NUR 445 Final Exam – Comprehensive
Study Bank Critical Care Nursing | Complex
Health Systems | High-Acuity Patient
Management Arizona College | 2026/2027
Academic Year
Section 1: Hemodynamics & Shock States (Questions 1-40)
1. A patient in the ICU has a pulmonary artery catheter. The nurse notes a
cardiac output of 2.5 L/min (normal 4-8 L/min). This indicates:
A) Increased cardiac output
B) Decreased cardiac output
C) Normal cardiac output
D) Increased preload
Answer: B – Normal cardiac output is 4-8 L/min. A value of 2.5 L/min
indicates decreased cardiac output (low flow state), which may be seen in
cardiogenic shock.
2. The nurse is caring for a patient with a pulmonary artery catheter. The
cardiac index is 1.8 L/min/m² (normal 2.5-4.0). This finding indicates:
A) Adequate tissue perfusion
B) Inadequate tissue perfusion
C) Normal cardiac function
D) Increased oxygen delivery
Answer: B – Cardiac index (CI) normalizes cardiac output to body surface
area. A CI <2.2 L/min/m² indicates inadequate tissue perfusion (low flow
state).
,3. A patient in shock has a systemic vascular resistance (SVR) of 400
dyn·s·cm⁻⁵ (normal 800-1200). This indicates:
A) Vasoconstriction
B) Vasodilation
C) Normal vascular tone
D) Increased afterload
Answer: B – Low SVR indicates vasodilation, which is characteristic of
distributive shock (septic, anaphylactic, neurogenic). High SVR indicates
vasoconstriction (hypovolemic, cardiogenic shock).
4. A patient in shock has an SVR of 1,600 dyn·s·cm⁻⁵ (normal 800-1200). This
indicates:
A) Vasodilation
B) Vasoconstriction
C) Normal vascular tone
D) Decreased afterload
Answer: B – High SVR indicates vasoconstriction, which is characteristic of
hypovolemic and cardiogenic shock (compensatory vasoconstriction to
maintain BP).
5. A patient with septic shock has hypotension despite fluid resuscitation.
The nurse anticipates an order for:
A) Norepinephrine (Levophed)
B) Nitroglycerin
C) Furosemide (Lasix)
D) Metoprolol (Lopressor)
,Answer: A – Norepinephrine is the first-line vasopressor for septic shock. It
causes vasoconstriction (increases SVR) to raise blood pressure and improve
organ perfusion.
6. The nurse is caring for a patient with cardiogenic shock. Which finding is
most consistent with this diagnosis?
A) Warm, flushed skin
B) Decreased cardiac output and increased SVR
C) Decreased SVR and increased cardiac output
D) Bounding pulses
Answer: B – Cardiogenic shock is characterized by decreased cardiac output
(pump failure) and compensatory vasoconstriction (increased SVR). Skin is
cool and clammy (not warm and flushed).
7. A patient with septic shock has warm, flushed skin and bounding pulses.
This is due to:
A) Vasoconstriction
B) Vasodilation (distributive shock)
C) Decreased cardiac output
D) Increased SVR
Answer: B – Septic shock causes massive vasodilation (decreased SVR),
leading to warm, flushed skin, bounding pulses, and hypotension.
8. The nurse is assessing a patient with hypovolemic shock. Which finding is
expected?
A) Warm, flushed skin
B) Decreased urine output
C) Bounding pulses
D) Increased central venous pressure (CVP)
, Answer: B – Hypovolemic shock causes decreased preload (low CVP),
decreased urine output (due to decreased renal perfusion), cool clammy
skin, and tachycardia.
9. The central venous pressure (CVP) normal range is:
A) 0-2 mm Hg
B) 2-6 mm Hg
C) 8-12 mm Hg
D) 15-20 mm Hg
Answer: B – Normal CVP is 2-6 mm Hg (or 4-8 cm H₂O). Low CVP indicates
hypovolemia; high CVP indicates fluid overload or right heart failure.
10. A patient with a CVP of 14 mm Hg (normal 2-6) is likely experiencing:
A) Hypovolemia
B) Fluid overload or right heart failure
C) Normal fluid status
D) Dehydration
Answer: B – Elevated CVP indicates increased right atrial pressure, which
may be due to fluid overload, right ventricular failure, pulmonary
hypertension, or tricuspid regurgitation.
11. The pulmonary artery wedge pressure (PAWP) normal range is:
A) 2-6 mm Hg
B) 4-12 mm Hg
C) 15-25 mm Hg
D) 25-35 mm Hg
Answer: B – Normal PAWP is 4-12 mm Hg. Elevated PAWP (>15-18 mm Hg)
indicates left ventricular failure or volume overload.
