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2026 CRITICAL CARE CARDIAC DRIPS NGN BUNDLE | 150 PRACTICE
QUESTIONS WITH DETAILED RATIONALES & PARTIAL CREDIT
SCORING | NOREPINEPHRINE, EPINEPHRINE, AMIODARONE,
DOPAMINE TITRATION & MONITORING | RN & PN HIGH-YIELD
REVIEW
QUESTION 1: NOREPINEPHRINE FIRST-LINE STATUS
• Question: A client in septic shock remains hypotensive after adequate fluid resuscitation.
Which vasopressor is recommended as first-line therapy?
• Options:
A. Dopamine
B. Norepinephrine
C. Phenylephrine as first choice
D. Dobutamine alone
• Zero-Flip Premium Rationale Box:
o Correct Answer: B
o Pathophysiology Summary: Norepinephrine is the preferred initial vasopressor
for septic shock according to current guidelines.
o Distractor Pitfalls: Dopamine is an alternative; dobutamine is primarily an
inotrope.
QUESTION 2: NOREPINEPHRINE TITRATION GOAL
• Question: A norepinephrine infusion is running at 0.12 mcg/kg/min. Current MAP is 58
mm Hg. What is the priority nursing action?
• Options:
A. Decrease the rate
B. Titrate upward per protocol to achieve target MAP
C. Stop the infusion
D. Switch immediately to epinephrine
• Zero-Flip Premium Rationale Box:
o Correct Answer: B
o Pathophysiology Summary: Persistent hypotension below target MAP requires
careful upward titration.
, 2
o Distractor Pitfalls: Decreasing the rate worsens perfusion.
QUESTION 3: NOREPINEPHRINE EXTRAVASATION
• Question: The peripheral site of a norepinephrine infusion becomes pale, cold, and
swollen. What is the priority action?
• Options:
A. Continue the infusion
B. Stop the infusion, aspirate residual drug, and administer phentolamine as ordered
C. Apply warm compresses only and keep the IV
D. Increase the infusion rate
• Zero-Flip Premium Rationale Box:
o Correct Answer: B
o Pathophysiology Summary: Vasopressor extravasation can cause tissue necrosis;
phentolamine is the specific antidote.
o Distractor Pitfalls: Continuing the infusion increases injury severity.
QUESTION 4: CENTRAL LINE PREFERENCE
• Question: Why is administration of continuous norepinephrine preferred via central
venous access?
• Options:
A. It is more comfortable
B. Risk of severe tissue injury with peripheral extravasation
C. Peripheral veins cannot deliver any vasopressor
D. Central lines require less monitoring
• Zero-Flip Premium Rationale Box:
o Correct Answer: B
o Pathophysiology Summary: Intense local vasoconstriction from extravasated
norepinephrine risks necrosis.
o Distractor Pitfalls: Peripheral use is possible short-term but higher risk.
QUESTION 5: EPINEPHRINE IN CARDIAC ARREST
• Question: During asystolic cardiac arrest, epinephrine 1 mg IV is given. How frequently
may this dose be repeated?
• Options:
A. Every 1 minute
, 3
B. Every 3–5 minutes
C. Every 10 minutes
D. Only once per arrest
• Zero-Flip Premium Rationale Box:
o Correct Answer: B
o Pathophysiology Summary: ACLS guidelines support epinephrine 1 mg every
3–5 minutes.
o Distractor Pitfalls: More frequent dosing increases adverse effects without
proven benefit.
QUESTION 6: EPINEPHRINE CONCENTRATION
• Question: Which concentration of epinephrine is standard for IV use during cardiac
arrest?
• Options:
A. 1:1,000
B. 1:10,000
C. 1:100
D. 1:100,000
• Zero-Flip Premium Rationale Box:
o Correct Answer: B
o Pathophysiology Summary: The 1:10,000 concentration is used for IV/IO
administration in arrest.
o Distractor Pitfalls: 1:1,000 is typically reserved for intramuscular anaphylaxis
dosing.
