KAPLAN CRITICAL CARE A PRACTICE TEST 100 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026
Q&A |STUDY GUIDE| INSTANT DOWNLOAD PDF
Core Domains
*- Cardiovascular Critical Care*
*- Respiratory Critical Care & Mechanical Ventilation*
*- Neurological Critical Care & ICP Management*
*- Renal Critical Care & Fluid/Electrolyte Balance*
*- Gastrointestinal & Nutritional Support*
*- Hematologic & Immune System Critical Care*
*- Infectious Disease & Sepsis Management*
*- Endocrine Critical Care & Metabolic Disorders*
*- Trauma & Emergency Critical Care*
*- Ethics, Legal Compliance & Professional Standards*
Introduction
This practice test is designed to prepare nursing professionals for the Kaplan Critical Care A certification examination. The assessment evaluates
critical knowledge and clinical decision-making skills essential for managing critically ill patients in intensive care settings. The exam consists of
100 multiple-choice questions that include both direct knowledge questions and scenario-based clinical cases. Questions assess foundational
theory, applied professional knowledge, regulatory and legal compliance requirements, ethics and professional standards, and real-world critical
care scenarios. The examination emphasizes real-world application and decision-making capabilities, requiring candidates to prioritize
interventions, interpret complex clinical data, and make safe, evidence-based choices under pressure. Success on this exam demonstrates readiness
to provide safe, competent critical care nursing practice.
SECTION ONE: QUESTIONS 1–100
Question 1
A patient in the ICU has a blood pressure of 78/42 mmHg, heart rate of 128 bpm, and cool, clammy skin. Lactate is 4.8 mmol/L. Which type of shock
is most likely?
A. Neurogenic shock
B. Cardiogenic shock
C. Hypovolemic shock
D. Obstructive shock
🟢 Correct answer: B
,🔴 RATIONALE: Cardiogenic shock presents with hypotension, tachycardia, cool/clammy skin, and elevated lactate due to poor tissue perfusion
from cardiac pump failure. The combination of hypotension with cool skin distinguishes it from neurogenic (warm skin) and helps differentiate from
hypovolemic/obstructive based on clinical context.
Question 2
A patient on mechanical ventilation has a pH of 7.28, PaCO2 of 58 mmHg, and PaO2 of 62 mmHg. What is the primary acid-base disturbance?
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Metabolic acidosis
🟢 Correct answer: C
🔴 RATIONALE: Low pH (<7.35) with elevated PaCO2 (>45 mmHg) indicates respiratory acidosis. The acidemia combined with hypercapnia
confirms this is respiratory in origin, not metabolic.
Question 3
Which intervention is the priority for a patient with a suspected tension pneumothorax?
A. Administer high-flow oxygen
B. Prepare for immediate needle decompression
C. Obtain a chest X-ray
D. Start IV fluids
🟢 Correct answer: B
🔴 RATIONALE: Tension pneumothorax is a life-threatening emergency requiring immediate needle decompression before imaging. Delaying for X-
ray can lead to cardiovascular collapse. Oxygen and fluids are supportive but not the priority intervention.
Question 4
A patient with septic shock has a central venous pressure (CVP) of 3 cm H2O. What does this indicate?
,A. Fluid overload
B. Adequate volume status
C. Hypovolemia
D. Cardiac failure
🟢 Correct answer: C
🔴 RATIONALE: A CVP of 3 cm H2O (normal 2-6 cm H2O, but low in septic shock context) indicates hypovolemia. In septic shock with
vasodilation, a low CVP suggests inadequate intravascular volume requiring fluid resuscitation.
Question 5
Which medication is the first-line vasoactive agent for norepinephrine-resistant hypotension in septic shock?
A. Dopamine
B. Vasopressin
C. Phenylephrine
D. Epinephrine
🟢 Correct answer: B
🔴 RATIONALE: Vasopressin is the recommended second-line vasoactive agent when norepinephrine alone fails to maintain adequate blood
pressure in septic shock, per Surviving Sepsis Campaign guidelines.
Question 6
A patient with acute respiratory distress syndrome (ARDS) has a PaO2/FiO2 ratio of 90. What severity classification is this?
A. Mild ARDS
B. Moderate ARDS
C. Severe ARDS
D. Not ARDS
🟢 Correct answer: C
🔴 RATIONALE: According to the Berlin definition, severe ARDS is defined by a PaO2/FiO2 ratio ≤100 mmHg. Moderate is 100-200, and mild is
200-300.
, Question 7
Which nursing action is most appropriate for preventing ventilator-associated pneumonia (VAP)?
A. Keep the patient supine at all times
B. Perform daily oral care with chlorhexidine
C. Change the ventilator circuit every 24 hours
D. Maintain cuff pressure at 15 cm H2O
🟢 Correct answer: B
🔴 RATIONALE: Daily oral care with chlorhexidine is a key VAP prevention strategy per evidence-based guidelines. The head should be elevated 30-
45°, not supine. Circuit changes are not needed every 24 hours, and cuff pressure should be 20-30 cm H2O.
Question 8
A patient with a traumatic head injury has an intracranial pressure (ICP) of 28 mmHg. What is the priority intervention?
A. Administer IV mannitol
B. Increase sedation
C. Elevate the head of bed to 30 degrees
D. Obtain a CT scan
🟢 Correct answer: C
🔴 RATIONALE: Elevating the head of bed to 30 degrees is the first-line, non-invasive intervention to reduce ICP. Mannitol may be used but
requires monitoring. Sedation and CT are important but head elevation is the immediate priority.
Question 9
Which electrolyte abnormality is most associated with torsades de pointes?
