Florida NCLEX Critical Care Nursing Practice Exam I
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1. A critically ill client develops sudden hypotension, tachycardia, and cool clammy
skin. Which nursing action should be performed first?
A. Administer prescribed antibiotics.
B. Assess airway, breathing, and circulation.
C. Insert a urinary catheter.
D. Obtain blood cultures.
Answer: B. Assess airway, breathing, and circulation.
Rationale: Initial assessment of airway, breathing, and circulation (ABCs) is always the
priority for an unstable patient. Stabilizing oxygenation and circulation takes precedence
before other interventions such as obtaining cultures or administering medications.
2. A client receiving mechanical ventilation suddenly has oxygen saturation decrease
from 98% to 84%. What is the nurse's priority action?
A. Increase intravenous fluids.
B. Assess the client and the ventilator.
C. Notify the healthcare provider immediately.
D. Administer pain medication.
Answer: B. Assess the client and the ventilator.
Rationale: The nurse should immediately determine whether the problem lies with the
patient or the ventilator. Rapid assessment includes checking airway patency, ventilator
connections, and lung sounds before notifying the provider.
3. Which assessment finding most strongly suggests decreased cardiac output?
,A. Warm extremities
B. Bounding peripheral pulses
C. Delayed capillary refill and altered mental status
D. Increased urine output
Answer: C. Delayed capillary refill and altered mental status
Rationale: Poor tissue perfusion caused by reduced cardiac output commonly presents
with delayed capillary refill, confusion, decreased urine output, and cool extremities.
4. Which laboratory value requires immediate intervention in a client receiving
intravenous insulin?
A. Sodium 138 mEq/L
B. Potassium 2.8 mEq/L
C. Glucose 180 mg/dL
D. Magnesium 2.0 mg/dL
Answer: B. Potassium 2.8 mEq/L
Rationale: Insulin drives potassium into cells, worsening hypokalemia. A potassium level of
2.8 mEq/L significantly increases the risk for life-threatening cardiac dysrhythmias and
requires immediate correction.
5. Which finding indicates effective fluid resuscitation in a client with septic shock?
A. Urine output 45 mL/hour
B. Respiratory rate 32 breaths/minute
C. Lactate continues to rise
D. Blood pressure 82/50 mmHg
Answer: A. Urine output 45 mL/hour
Rationale: Adequate urine output (at least 0.5 mL/kg/hour in adults) is an important
indicator of improved renal perfusion and successful fluid resuscitation.
6. Which arterial blood gas value indicates respiratory acidosis?
A. pH 7.30, PaCO₂ 55 mmHg, HCO₃⁻ 25 mEq/L
B. pH 7.50, PaCO₂ 30 mmHg, HCO₃⁻ 24 mEq/L
, C. pH 7.32, PaCO₂ 38 mmHg, HCO₃⁻ 18 mEq/L
D. pH 7.45, PaCO₂ 40 mmHg, HCO₃⁻ 24 mEq/L
Answer: A. pH 7.30, PaCO₂ 55 mmHg, HCO₃⁻ 25 mEq/L
Rationale: Respiratory acidosis is characterized by a decreased pH and elevated PaCO₂
caused by hypoventilation and carbon dioxide retention.
7. A client has a central venous pressure (CVP) of 2 mmHg. This finding most likely
indicates:
A. Fluid volume overload.
B. Right-sided heart failure.
C. Hypovolemia.
D. Cardiac tamponade.
Answer: C. Hypovolemia.
Rationale: A low CVP suggests reduced circulating blood volume, commonly associated
with dehydration or blood loss.
8. Which electrolyte imbalance places the client at greatest risk for ventricular
dysrhythmias?
A. Potassium 5.0 mEq/L
B. Potassium 3.0 mEq/L
C. Sodium 136 mEq/L
D. Calcium 9.2 mg/dL
Answer: B. Potassium 3.0 mEq/L
Rationale: Hypokalemia significantly increases myocardial irritability, predisposing the
client to dangerous ventricular arrhythmias.
9. A client with increased intracranial pressure suddenly develops unequal pupils.
What is the nurse's priority action?
