NSG 180 CRITICAL CARE NURSING FINAL EXAM] QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
- Hemodynamic Monitoring & Shock Syndromes
- Mechanical Ventilation & Respiratory Failure
- Cardiac Dysrhythmias & Acute Coronary Syndromes
- Neurologic Critical Care & Increased Intracranial Pressure
- Renal Failure & Continuous Renal Replacement Therapy
- Sepsis, Multisystem Organ Failure, & Resuscitation
- Pharmacology of Critical Care: Vasoactive & Sedation Agents
- Ethical & Legal Issues in the ICU (Advanced Directives, Brain Death)
- End-of-Life Care & Family Communication
- Trauma, Burns, & Post-Operative Complications
Introduction
*This comprehensive assessment is designed to evaluate mastery of NSG 180 Critical Care Nursing. The exam
covers foundational theory, applied clinical knowledge, regulatory compliance, ethical standards, and high-
acuity decision-making through 200 multiple-choice questions. Each item presents a realistic scenario requiring
prioritization, interpretation of monitoring data, or selection of immediate interventions. Emphasis is placed on
real-world application, including hemodynamic management, ventilator adjustments, dysrhythmia recognition,
and crisis resource management. The format simulates a standardized critical care certification examination.
Correct answers are verified with concise rationales to reinforce evidence-based practice.*
,SECTION ONE: QUESTIONS 1–100
Question 1
A patient with septic shock has a mean arterial pressure (MAP) of 55 mm Hg despite two liters of intravenous
crystalloids. The nurse anticipates which immediate intervention?
A. Administer norepinephrine infusion
B. Start a dopamine drip at 5 mcg/kg/min
C. Give a third liter of normal saline bolus
D. Prepare for central line placement only
🟢A
🔴 RATIONALE: Current guidelines recommend initiating vasopressors (norepinephrine first-line) if MAP
remains <65 mm Hg after adequate fluid resuscitation. Continuing fluids without vasoactive support may
worsen pulmonary edema without improving perfusion.
Question 2
While caring for a patient on mechanical ventilation in pressure support mode, the nurse notes a sudden drop
in expired tidal volume from 450 mL to 120 mL with no change in set pressure. Which action is most
appropriate?
A. Increase the pressure support level
B. Suction the endotracheal tube
C. Check for a disconnection or large air leak
D. Switch to pressure control ventilation
🟢C
,🔴 RATIONALE: A sudden, large decrease in expired tidal volume without a pressure change typically indicates a
disconnection, cuff leak, or ventilator circuit disconnect. Troubleshooting the circuit should precede changing
settings.
Question 3
A patient with an intracranial pressure (ICP) monitor has a sudden ICP spike from 14 to 32 mm Hg lasting three
minutes. The patient is drowsy but arousable. Which nursing action has the highest priority?
A. Administer mannitol 1 g/kg IV
B. Notify the provider immediately
C. Assess the patient’s pupillary response
D. Check the waveform for damping
🟢B
🔴 RATIONALE: An acute ICP elevation above 20-25 mm Hg requires immediate provider notification for
potential intervention. While further assessment is important, the priority is alerting the care team to a critical
change.
Question 4
Which hemodynamic profile best describes early (warm) distributive shock?
A. Low cardiac output, high systemic vascular resistance
B. High cardiac output, low systemic vascular resistance
C. Low cardiac output, low systemic vascular resistance
D. High cardiac output, high systemic vascular resistance
🟢B
, 🔴 RATIONALE: Early distributive shock (sepsis, neurogenic, anaphylaxis) is characterized by vasodilation (low
SVR) and compensatory high cardiac output. Low SVR plus high CO differentiates it from cardiogenic shock.
Question 5
A patient receiving continuous renal replacement therapy (CRRT) has a filter pressure that suddenly drops to
zero. The alarm indicates “loss of blood flow return.” What is the priority action?
A. Increase blood flow rate
B. Clamp the access line and call the provider
C. Check for kinking in the return line
D. Administer a saline bolus through the filter
🟢C
🔴 RATIONALE: Loss of return pressure with zero reading often indicates a kink or clamp on the return (venous)
line. The nurse should inspect the circuit immediately before considering more invasive troubleshooting.
Question 6
A patient with acute respiratory distress syndrome (ARDS) is on volume-controlled ventilation with a tidal
volume of 6 mL/kg predicted body weight. The plateau pressure is 32 cm H2O. Which adjustment is most
appropriate?