A. Hyperkalemia
B. Hypocalcemia
C. Hypomagnesemia
D. Hypernatremia
🟢 Correct answer: C
Q&A |STUDY GUIDE| INSTANT DOWNLOAD PDF
Core Domains
*- Cardiovascular Critical Care*
*- Respiratory Critical Care & Mechanical Ventilation*
*- Neurological Critical Care & ICP Management*
*- Renal Critical Care & Fluid/Electrolyte Balance*
*- Gastrointestinal & Nutritional Support*
*- Hematologic & Immune System Critical Care*
*- Infectious Disease & Sepsis Management*
*- Endocrine Critical Care & Metabolic Disorders*
*- Trauma & Emergency Critical Care*
*- Ethics, Legal Compliance & Professional Standards*
Introduction
This practice test is designed to prepare nursing professionals for the Kaplan Critical Care A certification examination. The assessment evaluates
critical knowledge and clinical decision-making skills essential for managing critically ill patients in intensive care settings. The exam consists of
100 multiple-choice questions that include both direct knowledge questions and scenario-based clinical cases. Questions assess foundational
theory, applied professional knowledge, regulatory and legal compliance requirements, ethics and professional standards, and real-world critical
care scenarios. The examination emphasizes real-world application and decision-making capabilities, requiring candidates to prioritize
interventions, interpret complex clinical data, and make safe, evidence-based choices under pressure. Success on this exam demonstrates readiness
to provide safe, competent critical care nursing practice.
SECTION ONE: QUESTIONS 1–100
Question 1
A patient in the ICU has a blood pressure of 78/42 mmHg, heart rate of 128 bpm, and cool, clammy skin. Lactate is 4.8 mmol/L. Which type of shock
is most likely?
A. Neurogenic shock
B. Cardiogenic shock
C. Hypovolemic shock
D. Obstructive shock
🟢 Correct answer: B
,🔴 RATIONALE: Cardiogenic shock presents with hypotension, tachycardia, cool/clammy skin, and elevated lactate due to poor tissue perfusion
from cardiac pump failure. The combination of hypotension with cool skin distinguishes it from neurogenic (warm skin) and helps differentiate from
hypovolemic/obstructive based on clinical context.
Question 2
A patient on mechanical ventilation has a pH of 7.28, PaCO2 of 58 mmHg, and PaO2 of 62 mmHg. What is the primary acid-base disturbance?
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Metabolic acidosis
🟢 Correct answer: C
🔴 RATIONALE: Low pH (<7.35) with elevated PaCO2 (>45 mmHg) indicates respiratory acidosis. The acidemia combined with hypercapnia
confirms this is respiratory in origin, not metabolic.
Question 3
Which intervention is the priority for a patient with a suspected tension pneumothorax?
A. Administer high-flow oxygen
B. Prepare for immediate needle decompression
C. Obtain a chest X-ray
D. Start IV fluids
🟢 Correct answer: B
🔴 RATIONALE: Tension pneumothorax is a life-threatening emergency requiring immediate needle decompression before imaging. Delaying for X-
ray can lead to cardiovascular collapse. Oxygen and fluids are supportive but not the priority intervention.
Question 4
A patient with septic shock has a central venous pressure (CVP) of 3 cm H2O. What does this indicate?
,A. Fluid overload
B. Adequate volume status
C. Hypovolemia
D. Cardiac failure
🟢 Correct answer: C
🔴 RATIONALE: A CVP of 3 cm H2O (normal 2-6 cm H2O, but low in septic shock context) indicates hypovolemia. In septic shock with
vasodilation, a low CVP suggests inadequate intravascular volume requiring fluid resuscitation.
Question 5
Which medication is the first-line vasoactive agent for norepinephrine-resistant hypotension in septic shock?
A. Dopamine
B. Vasopressin
C. Phenylephrine
D. Epinephrine
🟢 Correct answer: B
🔴 RATIONALE: Vasopressin is the recommended second-line vasoactive agent when norepinephrine alone fails to maintain adequate blood
pressure in septic shock, per Surviving Sepsis Campaign guidelines.
Question 6
A patient with acute respiratory distress syndrome (ARDS) has a PaO2/FiO2 ratio of 90. What severity classification is this?
A. Mild ARDS
B. Moderate ARDS
C. Severe ARDS
D. Not ARDS
🟢 Correct answer: C
🔴 RATIONALE: According to the Berlin definition, severe ARDS is defined by a PaO2/FiO2 ratio ≤100 mmHg. Moderate is 100-200, and mild is
200-300.
, Question 7
Which nursing action is most appropriate for preventing ventilator-associated pneumonia (VAP)?
A. Keep the patient supine at all times
B. Perform daily oral care with chlorhexidine
C. Change the ventilator circuit every 24 hours
D. Maintain cuff pressure at 15 cm H2O
🟢 Correct answer: B
🔴 RATIONALE: Daily oral care with chlorhexidine is a key VAP prevention strategy per evidence-based guidelines. The head should be elevated 30-
45°, not supine. Circuit changes are not needed every 24 hours, and cuff pressure should be 20-30 cm H2O.
Question 8
A patient with a traumatic head injury has an intracranial pressure (ICP) of 28 mmHg. What is the priority intervention?
A. Administer IV mannitol
B. Increase sedation
C. Elevate the head of bed to 30 degrees
D. Obtain a CT scan
🟢 Correct answer: C
🔴 RATIONALE: Elevating the head of bed to 30 degrees is the first-line, non-invasive intervention to reduce ICP. Mannitol may be used but
requires monitoring. Sedation and CT are important but head elevation is the immediate priority.
Question 9
Which electrolyte abnormality is most associated with torsades de pointes?
A. Hyperkalemia
B. Hypocalcemia
C. Hypomagnesemia
D. Hypernatremia
🟢 Correct answer: C
