CCRN Pain, Agitation, and Delirium Management

Question 1

Which validated tool is recommended by the Society of Critical Care Medicine (SCCM) for assessing pain in non-verbal ICU patients?

Accepted Answer

Behavioral Pain Scale (BPS)

Answer

The Behavioral Pain Scale (BPS) is a validated tool for assessing pain in non-verbal, mechanically ventilated ICU patients.

Question 2

A RASS score of -2 indicates which level of sedation?

Accepted Answer

Moderate sedation — movement or eye opening without eye contact

Answer

A RASS of -2 indicates light sedation, where the patient briefly awakens (eye opening and contact) to voice for less than 10 seconds.

Question 3

The SCCM PADIS guidelines recommend which target RASS level for most mechanically ventilated ICU patients?

Accepted Answer

0 to -2

Answer

PADIS guidelines recommend a target RASS of 0 to -2 (light sedation) to promote earlier liberation from mechanical ventilation and reduce delirium.

Question 4

Which assessment tool is considered the gold standard for detecting ICU delirium in mechanically ventilated patients?

Accepted Answer

Confusion Assessment Method for the ICU (CAM-ICU)

Answer

The CAM-ICU is the gold-standard validated tool for diagnosing delirium in ICU patients, including those on mechanical ventilation.

Question 5

Which non-pharmacological intervention is a first-line strategy to prevent and treat ICU delirium?

Accepted Answer

Early mobility and physical therapy

Answer

Early mobility and physical therapy are first-line non-pharmacological strategies proven to reduce the incidence and duration of ICU delirium.

CCRN Review Practice Test