HESI RN CRITICAL CARE NURSING HESI RN
CRITICAL CARE ACCURATE PRACTICE EXAM WITH
ALL POSSIBLE APPROVED WELL ELABORATED
PRACTICE QUESTIONS AND 100% CORRECT VERIFIED
ANSWERS WITH DETAILED RATIONALES PLUS
EXPERT ANSWER KEY (100% CORRECT VERIFIED
SOLUTIONS) 2026-2027 CURRENTLY UPDATED
VERSION Q&A GUARANTEED PASS A+ INSTANT
DOWNLOAD PDF
1. A patient with acute respiratory distress
syndrome (ARDS) is receiving mechanical ventilation
with a tidal volume of 6 mL/kg ideal body weight.
The nurse notes a plateau pressure of 32 cm H₂O.
Which action is most appropriate?
A. Increase the tidal volume to 8 mL/kg.
B. Decrease the respiratory rate.
,C. Administer a neuromuscular blocking agent.
D. Increase the positive end-expiratory pressure
(PEEP).
Correct Answer: C. Administer a neuromuscular
blocking agent.
Rationale: Plateau pressure >30 cm H₂O indicates
lung overdistension; neuromuscular blockade
reduces patient-ventilator dyssynchrony and
lowers plateau pressure without changing volume.
Increasing tidal volume worsens injury. Decreasing
rate does not address plateau. Increasing PEEP
may increase plateau pressure.
2. A patient in cardiogenic shock has a pulmonary
artery wedge pressure (PAWP) of 22 mm Hg and a
cardiac index (CI) of 1.8 L/min/m². Which
medication should the nurse anticipate?
A. Nitroglycerin
B. Dobutamine
C. Norepinephrine
D. Furosemide
,Correct Answer: B. Dobutamine.
Rationale: Low CI with high PAWP indicates pump
failure with fluid overload; dobutamine increases
contractility and CI while reducing preload.
Nitroglycerin reduces preload but does not
improve contractility. Norepinephrine increases
afterload. Furosemide reduces preload but does
not improve CI acutely.
3. During a rapid response, a patient with ST-
elevation myocardial infarction develops pulseless
ventricular tachycardia. The nurse’s first action is to:
A. Administer amiodarone 300 mg IV push.
B. Start chest compressions at 100-120/min.
C. Defibrillate at 200 J biphasic.
D. Check for a pulse again.
Correct Answer: B. Start chest compressions at
100-120/min.
Rationale: For pulseless VT, immediate high-
quality CPR is the priority before defibrillation.
Defibrillation follows after CPR if a shockable
, rhythm persists. Amiodarone is given after the first
shock. Pulse check delays compressions.
4. A patient with severe sepsis has a mean arterial
pressure (MAP) of 58 mm Hg despite 30 mL/kg
crystalloid bolus. Which vasopressor is first-line?
A. Epinephrine
B. Phenylephrine
C. Norepinephrine
D. Vasopressin
Correct Answer: C. Norepinephrine.
Rationale: Surviving Sepsis Campaign recommends
norepinephrine as first-line vasopressor for septic
shock unresponsive to fluids. Epinephrine is
second-line. Phenylephrine is not preferred.
Vasopressin is adjunctive.
5. A patient on a ventilator has an arterial blood
gas: pH 7.28, PaCO₂ 55 mm Hg, HCO₃⁻ 24 mEq/L.
Which ventilator adjustment is indicated?
A. Increase FiO₂.
CRITICAL CARE ACCURATE PRACTICE EXAM WITH
ALL POSSIBLE APPROVED WELL ELABORATED
PRACTICE QUESTIONS AND 100% CORRECT VERIFIED
ANSWERS WITH DETAILED RATIONALES PLUS
EXPERT ANSWER KEY (100% CORRECT VERIFIED
SOLUTIONS) 2026-2027 CURRENTLY UPDATED
VERSION Q&A GUARANTEED PASS A+ INSTANT
DOWNLOAD PDF
1. A patient with acute respiratory distress
syndrome (ARDS) is receiving mechanical ventilation
with a tidal volume of 6 mL/kg ideal body weight.
The nurse notes a plateau pressure of 32 cm H₂O.
Which action is most appropriate?
A. Increase the tidal volume to 8 mL/kg.
B. Decrease the respiratory rate.
,C. Administer a neuromuscular blocking agent.
D. Increase the positive end-expiratory pressure
(PEEP).
Correct Answer: C. Administer a neuromuscular
blocking agent.
Rationale: Plateau pressure >30 cm H₂O indicates
lung overdistension; neuromuscular blockade
reduces patient-ventilator dyssynchrony and
lowers plateau pressure without changing volume.
Increasing tidal volume worsens injury. Decreasing
rate does not address plateau. Increasing PEEP
may increase plateau pressure.
2. A patient in cardiogenic shock has a pulmonary
artery wedge pressure (PAWP) of 22 mm Hg and a
cardiac index (CI) of 1.8 L/min/m². Which
medication should the nurse anticipate?
A. Nitroglycerin
B. Dobutamine
C. Norepinephrine
D. Furosemide
,Correct Answer: B. Dobutamine.
Rationale: Low CI with high PAWP indicates pump
failure with fluid overload; dobutamine increases
contractility and CI while reducing preload.
Nitroglycerin reduces preload but does not
improve contractility. Norepinephrine increases
afterload. Furosemide reduces preload but does
not improve CI acutely.
3. During a rapid response, a patient with ST-
elevation myocardial infarction develops pulseless
ventricular tachycardia. The nurse’s first action is to:
A. Administer amiodarone 300 mg IV push.
B. Start chest compressions at 100-120/min.
C. Defibrillate at 200 J biphasic.
D. Check for a pulse again.
Correct Answer: B. Start chest compressions at
100-120/min.
Rationale: For pulseless VT, immediate high-
quality CPR is the priority before defibrillation.
Defibrillation follows after CPR if a shockable
, rhythm persists. Amiodarone is given after the first
shock. Pulse check delays compressions.
4. A patient with severe sepsis has a mean arterial
pressure (MAP) of 58 mm Hg despite 30 mL/kg
crystalloid bolus. Which vasopressor is first-line?
A. Epinephrine
B. Phenylephrine
C. Norepinephrine
D. Vasopressin
Correct Answer: C. Norepinephrine.
Rationale: Surviving Sepsis Campaign recommends
norepinephrine as first-line vasopressor for septic
shock unresponsive to fluids. Epinephrine is
second-line. Phenylephrine is not preferred.
Vasopressin is adjunctive.
5. A patient on a ventilator has an arterial blood
gas: pH 7.28, PaCO₂ 55 mm Hg, HCO₃⁻ 24 mEq/L.
Which ventilator adjustment is indicated?
A. Increase FiO₂.
