NGN HESI RN CRITICAL CARE V1
EXAM QUESTIONS AND CORRECT
ANSWERS
1. A patient in the ICU has a Central Venous Pressure (CVP) of 1 mmHg and a heart rate of 115
bpm. Which intervention should the nurse anticipate first?
A. Administer Furosemide 40 mg IV push.
B. Initiate a Norepinephrine infusion at 2 mcg/min.
C. Administer a 500 mL bolus of 0.9% Normal Saline.
D. Perform an immediate synchronized cardioversion.
Answer: C
Conceptual Explanation: A CVP of 1 mmHg indicates significant fluid volume deficit
(normal range 2-8 mmHg). The tachycardia is a compensatory mechanism. Volume
resuscitation is the priority.
2. A client with ARDS is being mechanically ventilated with a PEEP of 15 cm H2O. Which
assessment finding is most concerning to the nurse?
A. PaO2 of 65 mmHg.
B. Crackles at the lung bases.
C. A drop in blood pressure from 120/80 to 90/60 mmHg.
,D. Respiratory rate of 22 breaths per minute.
Answer: C
Conceptual Explanation: High levels of PEEP increase intrathoracic pressure, which
decreases venous return and cardiac output, leading to hypotension.
3. The nurse is caring for a patient in septic shock. The healthcare provider orders a fluid
bolus of 30 mL/kg. What is the primary goal of this intervention?
A. Achieve a Mean Arterial Pressure (MAP) of at least 65 mmHg.
B. Decrease the heart rate to below 100 bpm.
C. Increase the systemic vascular resistance (SVR).
D. Reduce the patient’s serum lactate levels.
Answer: A
Conceptual Explanation: In septic shock, the goal of fluid resuscitation is to maintain
adequate tissue perfusion, typically measured by a MAP of 65 mmHg or higher.
4. A patient develops ventricular fibrillation. After calling for help and starting CPR, what is
the next priority action?
A. Administer Epinephrine 1 mg IV push.
B. Prepare for immediate synchronized cardioversion.
C. Intubate the patient to secure the airway.
D. Defibrillate the patient as soon as a shock is advised.
, Answer: D
Conceptual Explanation: For ventricular fibrillation, the priority is early defibrillation.
Synchronization is for rhythms with a pulse.
5. A client is admitted with a suspected traumatic brain injury. Which of the following
assessment findings represents Cushing’s Triad?
A. Bradycardia, hypertension with widened pulse pressure, and irregular respirations.
B. Tachycardia, hypotension, and tachypnea.
C. Hypotension, bradycardia, and Cheyne-Stokes respirations.
D. Tachycardia, hypertension, and hyperthermia.
Answer: A
Conceptual Explanation: Cushing’s Triad (bradycardia, hypertension/widened pulse
pressure, and irregular breathing) is a late sign of increased intracranial pressure.
6. A patient with a pulmonary artery catheter has a Pulmonary Artery Wedge Pressure
(PAWP) of 22 mmHg. Which medication does the nurse expect to administer?
A. Furosemide
B. Lactated Ringer’s
C. Vasopressin
D. Albumin
Answer: A
EXAM QUESTIONS AND CORRECT
ANSWERS
1. A patient in the ICU has a Central Venous Pressure (CVP) of 1 mmHg and a heart rate of 115
bpm. Which intervention should the nurse anticipate first?
A. Administer Furosemide 40 mg IV push.
B. Initiate a Norepinephrine infusion at 2 mcg/min.
C. Administer a 500 mL bolus of 0.9% Normal Saline.
D. Perform an immediate synchronized cardioversion.
Answer: C
Conceptual Explanation: A CVP of 1 mmHg indicates significant fluid volume deficit
(normal range 2-8 mmHg). The tachycardia is a compensatory mechanism. Volume
resuscitation is the priority.
2. A client with ARDS is being mechanically ventilated with a PEEP of 15 cm H2O. Which
assessment finding is most concerning to the nurse?
A. PaO2 of 65 mmHg.
B. Crackles at the lung bases.
C. A drop in blood pressure from 120/80 to 90/60 mmHg.
,D. Respiratory rate of 22 breaths per minute.
Answer: C
Conceptual Explanation: High levels of PEEP increase intrathoracic pressure, which
decreases venous return and cardiac output, leading to hypotension.
3. The nurse is caring for a patient in septic shock. The healthcare provider orders a fluid
bolus of 30 mL/kg. What is the primary goal of this intervention?
A. Achieve a Mean Arterial Pressure (MAP) of at least 65 mmHg.
B. Decrease the heart rate to below 100 bpm.
C. Increase the systemic vascular resistance (SVR).
D. Reduce the patient’s serum lactate levels.
Answer: A
Conceptual Explanation: In septic shock, the goal of fluid resuscitation is to maintain
adequate tissue perfusion, typically measured by a MAP of 65 mmHg or higher.
4. A patient develops ventricular fibrillation. After calling for help and starting CPR, what is
the next priority action?
A. Administer Epinephrine 1 mg IV push.
B. Prepare for immediate synchronized cardioversion.
C. Intubate the patient to secure the airway.
D. Defibrillate the patient as soon as a shock is advised.
, Answer: D
Conceptual Explanation: For ventricular fibrillation, the priority is early defibrillation.
Synchronization is for rhythms with a pulse.
5. A client is admitted with a suspected traumatic brain injury. Which of the following
assessment findings represents Cushing’s Triad?
A. Bradycardia, hypertension with widened pulse pressure, and irregular respirations.
B. Tachycardia, hypotension, and tachypnea.
C. Hypotension, bradycardia, and Cheyne-Stokes respirations.
D. Tachycardia, hypertension, and hyperthermia.
Answer: A
Conceptual Explanation: Cushing’s Triad (bradycardia, hypertension/widened pulse
pressure, and irregular breathing) is a late sign of increased intracranial pressure.
6. A patient with a pulmonary artery catheter has a Pulmonary Artery Wedge Pressure
(PAWP) of 22 mmHg. Which medication does the nurse expect to administer?
A. Furosemide
B. Lactated Ringer’s
C. Vasopressin
D. Albumin
Answer: A
