NGN HESI RN CRITICAL CARE V3
EXAM QUESTIONS AND CORRECT
ANSWERS
1. A patient with Acute Respiratory Distress Syndrome (ARDS) is receiving mechanical
ventilation with a PEEP of 15 cm H2O. Which assessment finding is most concerning to the
nurse?
A. Cardiac output of 3.2 L/min
B. PAO2 of 65 mmHg
C. Respiratory rate of 22 breaths/min
D. Tidal volume of 400 mL
Answer: A
Conceptual Explanation: High levels of PEEP increase intrathoracic pressure, which can
decrease venous return to the heart and subsequently lower cardiac output. A CO of 3.2
L/min is below the normal range (4-8 L/min).
2. A patient in the ICU is being treated for septic shock. Despite fluid resuscitation, the MAP
remains at 55 mmHg. Which medication should the nurse anticipate administering first?
A. Norepinephrine
B. Dopamine
,C. Dobutamine
D. Nitroprusside
Answer: A
Conceptual Explanation: Norepinephrine is the first-line vasopressor for septic shock
refractory to fluid resuscitation to maintain a MAP >65 mmHg.
3. A client has a central venous pressure (CVP) of 20 mmHg and a pulmonary capillary wedge
pressure (PCWP) of 22 mmHg. Which condition does the nurse suspect?
A. Hypovolemic shock
B. Anaphylactic shock
C. Right ventricular failure only
D. Hypervolemia
Answer: D
Conceptual Explanation: Elevated CVP (normal 2-8 mmHg) and PCWP (normal 6-12
mmHg) both indicate fluid volume excess or hypervolemia.
4. The nurse is caring for a patient on a ventilator. The high-pressure alarm sounds. Which
action should the nurse take first?
A. Manually bag the patient
B. Suction the patient’s airway
C. Assess the tubing for kinks
, D. Check the oxygen connection
Answer: C
Conceptual Explanation: Initial action for a high-pressure alarm should be checking for
obstructions such as kinks or the patient biting the tube before moving to more invasive
actions like suctioning.
5. A patient with a traumatic brain injury has an intracranial pressure (ICP) of 22 mmHg and a
MAP of 70 mmHg. What is the Cerebral Perfusion Pressure (CPP)?
A. 48 mmHg
B. 92 mmHg
C. 50 mmHg
D. 1540 mmHg
Answer: A
Conceptual Explanation: CPP is calculated as MAP minus ICP (70 - 22 = 48 mmHg).
Normal CPP is 60-100 mmHg; 48 is low.
6. Which rhythm is characterized by a lack of P waves and an irregular ventricular rate?
A. Atrial Fibrillation
B. Ventricular Tachycardia
C. Third-degree Heart Block
D. Sinus Bradycardia
EXAM QUESTIONS AND CORRECT
ANSWERS
1. A patient with Acute Respiratory Distress Syndrome (ARDS) is receiving mechanical
ventilation with a PEEP of 15 cm H2O. Which assessment finding is most concerning to the
nurse?
A. Cardiac output of 3.2 L/min
B. PAO2 of 65 mmHg
C. Respiratory rate of 22 breaths/min
D. Tidal volume of 400 mL
Answer: A
Conceptual Explanation: High levels of PEEP increase intrathoracic pressure, which can
decrease venous return to the heart and subsequently lower cardiac output. A CO of 3.2
L/min is below the normal range (4-8 L/min).
2. A patient in the ICU is being treated for septic shock. Despite fluid resuscitation, the MAP
remains at 55 mmHg. Which medication should the nurse anticipate administering first?
A. Norepinephrine
B. Dopamine
,C. Dobutamine
D. Nitroprusside
Answer: A
Conceptual Explanation: Norepinephrine is the first-line vasopressor for septic shock
refractory to fluid resuscitation to maintain a MAP >65 mmHg.
3. A client has a central venous pressure (CVP) of 20 mmHg and a pulmonary capillary wedge
pressure (PCWP) of 22 mmHg. Which condition does the nurse suspect?
A. Hypovolemic shock
B. Anaphylactic shock
C. Right ventricular failure only
D. Hypervolemia
Answer: D
Conceptual Explanation: Elevated CVP (normal 2-8 mmHg) and PCWP (normal 6-12
mmHg) both indicate fluid volume excess or hypervolemia.
4. The nurse is caring for a patient on a ventilator. The high-pressure alarm sounds. Which
action should the nurse take first?
A. Manually bag the patient
B. Suction the patient’s airway
C. Assess the tubing for kinks
, D. Check the oxygen connection
Answer: C
Conceptual Explanation: Initial action for a high-pressure alarm should be checking for
obstructions such as kinks or the patient biting the tube before moving to more invasive
actions like suctioning.
5. A patient with a traumatic brain injury has an intracranial pressure (ICP) of 22 mmHg and a
MAP of 70 mmHg. What is the Cerebral Perfusion Pressure (CPP)?
A. 48 mmHg
B. 92 mmHg
C. 50 mmHg
D. 1540 mmHg
Answer: A
Conceptual Explanation: CPP is calculated as MAP minus ICP (70 - 22 = 48 mmHg).
Normal CPP is 60-100 mmHg; 48 is low.
6. Which rhythm is characterized by a lack of P waves and an irregular ventricular rate?
A. Atrial Fibrillation
B. Ventricular Tachycardia
C. Third-degree Heart Block
D. Sinus Bradycardia
