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WEST COAST UNIVERSITY NURS 480 – HIGH-
ACUITY AND CRITICAL CARE NURSING
COMPREHENSIVE PRACTICE EXAM
QUESTIONS WITH ANSWERS AND RATIONALES
GRADED A+ 2026/27 | 100% GUARANTEED PASS
Covers Cardiac Emergencies, Respiratory Failure, Neurological
Emergencies, Shock, Sepsis, Multisystem Organ Failure, Burns, Trauma,
and Advanced Hemodynamic Monitoring
QUESTION 1
A patient in the intensive care unit is in cardiogenic shock. Which
hemodynamic parameter is expected?
A) Decreased cardiac output and increased systemic vascular resistance
B) Increased cardiac output and decreased systemic vascular resistance
C) Decreased cardiac output and decreased systemic vascular resistance
D) Normal cardiac output and increased systemic vascular resistance
Verified Answer: A
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Rationale: Cardiogenic shock is characterized by decreased cardiac
output and increased systemic vascular resistance due to compensatory
vasoconstriction. This results from pump failure. Treatment focuses on
improving contractility and reducing afterload.
QUESTION 2
A patient is admitted with septic shock. Which finding is most indicative
of this condition?
A) Hypotension despite adequate fluid resuscitation
B) Hypertension with bradycardia
C) Increased urine output
D) Warm, dry skin
Verified Answer: A
Rationale: Septic shock is defined as sepsis with persistent hypotension
requiring vasopressors to maintain mean arterial pressure of 65 mmHg
or greater despite adequate fluid resuscitation. Early sepsis may present
with warm, vasodilated skin, but shock presents with hypotension.
QUESTION 3
A patient with acute respiratory distress syndrome is on mechanical
ventilation. Which ventilator setting is most appropriate to prevent
further lung injury?
A) High tidal volume (10-12 mL/kg)
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B) Low tidal volume (6-8 mL/kg)
C) High positive end-expiratory pressure (PEEP) of 20 cm H2O
D) Low respiratory rate
Verified Answer: B
Rationale: Low tidal volume ventilation (6-8 mL/kg ideal body weight)
is recommended for ARDS to prevent volutrauma and barotrauma. High
PEEP may be used but should be individualized. The goal is to maintain
plateau pressure below 30 cm H2O.
QUESTION 4
A patient with a traumatic brain injury has an intracranial pressure of 25
mmHg. What is the priority nursing action?
A) Administer mannitol
B) Elevate the head of the bed to 30 degrees
C) Notify the healthcare provider
D) All of the above
Verified Answer: D
Rationale: All actions are appropriate for elevated ICP (normal is 5-15
mmHg). Head elevation promotes venous drainage, mannitol reduces
cerebral edema, and the provider must be notified. Hyperventilation may
also be used transiently.
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QUESTION 5
A patient is in ventricular fibrillation. What is the priority nursing
action?
A) Administer amiodarone
B) Perform defibrillation
C) Administer epinephrine
D) Begin chest compressions
Verified Answer: B
Rationale: Defibrillation is the priority treatment for ventricular
fibrillation and pulseless ventricular tachycardia. It should be performed
as soon as possible. Chest compressions are initiated until the
defibrillator is ready. Epinephrine and amiodarone are given after
defibrillation.
QUESTION 6
A patient with sepsis has a lactate level of 4.5 mmol/L. This finding
indicates:
A) Adequate tissue perfusion
B) Tissue hypoperfusion and anaerobic metabolism
C) Normal metabolic state
D) Liver dysfunction
Verified Answer: B
WEST COAST UNIVERSITY NURS 480 – HIGH-
ACUITY AND CRITICAL CARE NURSING
COMPREHENSIVE PRACTICE EXAM
QUESTIONS WITH ANSWERS AND RATIONALES
GRADED A+ 2026/27 | 100% GUARANTEED PASS
Covers Cardiac Emergencies, Respiratory Failure, Neurological
Emergencies, Shock, Sepsis, Multisystem Organ Failure, Burns, Trauma,
and Advanced Hemodynamic Monitoring
QUESTION 1
A patient in the intensive care unit is in cardiogenic shock. Which
hemodynamic parameter is expected?
A) Decreased cardiac output and increased systemic vascular resistance
B) Increased cardiac output and decreased systemic vascular resistance
C) Decreased cardiac output and decreased systemic vascular resistance
D) Normal cardiac output and increased systemic vascular resistance
Verified Answer: A
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Rationale: Cardiogenic shock is characterized by decreased cardiac
output and increased systemic vascular resistance due to compensatory
vasoconstriction. This results from pump failure. Treatment focuses on
improving contractility and reducing afterload.
QUESTION 2
A patient is admitted with septic shock. Which finding is most indicative
of this condition?
A) Hypotension despite adequate fluid resuscitation
B) Hypertension with bradycardia
C) Increased urine output
D) Warm, dry skin
Verified Answer: A
Rationale: Septic shock is defined as sepsis with persistent hypotension
requiring vasopressors to maintain mean arterial pressure of 65 mmHg
or greater despite adequate fluid resuscitation. Early sepsis may present
with warm, vasodilated skin, but shock presents with hypotension.
QUESTION 3
A patient with acute respiratory distress syndrome is on mechanical
ventilation. Which ventilator setting is most appropriate to prevent
further lung injury?
A) High tidal volume (10-12 mL/kg)
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B) Low tidal volume (6-8 mL/kg)
C) High positive end-expiratory pressure (PEEP) of 20 cm H2O
D) Low respiratory rate
Verified Answer: B
Rationale: Low tidal volume ventilation (6-8 mL/kg ideal body weight)
is recommended for ARDS to prevent volutrauma and barotrauma. High
PEEP may be used but should be individualized. The goal is to maintain
plateau pressure below 30 cm H2O.
QUESTION 4
A patient with a traumatic brain injury has an intracranial pressure of 25
mmHg. What is the priority nursing action?
A) Administer mannitol
B) Elevate the head of the bed to 30 degrees
C) Notify the healthcare provider
D) All of the above
Verified Answer: D
Rationale: All actions are appropriate for elevated ICP (normal is 5-15
mmHg). Head elevation promotes venous drainage, mannitol reduces
cerebral edema, and the provider must be notified. Hyperventilation may
also be used transiently.
, 4 | Page
QUESTION 5
A patient is in ventricular fibrillation. What is the priority nursing
action?
A) Administer amiodarone
B) Perform defibrillation
C) Administer epinephrine
D) Begin chest compressions
Verified Answer: B
Rationale: Defibrillation is the priority treatment for ventricular
fibrillation and pulseless ventricular tachycardia. It should be performed
as soon as possible. Chest compressions are initiated until the
defibrillator is ready. Epinephrine and amiodarone are given after
defibrillation.
QUESTION 6
A patient with sepsis has a lactate level of 4.5 mmol/L. This finding
indicates:
A) Adequate tissue perfusion
B) Tissue hypoperfusion and anaerobic metabolism
C) Normal metabolic state
D) Liver dysfunction
Verified Answer: B
