NGN HESI RN CRITICAL CARE FINAL
EXAM PREP QUESTIONS AND
CORRECT ANSWERS
1. A patient in the ICU has a Pulmonary Capillary Wedge Pressure (PCWP) of 22 mmHg. Which
clinical finding should the nurse expect to assess?
A. Jugular venous distention and peripheral edema
B. Decreased urinary output and poor skin turgor
C. Crackles in the lungs and dyspnea
D. Hyperactive bowel sounds and increased appetite
Answer: C
Conceptual Explanation: A normal PCWP is 4 to 12 mmHg. A level of 22 mmHg indicates
left-sided heart failure or fluid overload, leading to pulmonary congestion (crackles and
dyspnea). Options A reflects right-sided failure.
2. A client is on mechanical ventilation with Pressure Support Ventilation (PSV). What is the
primary purpose of this mode?
A. To guarantee a specific tidal volume for every breath
B. To provide a mandatory respiratory rate for the patient
C. To decrease the work of breathing during spontaneous breaths
,D. To deliver a high concentration of oxygen during emergencies
Answer: C
Conceptual Explanation: Pressure Support Ventilation is used to decrease the work of
breathing by providing a preset pressure during spontaneous inspiration, often used
during weaning.
3. A patient with a traumatic brain injury (TBI) has an intracranial pressure (ICP) of 25 mmHg.
Which nursing intervention is a priority?
A. Hyperventilate the patient to a PaCO2 of 25 mmHg
B. Maintain the head of the bed at 30 to 45 degrees
C. Cluster nursing care to promote rest
D. Suction the patient every hour to ensure airway patency
Answer: B
Conceptual Explanation: Elevating the head of the bed promotes venous drainage and
helps lower ICP. Clustering care and frequent suctioning can actually increase ICP.
Hyperventilation is only a short-term emergency measure.
4. In the early stages of septic shock, which hemodynamic parameter would the nurse most
likely observe?
A. Increased Systemic Vascular Resistance (SVR)
B. Decreased Cardiac Output (CO)
, C. Increased Pulmonary Capillary Wedge Pressure (PCWP)
D. Decreased Systemic Vascular Resistance (SVR)
Answer: D
Conceptual Explanation: Septic shock is a distributive shock characterized by massive
vasodilation, which leads to a decrease in SVR. Cardiac output is usually increased initially
as a compensatory mechanism.
5. A patient is admitted with Acute Respiratory Distress Syndrome (ARDS). Which ventilator
setting is specifically used to prevent alveolar collapse at the end of expiration?
A. Fraction of Inspired Oxygen (FiO2)
B. Tidal Volume (TV)
C. Inspiratory Reserve Volume (IRV)
D. Positive End-Expiratory Pressure (PEEP)
Answer: D
Conceptual Explanation: PEEP provides pressure at the end of expiration to keep the
alveoli open, improving gas exchange and preventing atelectasis in ARDS.
6. Which assessment finding in a patient with a T4 spinal cord injury indicates Autonomic
Dysreflexia?
A. Hypotension and tachycardia
B. Sudden hypertension and pounding headache
EXAM PREP QUESTIONS AND
CORRECT ANSWERS
1. A patient in the ICU has a Pulmonary Capillary Wedge Pressure (PCWP) of 22 mmHg. Which
clinical finding should the nurse expect to assess?
A. Jugular venous distention and peripheral edema
B. Decreased urinary output and poor skin turgor
C. Crackles in the lungs and dyspnea
D. Hyperactive bowel sounds and increased appetite
Answer: C
Conceptual Explanation: A normal PCWP is 4 to 12 mmHg. A level of 22 mmHg indicates
left-sided heart failure or fluid overload, leading to pulmonary congestion (crackles and
dyspnea). Options A reflects right-sided failure.
2. A client is on mechanical ventilation with Pressure Support Ventilation (PSV). What is the
primary purpose of this mode?
A. To guarantee a specific tidal volume for every breath
B. To provide a mandatory respiratory rate for the patient
C. To decrease the work of breathing during spontaneous breaths
,D. To deliver a high concentration of oxygen during emergencies
Answer: C
Conceptual Explanation: Pressure Support Ventilation is used to decrease the work of
breathing by providing a preset pressure during spontaneous inspiration, often used
during weaning.
3. A patient with a traumatic brain injury (TBI) has an intracranial pressure (ICP) of 25 mmHg.
Which nursing intervention is a priority?
A. Hyperventilate the patient to a PaCO2 of 25 mmHg
B. Maintain the head of the bed at 30 to 45 degrees
C. Cluster nursing care to promote rest
D. Suction the patient every hour to ensure airway patency
Answer: B
Conceptual Explanation: Elevating the head of the bed promotes venous drainage and
helps lower ICP. Clustering care and frequent suctioning can actually increase ICP.
Hyperventilation is only a short-term emergency measure.
4. In the early stages of septic shock, which hemodynamic parameter would the nurse most
likely observe?
A. Increased Systemic Vascular Resistance (SVR)
B. Decreased Cardiac Output (CO)
, C. Increased Pulmonary Capillary Wedge Pressure (PCWP)
D. Decreased Systemic Vascular Resistance (SVR)
Answer: D
Conceptual Explanation: Septic shock is a distributive shock characterized by massive
vasodilation, which leads to a decrease in SVR. Cardiac output is usually increased initially
as a compensatory mechanism.
5. A patient is admitted with Acute Respiratory Distress Syndrome (ARDS). Which ventilator
setting is specifically used to prevent alveolar collapse at the end of expiration?
A. Fraction of Inspired Oxygen (FiO2)
B. Tidal Volume (TV)
C. Inspiratory Reserve Volume (IRV)
D. Positive End-Expiratory Pressure (PEEP)
Answer: D
Conceptual Explanation: PEEP provides pressure at the end of expiration to keep the
alveoli open, improving gas exchange and preventing atelectasis in ARDS.
6. Which assessment finding in a patient with a T4 spinal cord injury indicates Autonomic
Dysreflexia?
A. Hypotension and tachycardia
B. Sudden hypertension and pounding headache