Study Bank Critical Care Nursing | Complex
Health Systems | High-Acuity Patient
Management Arizona College | 2026/2027
Academic Year
Section 1: Hemodynamics & Shock States (Questions 1-40)
1. A patient in the ICU has a pulmonary artery catheter. The nurse notes a
cardiac output of 2.5 L/min (normal 4-8 L/min). This indicates:
A) Increased cardiac output
B) Decreased cardiac output
C) Normal cardiac output
D) Increased preload
Answer: B – Normal cardiac output is 4-8 L/min. A value of 2.5 L/min
indicates decreased cardiac output (low flow state), which may be seen in
cardiogenic shock.
2. The nurse is caring for a patient with a pulmonary artery catheter. The
cardiac index is 1.8 L/min/m² (normal 2.5-4.0). This finding indicates:
A) Adequate tissue perfusion
B) Inadequate tissue perfusion
C) Normal cardiac function
D) Increased oxygen delivery
Answer: B – Cardiac index (CI) normalizes cardiac output to body surface
area. A CI <2.2 L/min/m² indicates inadequate tissue perfusion (low flow
state).
,3. A patient in shock has a systemic vascular resistance (SVR) of 400
dyn·s·cm⁻⁵ (normal 800-1200). This indicates:
A) Vasoconstriction
B) Vasodilation
C) Normal vascular tone
D) Increased afterload
Answer: B – Low SVR indicates vasodilation, which is characteristic of
distributive shock (septic, anaphylactic, neurogenic). High SVR indicates
vasoconstriction (hypovolemic, cardiogenic shock).
4. A patient in shock has an SVR of 1,600 dyn·s·cm⁻⁵ (normal 800-1200). This
indicates:
A) Vasodilation
B) Vasoconstriction
C) Normal vascular tone
D) Decreased afterload
Answer: B – High SVR indicates vasoconstriction, which is characteristic of
hypovolemic and cardiogenic shock (compensatory vasoconstriction to
maintain BP).
5. A patient with septic shock has hypotension despite fluid resuscitation.
The nurse anticipates an order for:
A) Norepinephrine (Levophed)
B) Nitroglycerin
C) Furosemide (Lasix)
D) Metoprolol (Lopressor)
,Answer: A – Norepinephrine is the first-line vasopressor for septic shock. It
causes vasoconstriction (increases SVR) to raise blood pressure and improve
organ perfusion.
6. The nurse is caring for a patient with cardiogenic shock. Which finding is
most consistent with this diagnosis?
A) Warm, flushed skin
B) Decreased cardiac output and increased SVR
C) Decreased SVR and increased cardiac output
D) Bounding pulses
Answer: B – Cardiogenic shock is characterized by decreased cardiac output
(pump failure) and compensatory vasoconstriction (increased SVR). Skin is
cool and clammy (not warm and flushed).
7. A patient with septic shock has warm, flushed skin and bounding pulses.
This is due to:
A) Vasoconstriction
B) Vasodilation (distributive shock)
C) Decreased cardiac output
D) Increased SVR
Answer: B – Septic shock causes massive vasodilation (decreased SVR),
leading to warm, flushed skin, bounding pulses, and hypotension.
8. The nurse is assessing a patient with hypovolemic shock. Which finding is
expected?
A) Warm, flushed skin
B) Decreased urine output
C) Bounding pulses
D) Increased central venous pressure (CVP)
, Answer: B – Hypovolemic shock causes decreased preload (low CVP),
decreased urine output (due to decreased renal perfusion), cool clammy
skin, and tachycardia.
9. The central venous pressure (CVP) normal range is:
A) 0-2 mm Hg
B) 2-6 mm Hg
C) 8-12 mm Hg
D) 15-20 mm Hg
Answer: B – Normal CVP is 2-6 mm Hg (or 4-8 cm H₂O). Low CVP indicates
hypovolemia; high CVP indicates fluid overload or right heart failure.
10. A patient with a CVP of 14 mm Hg (normal 2-6) is likely experiencing:
A) Hypovolemia
B) Fluid overload or right heart failure
C) Normal fluid status
D) Dehydration
Answer: B – Elevated CVP indicates increased right atrial pressure, which
may be due to fluid overload, right ventricular failure, pulmonary
hypertension, or tricuspid regurgitation.
11. The pulmonary artery wedge pressure (PAWP) normal range is:
A) 2-6 mm Hg
B) 4-12 mm Hg
C) 15-25 mm Hg
D) 25-35 mm Hg
Answer: B – Normal PAWP is 4-12 mm Hg. Elevated PAWP (>15-18 mm Hg)
indicates left ventricular failure or volume overload.