QUESTION 7: EPINEPHRINE IN ANAPHYLAXIS VS ARREST
• Question: A client in anaphylactic shock receives epinephrine. How does the route and
concentration typically differ from cardiac-arrest dosing?
• Options:
A. Identical in all cases
B. Intramuscular 1:1,000 is preferred for initial anaphylaxis treatment
C. Only IV 1:10,000 is ever used
D. Oral administration is first-line
• Zero-Flip Premium Rationale Box:
, 4
o Correct Answer: B
o Pathophysiology Summary: Early anaphylaxis is treated with IM epinephrine
1:1,000; IV is reserved for severe cases or arrest.
o Distractor Pitfalls: Route and concentration are not interchangeable.
QUESTION 8: AMIODARONE INDICATION
• Question: Amiodarone is most appropriately used in which situation?
• Options:
A. Stable narrow-complex SVT as first-line
B. Refractory ventricular fibrillation or unstable ventricular tachycardia
C. Asymptomatic sinus bradycardia
D. First-line for all atrial fibrillation
• Zero-Flip Premium Rationale Box:
o Correct Answer: B
o Pathophysiology Summary: Amiodarone is indicated for shock-refractory
VF/pVT and selected stable wide-complex tachycardias.
o Distractor Pitfalls: It is not first-line for most SVTs or bradycardia.
QUESTION 9: AMIODARONE LOADING INFUSION
• Question: During the initial amiodarone loading infusion, the client develops significant
hypotension. What is the priority action?
• Options:
A. Increase the rate
B. Slow or stop the infusion and notify the provider
C. Administer an additional bolus
D. Continue at the current rate
• Zero-Flip Premium Rationale Box:
o Correct Answer: B
o Pathophysiology Summary: Amiodarone can cause vasodilation and myocardial
depression; hypotension requires rate reduction or cessation.
o Distractor Pitfalls: Increasing the rate worsens hemodynamic instability.
QUESTION 10: AMIODARONE CHRONIC TOXICITY
2026 CRITICAL CARE CARDIAC DRIPS NGN BUNDLE | 150 PRACTICE
QUESTIONS WITH DETAILED RATIONALES & PARTIAL CREDIT
SCORING | NOREPINEPHRINE, EPINEPHRINE, AMIODARONE,
DOPAMINE TITRATION & MONITORING | RN & PN HIGH-YIELD
REVIEW
QUESTION 1: NOREPINEPHRINE FIRST-LINE STATUS
• Question: A client in septic shock remains hypotensive after adequate fluid resuscitation.
Which vasopressor is recommended as first-line therapy?
• Options:
A. Dopamine
B. Norepinephrine
C. Phenylephrine as first choice
D. Dobutamine alone
• Zero-Flip Premium Rationale Box:
o Correct Answer: B
o Pathophysiology Summary: Norepinephrine is the preferred initial vasopressor
for septic shock according to current guidelines.
o Distractor Pitfalls: Dopamine is an alternative; dobutamine is primarily an
inotrope.
QUESTION 2: NOREPINEPHRINE TITRATION GOAL
• Question: A norepinephrine infusion is running at 0.12 mcg/kg/min. Current MAP is 58
mm Hg. What is the priority nursing action?
• Options:
A. Decrease the rate
B. Titrate upward per protocol to achieve target MAP
C. Stop the infusion
D. Switch immediately to epinephrine
• Zero-Flip Premium Rationale Box:
o Correct Answer: B
o Pathophysiology Summary: Persistent hypotension below target MAP requires
careful upward titration.
, 2
o Distractor Pitfalls: Decreasing the rate worsens perfusion.
QUESTION 3: NOREPINEPHRINE EXTRAVASATION
• Question: The peripheral site of a norepinephrine infusion becomes pale, cold, and
swollen. What is the priority action?
