The effective use of nursing diagnosis internationally depends in part on incorporating language and cultural difference into the common language of nursing. International validation studies can provide a basis for this effort. This study tested three diagnoses—anxiety, hopelessness, and ineffective airway clearance—through multinational validation. The Diagnostic Content Validity (DCV) model was used to collect data from critical care nurses in six countries. Defining characteristics rated as critical (> .80) by the total sample were dyspnea for ineffective airway clearance and panic and nervousness for anxiety. No critical defining characteristics for hopelessness were identified. DCV ratios for all defining characteristics are compared by country.