A. Document the finding.
B. Reassess in one hour.
Updated Exam 2026 WITH Recent Newest Verified And Well
Analyzed Exam Questions (Actual Exam 2026-2027) Correct
Detailed & Verified ANSWERS (100% Accurate Solutions)
ALREADY GRADED A+||NEWEST VERSION Of
The Exam Guarantee Pass!!
1. A critically ill client develops sudden hypotension, tachycardia, and cool clammy
skin. Which nursing action should be performed first?
A. Administer prescribed antibiotics.
B. Assess airway, breathing, and circulation.
C. Insert a urinary catheter.
D. Obtain blood cultures.
Answer: B. Assess airway, breathing, and circulation.
Rationale: Initial assessment of airway, breathing, and circulation (ABCs) is always the
priority for an unstable patient. Stabilizing oxygenation and circulation takes precedence
before other interventions such as obtaining cultures or administering medications.
2. A client receiving mechanical ventilation suddenly has oxygen saturation decrease
from 98% to 84%. What is the nurse's priority action?
A. Increase intravenous fluids.
B. Assess the client and the ventilator.
C. Notify the healthcare provider immediately.
D. Administer pain medication.
Answer: B. Assess the client and the ventilator.
Rationale: The nurse should immediately determine whether the problem lies with the
patient or the ventilator. Rapid assessment includes checking airway patency, ventilator
connections, and lung sounds before notifying the provider.
3. Which assessment finding most strongly suggests decreased cardiac output?
,A. Warm extremities
B. Bounding peripheral pulses
C. Delayed capillary refill and altered mental status
D. Increased urine output
Answer: C. Delayed capillary refill and altered mental status
Rationale: Poor tissue perfusion caused by reduced cardiac output commonly presents
with delayed capillary refill, confusion, decreased urine output, and cool extremities.
4. Which laboratory value requires immediate intervention in a client receiving
intravenous insulin?
A. Sodium 138 mEq/L
B. Potassium 2.8 mEq/L
C. Glucose 180 mg/dL
D. Magnesium 2.0 mg/dL
Answer: B. Potassium 2.8 mEq/L
Rationale: Insulin drives potassium into cells, worsening hypokalemia. A potassium level of
2.8 mEq/L significantly increases the risk for life-threatening cardiac dysrhythmias and
requires immediate correction.
5. Which finding indicates effective fluid resuscitation in a client with septic shock?
A. Urine output 45 mL/hour
B. Respiratory rate 32 breaths/minute
C. Lactate continues to rise
D. Blood pressure 82/50 mmHg
Answer: A. Urine output 45 mL/hour
Rationale: Adequate urine output (at least 0.5 mL/kg/hour in adults) is an important
indicator of improved renal perfusion and successful fluid resuscitation.
6. Which arterial blood gas value indicates respiratory acidosis?
A. pH 7.30, PaCO₂ 55 mmHg, HCO₃⁻ 25 mEq/L
B. pH 7.50, PaCO₂ 30 mmHg, HCO₃⁻ 24 mEq/L
, C. pH 7.32, PaCO₂ 38 mmHg, HCO₃⁻ 18 mEq/L
D. pH 7.45, PaCO₂ 40 mmHg, HCO₃⁻ 24 mEq/L
Answer: A. pH 7.30, PaCO₂ 55 mmHg, HCO₃⁻ 25 mEq/L
Rationale: Respiratory acidosis is characterized by a decreased pH and elevated PaCO₂
caused by hypoventilation and carbon dioxide retention.
7. A client has a central venous pressure (CVP) of 2 mmHg. This finding most likely
indicates:
A. Fluid volume overload.
B. Right-sided heart failure.
C. Hypovolemia.
D. Cardiac tamponade.
Answer: C. Hypovolemia.
Rationale: A low CVP suggests reduced circulating blood volume, commonly associated
with dehydration or blood loss.
8. Which electrolyte imbalance places the client at greatest risk for ventricular
dysrhythmias?
A. Potassium 5.0 mEq/L
B. Potassium 3.0 mEq/L
C. Sodium 136 mEq/L
D. Calcium 9.2 mg/dL
Answer: B. Potassium 3.0 mEq/L
Rationale: Hypokalemia significantly increases myocardial irritability, predisposing the
client to dangerous ventricular arrhythmias.
9. A client with increased intracranial pressure suddenly develops unequal pupils.
What is the nurse's priority action?
A. Document the finding.
B. Reassess in one hour.
