NCLEX Critical Care Nurse Questions and answers 2026

Which hemodynamic parameter best indicates left ventricular function A. Central venous pressure B. Pulmonary capillary wedge pressure ️️ C. Heart rate D. Blood pressure What is the priority intervention for a patient with acute respiratory distress syndrome (ARDS) A. Administer antibiotics B. Optimize oxygenation and ventilation ️️ C. Restrict fluids D. Initiate insulin therapy Which electrolyte imbalance is most dangerous in a patient with renal failure A. Hypokalemia B. Hyperkalemia ️️ C. Hyponatremia D. Hypocalcemia What is the first-line treatment for ventricular tachycardia with a pulse A. Defibrillation B. Synchronized cardioversion ️️ C. CPR only D. Amiodarone PO Which assessment finding indicates early sepsis A. Hypotension and bradycardia B. Tachycardia and fever ️️ C. Hypertension and hypothermia D. Bradycardia and oliguria Which hemodynamic change occurs in cardiogenic shock A. Increased cardiac output B. Decreased cardiac output ️️ C. Decreased systemic vascular resistance D. Increased urine output What is the most important nursing intervention for a patient with increased intracranial pressure A. Elevate legs B. Maintain head of bed at 30 degrees ️️ C. Rapid infusion of fluids D. Encourage coughing Which arterial blood gas finding indicates uncompensated metabolic acidosis A. pH 7.35, HCO3- low ️️ B. pH 7.45, HCO3- high C. pH 7.35, PaCO2 high D. pH 7.45, PaCO2 low Which medication is first-line for septic shock management A. Dopamine B. Norepinephrine ️️ C. Phenylephrine D. Epinephrine What is the earliest sign of hypovolemic shock A. Hypotension B. Tachycardia ️️ C. Oliguria D. Cool, clammy skin Which assessment finding requires immediate intervention in a post-cardiac surgery patient A. Mild incisional pain B. Sudden chest pain and hypotension ️️ C. Stable heart rate D. Slight confusion Which lab value is critical for monitoring in acute liver failure A. Creatinine B. INR ️️ C. Potassium D. Glucose What is the priority for a patient with tension pneumothorax A. Administer bronchodilator B. Needle decompression ️️ C. Intubation only D. Chest physiotherapy Which finding suggests impending airway compromise A. Hoarseness and stridor ️️ B. Dry cough C. Mild wheezing D. Nasal congestion Which intervention is critical for a patient with elevated ICP and worsening neurologic status A. Administer diuretic ️️ B. Encourage fluid intake C. Begin passive exercises D. Delay oxygen therapy What is the first-line treatment for symptomatic bradycardia A. Atropine ️️ B. Epinephrine C. Amiodarone D. Synchronized cardioversion Which finding indicates worsening cardiogenic pulmonary edema A. Pink frothy sputum ️️ B. Clear lung sounds C. Bradycardia D. Hypothermia Which parameter best evaluates effectiveness of mechanical ventilation A. Heart rate B. Arterial blood gas ️️ C. Urine output D. Blood glucose Which nursing intervention prevents ventilator-associated pneumonia A. Elevate HOB 30–45 degrees ️️ B. Maintain supine position C. Limit suctioning D. Delay oral care Which medication is used to treat torsades de pointes A. Amiodarone B. Magnesium sulfate ️️ C. Lidocaine D. Epinephrine Which finding indicates early hypoxemia A. Confusion B. Restlessness ️️ C. Cyanosis D. Bradycardia Which lab indicates risk for bleeding in a critically ill patient A. Hematocrit B. INR ️️ C. Creatinine D. Sodium Which assessment is priority in a patient with acute MI A. Peripheral edema B. Chest pain and vital signs C. Abdominal distension D. Skin turgor Which intervention is priority for a patient with cardiac tamponade A. Administer fluids B. Prepare for pericardiocentesis C. Start beta-blocker D. Monitor urine output Which lab indicates worsening kidney function in ICU A. ALT B. Creatinine C. WBC D. Platelet count Which action is priority for sudden ventricular fibrillation A. Synchronized cardioversion B. Immediate defibrillation C. CPR only D. Administer amiodarone PO Which electrolyte imbalance increases risk for arrhythmias A. Hypernatremia B. Hypokalemia C. Hypercalcemia D. Hypophosphatemia Which intervention reduces intracranial hypertension A. Trendelenburg position B. Head of bed 30 degrees C. Rapid IV fluids D. High PEEP ventilation Which assessment indicates early sepsis A. Fever and tachycardia B. Bradycardia and hypotension C. Normal vitals D. Hypothermia only Which lab finding indicates tissue hypoxia A. Elevated lactate B. Low hemoglobin only C. High sodium D. Elevated potassium Which intervention is priority for hypovolemic shock A. Administer isotonic fluids B. Restrict fluids C. Delay therapy D. Administer diuretics Which finding requires immediate airway intervention A. Drooling, stridor B. Mild cough C. Stable SpO2 D. Clear lung sounds Which parameter best guides fluid resuscitation A. Heart rate only B. Urine output C. Temperature D. Weight Which intervention prevents ICU-acquired weakness A. Early mobilization B. Prolonged bed rest C. Sedation only D. Delay PT Which assessment indicates worsening shock A. Tachycardia, hypotension B. Normal vitals C. Bradycardia only D. Warm extremities Which medication is used to treat acute pulmonary edema A. Furosemide B. Dopamine C. Epinephrine D. IV fluids Which intervention improves oxygenation in ARDS