TEST BANK FOR INTRODUCTION TO CRITICAL
CARE NURSING, 8TH EDITION, MARY LOU SOLE,
DEBORAH KLEIN, MARTHE MOSELEY.
,
,Chapter 1: Overview of Critical Care Nursing Test Ban
MULTIPLE CHOICE
1. Which of the following professional organizations best supports critical care nursing
practice?
a. American Association of Critical-Care Nurses
b. American Heart Association
c. American Nurses Association
d. Society of Critical Care Medicine
ANS: 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 CareMedicine represents
the multi-professional critical care team under the direction of an intensivist.
DIF: Cognitive Level: Knowledge REF: p. 4
OBJ: Discuss the purposes and functions of the professional organizations that
support critical carepractice. TOP: Nursing Process Step: N/A
MSC: NCLEX: Safe and Effective Care Environment
2. A nurse has been working as a staff nurse in the surgical intensive care unit for
2 years and isinterested in certification. Which credential would be most
applicable for her to seek?
a. ACNPC
b. CCNS
c. CCRN
d. PCCN
ANS: C
The CCRN certification is appropriate for nurses in bedside practice who care
for critically illpatients. The ACNPC certification is for acute care nurse
practitioners. The CCNS certification is for critical care clinical nurse
specialists. The PCCN certification is for staff nurses working in progressive
care, intermediate care, or step-down unit settings.
DIF: Cognitive Level: ApplicationREF: p. 5
OBJ: Explain certification options for critical care nurses. TOP: Nursing
Process Step: N/AMSC: NCLEX: Safe and Effective Care Environment
,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.
ANS: D
, Certification assists in validating knowledge of the field, promotes excellence in
the profession, and helps nurses to maintain their knowledge of critical care
nursing. Certificationhelps 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 graduate school; however, achieving
certification demonstrates motivation for achievement and professionalism.
Magnet facilities are rated on the number of certified nurses; however, that isnot
the purpose of certification.
DIF: Cognitive Level: Analysis REF: pp. 4-5
OBJ: Explain certification options for critical care nurses. TOP: Nursing
Process Step: N/AMSC: NCLEX: Safe and Effective Care Environment
4. The synergy model of practice focuses on:
a. allowing unrestricted visiting for the patient 24 hours each day.
b. holistic and alternative therapies.
c. needs of patients and their families, which drives nursing competency.
d. patients’ needs for energy and support.
ANS: 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 involvetailored visiting to meet the patient’s and
family’s needs and application of alternative therapies if desired by the
patient, but that is not the primary focus of the model.
DIF: Cognitive Level: ApplicationREF: p. 5 | Fig. 1-3
OBJ: Describe standards of professional practice for critical care nursing.
TOP: Nursing Process Step: N/A MSC: NCLEX: Safe and Effective Care
Environment
5. The family of your critically ill patient tells you that they have not spoken with
the physicianin over 24 hours and they have some questions that they want
clarified. During morning rounds, you convey this concern to the attending
intensivist and arrange for her to meet withthe family at 4:00 PM in the
conference room. 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
ANS: C
Although one might consider that all of these competencies are being addressed,
communication and collaboration with the family and physician best exemplify
thecompetency of collaboration.
DIF: Cognitive Level: Analysis REF: p. 9
OBJ: Describe standards of professional practice for critical care nursing.
, TOP: Nursing Process Step: N/A MSC: NCLEX: Safe and Effective Care
Environment
6. The AACN Standards for Acute and Critical Care Nursing Practice use what
framework toguide critical care nursing practice?
a. Evidence-based practice
b. Healthy work environment
, c. National Patient Safety Goals
d. Nursing process
ANS: D
The AACN Standards for Acute and Critical Care Nursing Practice delineate the
nursing process as applied to critically ill patients: collect data, determine
diagnoses, identify expectedoutcomes, develop a plan of care, implement
interventions, and evaluate care. AACN promotes a healthy work environment,
but this is not included in the Standards. The Joint Commission has established
National Patient Safety Goals, but these are not the AACN Standards.
DIF: Cognitive Level: Analysis REF: p. 5 | Box 1-2
OBJ: Describe standards of professional practice for critical care nursing.
TOP: Nursing Process Step: N/A MSC: NCLEX: Safe and Effective Care
Environment
7. The charge nurse is responsible for making the patient assignments on the
critical care unit. She assigns the experienced, certified nurse to care for the
acutely ill patient with sepsis whoalso requires continuous renal replacement
therapy and mechanical ventilation. She assigns the nurse with less than 1 year
of experience 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
ANS: 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 related to team
training, National Patient Safety Goals are specified by The Joint Commission
to promote safe care but do not incorporate the synergy model. The Quality and
Safety Education for Nurses initiative involves targeted education to
undergraduate and graduate nursing students to learn quality and safety
concepts.
DIF: Cognitive Level: Analysis REF: p. 5 | Fig. 1-3
OBJ: Describe standards of professional practice for critical care nursing.
TOP: Nursing Process Step: N/A MSC: NCLEX: Safe and Effective Care
Environment
8. The vision of the American Association of Critical-Care Nurses is a healthcare
system drivenby:
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.
ANS: C
,The AACN vision is a healthcare system driven by the needs of critically ill
patients andfamilies 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 SCCM promotes care from a
multiprofessional team under the direction of a critical care physician.
DIF: Cognitive Level: Knowledge REF: p. 4
, OBJ: Discuss the purposes and functions of the professional organizations that
support critical carepractice. TOP: Nursing Process Step: N/A
MSC: NCLEX: Safe and Effective Care Environment
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.
ANS: 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, be used for patient/family teaching, and address
diversity needs; however, the main outcome of effectivecommunication is
patient safety.
DIF: Cognitive Level: Knowledge REF: pp. 8-9
OBJ: Describe quality and safety initiatives related to critical care nursing.
TOP: Nursing Process Step: N/A MSC: NCLEX: Safe and Effective Care
Environment
10. You are caring for a critically ill patient whose urine output has been low for 2
consecutive hours. After a thorough patient assessment, you call the intensivist
with the following report.Dr. Smith, I’m calling about Mrs. P., your 65-year-
old patient in CCU 10. Her urine output for the past 2 hours totaled only 40
mL. She arrived from surgery to repair an aortic aneurysm 4 hours ago and
remains on mechanical ventilation. In the past 2 hours, her heart rate has
increased from 80 to 100 beats per minute and her blood pressure has
decreased from 128/82 to 100/70 mm Hg. She is being given an infusion of
normal saline at 100 mL perhour. Her right atrial pressure through the
subclavian central line is low at 3 mm Hg. Her urine is concentrated. Her BUN
and creatinine levels have been stable and in normal range. Her abdominal
dressing is dry with no indication of bleeding. My assessment suggests that
Mrs. P. is hypovolemic and I would like you to consider increasing her fluids
or giving her afluid challenge. Using the SBAR model for communication, the
information the nurse gives about the patient’s history and vital signs is:
a. Situation
b. Background
c. Assessment
d. Recommendation
ANS: B
The history and vital signs are part of the background. Information regarding
the low urineoutput is the situation. Information regarding possible
hypovolemia is part of the nurse’s assessment, and the suggestion for fluids is
the recommendation.
