers
AACNANScertify nurses; protect consumer by establishing high standards of professional practice
CCRNANScertification for nurses who provide care in critically ill adult, pediatric, or neonatal
populations
PCCNANScertification for nurses who provide acute care in progressive care, telemetry, and similar
units
CNMLANScertification for critical care managers and leaders
CCNSANScertification for acute and critical care clinical nurse specialists
Level A (Scale for Rating Research Evidence)ANSmeta-analysis or metasynthesis studies; results
consistently support specific action, intervention, or treatment
Level B (Scale for Rating Research Evidence)ANSrandomized and nonrandomized controlled studies;
results consistently support specific action, intervention, or treatment
Level C (Scale for Rating Research Evidence)ANSqualitative, descriptive, or correlational studies,
reviews, or trials with inconsistent results
Level D (Scale for Rating Research Evidence)ANSPeer-reviewed with clinical studies to support
recommendations
Level E (Scale for Rating Research Evidence)ANStheory-based evidence from expert opinions
Level M (Scale for Rating Research Evidence)ANSManufacturer's recommendation only
,Ask-Tell-Ask (Communication)ANSCommunication technique that assesses concerns before providing
info
Situational Awareness (Communication)ANSbeing aware of one's surroundings
Calgary Family AssessmentANSAssessment that involves structural, developmental, and functional
assessments
Family BundleANSProvide structure for planning and carrying out family care; based on 5 concepts:
evaluate, plan; involve; communicate; support (EPICS)
PrinciplismANSwidely applied ethical approach based of 4 fundamental moral principles to
contemporary ethical dilemmas; respect for autonomy; beneficence; nonmaleficence; justice
BeneficenceANSthe 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
FutilityANSstates that care should not be given if it is futile in terms of improving comfort or the
medical outcome
VeracityANSstates that persons are obligated to tell the truth in their communication with others
FidelityANSrequires that one has a moral duty to be faithful to the commitments made to others
Elements of Informed ConsentANScompetence (capacity); voluntariness; disclosure of information
Living WillANSa 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
ProxyANSa 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
, SurrogateANSa competent adult designated by a person to make health care decisions should that
person become incapacitated
Patient Self-Determination act (End-of-life issue)ANSrequires 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 TherapyANSPriority 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 WIthdrawalANSKnown 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 therapyANSvasopressors; 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 treatmentANSlife-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 AssessmentANSUsed 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)ANS4 to 8 L/minute
normal central venous pressure (CVP) and Right atrial pressure (RAP) (hemodynamic values)ANS2 to
6 mm Hg
Normal stroke volume (SV) (hemodynamic values)ANS60 to 130 mL/beat
normal mixed venous O2 sat (SvO2) (hemodynamic values)ANS60% to 75%
Normal central venous O2 sat (ScvO2)ANS65% to 85%
Critical Care Exam 1Questions And
Answers
AACNANScertify nurses; protect consumer by establishing high standards of professional practice
CCRNANScertification for nurses who provide care in critically ill adult, pediatric, or neonatal
populations
PCCNANScertification for nurses who provide acute care in progressive care, telemetry, and similar
units
CNMLANScertification for critical care managers and leaders
CCNSANScertification for acute and critical care clinical nurse specialists
Level A (Scale for Rating Research Evidence)ANSmeta-analysis or metasynthesis studies; results
consistently support specific action, intervention, or treatment
Level B (Scale for Rating Research Evidence)ANSrandomized and nonrandomized controlled studies;
results consistently support specific action, intervention, or treatment
Level C (Scale for Rating Research Evidence)ANSqualitative, descriptive, or correlational studies,
reviews, or trials with inconsistent results
Level D (Scale for Rating Research Evidence)ANSPeer-reviewed with clinical studies to support
recommendations
Level E (Scale for Rating Research Evidence)ANStheory-based evidence from expert opinions
Level M (Scale for Rating Research Evidence)ANSManufacturer's recommendation only
,Ask-Tell-Ask (Communication)ANSCommunication technique that assesses concerns before providing
info
Situational Awareness (Communication)ANSbeing aware of one's surroundings
Calgary Family AssessmentANSAssessment that involves structural, developmental, and functional
assessments
Family BundleANSProvide structure for planning and carrying out family care; based on 5 concepts:
evaluate, plan; involve; communicate; support (EPICS)
PrinciplismANSwidely applied ethical approach based of 4 fundamental moral principles to
contemporary ethical dilemmas; respect for autonomy; beneficence; nonmaleficence; justice
BeneficenceANSthe 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
FutilityANSstates that care should not be given if it is futile in terms of improving comfort or the
medical outcome
VeracityANSstates that persons are obligated to tell the truth in their communication with others
FidelityANSrequires that one has a moral duty to be faithful to the commitments made to others
Elements of Informed ConsentANScompetence (capacity); voluntariness; disclosure of information
Living WillANSa 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
ProxyANSa 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
, SurrogateANSa competent adult designated by a person to make health care decisions should that
person become incapacitated
Patient Self-Determination act (End-of-life issue)ANSrequires 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 TherapyANSPriority 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 WIthdrawalANSKnown 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 therapyANSvasopressors; 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 treatmentANSlife-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 AssessmentANSUsed 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)ANS4 to 8 L/minute
normal central venous pressure (CVP) and Right atrial pressure (RAP) (hemodynamic values)ANS2 to
6 mm Hg
Normal stroke volume (SV) (hemodynamic values)ANS60 to 130 mL/beat
normal mixed venous O2 sat (SvO2) (hemodynamic values)ANS60% to 75%
Normal central venous O2 sat (ScvO2)ANS65% to 85%