A. Increase tidal volume to 8 mL/kg
B. Decrease the respiratory rate
C. Reduce PEEP by 2 cm H2O
D. Request a neuromuscular blocker infusion
🟢D
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
- Hemodynamic Monitoring & Shock Syndromes
- Mechanical Ventilation & Respiratory Failure
- Cardiac Dysrhythmias & Acute Coronary Syndromes
- Neurologic Critical Care & Increased Intracranial Pressure
- Renal Failure & Continuous Renal Replacement Therapy
- Sepsis, Multisystem Organ Failure, & Resuscitation
- Pharmacology of Critical Care: Vasoactive & Sedation Agents
- Ethical & Legal Issues in the ICU (Advanced Directives, Brain Death)
- End-of-Life Care & Family Communication
- Trauma, Burns, & Post-Operative Complications
Introduction
*This comprehensive assessment is designed to evaluate mastery of NSG 180 Critical Care Nursing. The exam
covers foundational theory, applied clinical knowledge, regulatory compliance, ethical standards, and high-
acuity decision-making through 200 multiple-choice questions. Each item presents a realistic scenario requiring
prioritization, interpretation of monitoring data, or selection of immediate interventions. Emphasis is placed on
real-world application, including hemodynamic management, ventilator adjustments, dysrhythmia recognition,
and crisis resource management. The format simulates a standardized critical care certification examination.
Correct answers are verified with concise rationales to reinforce evidence-based practice.*
,SECTION ONE: QUESTIONS 1–100
Question 1
A patient with septic shock has a mean arterial pressure (MAP) of 55 mm Hg despite two liters of intravenous
crystalloids. The nurse anticipates which immediate intervention?
A. Administer norepinephrine infusion
B. Start a dopamine drip at 5 mcg/kg/min
C. Give a third liter of normal saline bolus
D. Prepare for central line placement only
🟢A
🔴 RATIONALE: Current guidelines recommend initiating vasopressors (norepinephrine first-line) if MAP
remains <65 mm Hg after adequate fluid resuscitation. Continuing fluids without vasoactive support may
worsen pulmonary edema without improving perfusion.
Question 2
While caring for a patient on mechanical ventilation in pressure support mode, the nurse notes a sudden drop
in expired tidal volume from 450 mL to 120 mL with no change in set pressure. Which action is most
appropriate?
A. Increase the pressure support level
B. Suction the endotracheal tube
C. Check for a disconnection or large air leak
D. Switch to pressure control ventilation
🟢C
,🔴 RATIONALE: A sudden, large decrease in expired tidal volume without a pressure change typically indicates a
disconnection, cuff leak, or ventilator circuit disconnect. Troubleshooting the circuit should precede changing
settings.
Question 3
A patient with an intracranial pressure (ICP) monitor has a sudden ICP spike from 14 to 32 mm Hg lasting three
minutes. The patient is drowsy but arousable. Which nursing action has the highest priority?
A. Administer mannitol 1 g/kg IV
B. Notify the provider immediately
C. Assess the patient’s pupillary response
D. Check the waveform for damping
🟢B
🔴 RATIONALE: An acute ICP elevation above 20-25 mm Hg requires immediate provider notification for
potential intervention. While further assessment is important, the priority is alerting the care team to a critical
change.
Question 4
Which hemodynamic profile best describes early (warm) distributive shock?
A. Low cardiac output, high systemic vascular resistance
B. High cardiac output, low systemic vascular resistance
C. Low cardiac output, low systemic vascular resistance
D. High cardiac output, high systemic vascular resistance
🟢B
, 🔴 RATIONALE: Early distributive shock (sepsis, neurogenic, anaphylaxis) is characterized by vasodilation (low
SVR) and compensatory high cardiac output. Low SVR plus high CO differentiates it from cardiogenic shock.
Question 5
A patient receiving continuous renal replacement therapy (CRRT) has a filter pressure that suddenly drops to
zero. The alarm indicates “loss of blood flow return.” What is the priority action?
A. Increase blood flow rate
B. Clamp the access line and call the provider
C. Check for kinking in the return line
D. Administer a saline bolus through the filter
🟢C
🔴 RATIONALE: Loss of return pressure with zero reading often indicates a kink or clamp on the return (venous)
line. The nurse should inspect the circuit immediately before considering more invasive troubleshooting.
Question 6
A patient with acute respiratory distress syndrome (ARDS) is on volume-controlled ventilation with a tidal
volume of 6 mL/kg predicted body weight. The plateau pressure is 32 cm H2O. Which adjustment is most
appropriate?
A. Increase tidal volume to 8 mL/kg
B. Decrease the respiratory rate
C. Reduce PEEP by 2 cm H2O
D. Request a neuromuscular blocker infusion
🟢D
