NGN HESI RN CRITICAL CARE
PRACTICE EXAM QUESTIONS AND
CORRECT ANSWERS
1. A patient in the ICU has a Central Venous Pressure (CVP) of 18 mmHg. Which clinical
assessment finding is the nurse most likely to observe?
A. Poor skin turgor and dry mucous membranes
B. Flat neck veins when the head of the bed is at 30 degrees
C. Jugular venous distention and peripheral edema
D. A heart rate of 120 beats per minute with a thready pulse
Answer: C
Conceptual Explanation: A normal CVP is 2-8 mmHg. A value of 18 mmHg indicates fluid
volume overload or right-sided heart failure, which manifests as JVD and edema.
2. Which mechanical ventilator setting is specifically designed to prevent the collapse of small
airways and alveoli at the end of expiration?
A. Positive End-Expiratory Pressure (PEEP)
B. Fraction of Inspired Oxygen (FiO2)
C. Tidal Volume (Vt)
D. Inspiratory Flow Rate
,Answer: A
Conceptual Explanation: PEEP maintains pressure in the lungs at the end of expiration to
keep alveoli open, improving gas exchange and oxygenation, especially in ARDS.
3. A patient with Acute Respiratory Distress Syndrome (ARDS) is placed in the prone position.
What is the primary physiological benefit of this intervention?
A. Decreasing the patient’s work of breathing
B. Recruiting collapsed alveoli in the posterior lung segments
C. Reducing the need for sedation and neuromuscular blockade
D. Allowing for easier suctioning of tracheal secretions
Answer: B
Conceptual Explanation: Prone positioning improves oxygenation by redistributing
pulmonary blood flow and recruiting alveoli in the dorsal (posterior) areas of the lungs.
4. A patient is admitted with a suspected spinal cord injury at T4. The nurse notes a blood
pressure of 82/40 mmHg and a heart rate of 48 bpm. Which type of shock is suspected?
A. Hypovolemic shock
B. Neurogenic shock
C. Cardiogenic shock
D. Septic shock
Answer: B
, Conceptual Explanation: Neurogenic shock occurs with spinal injuries above T6,
characterized by hypotension and bradycardia due to loss of sympathetic tone.
5. The nurse is caring for a patient on a ventilator who triggers the high-pressure alarm.
Which action should the nurse take first?
A. Check the ventilator tubing for kinks or condensation
B. Increase the oxygen concentration to 100%
C. Suction the patient to clear secretions
D. Auscultate the patient’s breath sounds
Answer: D
Conceptual Explanation: While checking for kinks is important, the nurse must first
assess the patient’s clinical status (breath sounds) to rule out pneumothorax or acute
distress.
6. Which lab value is the most sensitive indicator of adequate fluid resuscitation in a patient
with septic shock?
A. Serum Creatinine
B. Blood Urea Nitrogen (BUN)
C. White Blood Cell (WBC) count
D. Serum Lactate level
Answer: D
PRACTICE EXAM QUESTIONS AND
CORRECT ANSWERS
1. A patient in the ICU has a Central Venous Pressure (CVP) of 18 mmHg. Which clinical
assessment finding is the nurse most likely to observe?
A. Poor skin turgor and dry mucous membranes
B. Flat neck veins when the head of the bed is at 30 degrees
C. Jugular venous distention and peripheral edema
D. A heart rate of 120 beats per minute with a thready pulse
Answer: C
Conceptual Explanation: A normal CVP is 2-8 mmHg. A value of 18 mmHg indicates fluid
volume overload or right-sided heart failure, which manifests as JVD and edema.
2. Which mechanical ventilator setting is specifically designed to prevent the collapse of small
airways and alveoli at the end of expiration?
A. Positive End-Expiratory Pressure (PEEP)
B. Fraction of Inspired Oxygen (FiO2)
C. Tidal Volume (Vt)
D. Inspiratory Flow Rate
,Answer: A
Conceptual Explanation: PEEP maintains pressure in the lungs at the end of expiration to
keep alveoli open, improving gas exchange and oxygenation, especially in ARDS.
3. A patient with Acute Respiratory Distress Syndrome (ARDS) is placed in the prone position.
What is the primary physiological benefit of this intervention?
A. Decreasing the patient’s work of breathing
B. Recruiting collapsed alveoli in the posterior lung segments
C. Reducing the need for sedation and neuromuscular blockade
D. Allowing for easier suctioning of tracheal secretions
Answer: B
Conceptual Explanation: Prone positioning improves oxygenation by redistributing
pulmonary blood flow and recruiting alveoli in the dorsal (posterior) areas of the lungs.
4. A patient is admitted with a suspected spinal cord injury at T4. The nurse notes a blood
pressure of 82/40 mmHg and a heart rate of 48 bpm. Which type of shock is suspected?
A. Hypovolemic shock
B. Neurogenic shock
C. Cardiogenic shock
D. Septic shock
Answer: B
, Conceptual Explanation: Neurogenic shock occurs with spinal injuries above T6,
characterized by hypotension and bradycardia due to loss of sympathetic tone.
5. The nurse is caring for a patient on a ventilator who triggers the high-pressure alarm.
Which action should the nurse take first?
A. Check the ventilator tubing for kinks or condensation
B. Increase the oxygen concentration to 100%
C. Suction the patient to clear secretions
D. Auscultate the patient’s breath sounds
Answer: D
Conceptual Explanation: While checking for kinks is important, the nurse must first
assess the patient’s clinical status (breath sounds) to rule out pneumothorax or acute
distress.
6. Which lab value is the most sensitive indicator of adequate fluid resuscitation in a patient
with septic shock?
A. Serum Creatinine
B. Blood Urea Nitrogen (BUN)
C. White Blood Cell (WBC) count
D. Serum Lactate level
Answer: D