• Options:
A. Continue the infusion
B. Stop the infusion, aspirate residual drug, and administer phentolamine as ordered
C. Apply warm compresses only and keep the IV
D. Increase the infusion rate
• Zero-Flip Premium Rationale Box:
o Correct Answer: B
o Pathophysiology Summary: Vasopressor extravasation can cause tissue necrosis;
phentolamine is the specific antidote.
o Distractor Pitfalls: Continuing the infusion increases injury severity.
QUESTION 4: CENTRAL LINE PREFERENCE
• Question: Why is administration of continuous norepinephrine preferred via central
venous access?
• Options:
A. It is more comfortable
B. Risk of severe tissue injury with peripheral extravasation
C. Peripheral veins cannot deliver any vasopressor
D. Central lines require less monitoring
• Zero-Flip Premium Rationale Box:
o Correct Answer: B
o Pathophysiology Summary: Intense local vasoconstriction from extravasated
norepinephrine risks necrosis.
o Distractor Pitfalls: Peripheral use is possible short-term but higher risk.
QUESTION 5: EPINEPHRINE IN CARDIAC ARREST
• Question: During asystolic cardiac arrest, epinephrine 1 mg IV is given. How frequently
may this dose be repeated?
• Options:
A. Every 1 minute
, 3
B. Every 3–5 minutes
C. Every 10 minutes
D. Only once per arrest
• Zero-Flip Premium Rationale Box:
o Correct Answer: B
o Pathophysiology Summary: ACLS guidelines support epinephrine 1 mg every
3–5 minutes.
o Distractor Pitfalls: More frequent dosing increases adverse effects without
proven benefit.
QUESTION 6: EPINEPHRINE CONCENTRATION
• Question: Which concentration of epinephrine is standard for IV use during cardiac
arrest?
• Options:
A. 1:1,000
B. 1:10,000
C. 1:100
D. 1:100,000
• Zero-Flip Premium Rationale Box:
o Correct Answer: B
o Pathophysiology Summary: The 1:10,000 concentration is used for IV/IO
administration in arrest.
o Distractor Pitfalls: 1:1,000 is typically reserved for intramuscular anaphylaxis
dosing.
QUESTION 7: EPINEPHRINE IN ANAPHYLAXIS VS ARREST
• Question: A client in anaphylactic shock receives epinephrine. How does the route and
concentration typically differ from cardiac-arrest dosing?
• Options:
A. Identical in all cases
B. Intramuscular 1:1,000 is preferred for initial anaphylaxis treatment
C. Only IV 1:10,000 is ever used
D. Oral administration is first-line
• Zero-Flip Premium Rationale Box:
, 4
o Correct Answer: B
o Pathophysiology Summary: Early anaphylaxis is treated with IM epinephrine
1:1,000; IV is reserved for severe cases or arrest.
o Distractor Pitfalls: Route and concentration are not interchangeable.
QUESTION 8: AMIODARONE INDICATION
• Question: Amiodarone is most appropriately used in which situation?
• Options:
A. Stable narrow-complex SVT as first-line
B. Refractory ventricular fibrillation or unstable ventricular tachycardia
C. Asymptomatic sinus bradycardia
D. First-line for all atrial fibrillation
• Zero-Flip Premium Rationale Box:
o Correct Answer: B
o Pathophysiology Summary: Amiodarone is indicated for shock-refractory
VF/pVT and selected stable wide-complex tachycardias.
o Distractor Pitfalls: It is not first-line for most SVTs or bradycardia.
QUESTION 9: AMIODARONE LOADING INFUSION
• Question: During the initial amiodarone loading infusion, the client develops significant
hypotension. What is the priority action?
• Options:
A. Increase the rate
B. Slow or stop the infusion and notify the provider
C. Administer an additional bolus
D. Continue at the current rate
• Zero-Flip Premium Rationale Box:
o Correct Answer: B
o Pathophysiology Summary: Amiodarone can cause vasodilation and myocardial
depression; hypotension requires rate reduction or cessation.
o Distractor Pitfalls: Increasing the rate worsens hemodynamic instability.
QUESTION 10: AMIODARONE CHRONIC TOXICITY
