NGN HESI RN CRITICAL CARE FINAL
EXAM 2026/2027 QUESTIONS AND
CORRECT ANSWERS
1. A patient in the ICU is diagnosed with Septic Shock. Which of the following hemodynamic
findings is most characteristic of the early (hyperdynamic) phase?
A. Decreased Cardiac Output and increased Systemic Vascular Resistance (SVR)
B. Decreased Central Venous Pressure (CVP) and increased SVR
C. Increased Pulmonary Capillary Wedge Pressure (PCWP) and bradycardia
D. Increased Cardiac Output and decreased Systemic Vascular Resistance (SVR)
Answer: D
Conceptual Explanation: In early septic shock, the body compensates for vasodilation by
increasing cardiac output. SVR is low due to massive peripheral vasodilation caused by
inflammatory mediators.
2. A nurse is caring for a patient on mechanical ventilation. The high-pressure alarm sounds.
Which action should the nurse take first?
A. Check for a leak in the ventilator circuit
B. Decrease the PEEP setting
C. Suction the patient to clear secretions
,D. Increase the oxygen concentration to 100%
Answer: C
Conceptual Explanation: High-pressure alarms are triggered by increased resistance,
such as secretions, biting the tube, or kinks. Suctioning is the priority intervention to clear
the airway.
3. A patient with a traumatic brain injury has an ICP of 22 mmHg and a MAP of 85 mmHg.
What is the calculated Cerebral Perfusion Pressure (CPP)?
A. 107 mmHg
B. 63 mmHg
C. 60 mmHg
D. 110 mmHg
Answer: B
Conceptual Explanation: CPP is calculated as MAP minus ICP (85 - 22 = 63). A normal CPP
is typically 60-100 mmHg.
4. Which cardiac rhythm requires immediate unsynchronized cardioversion (defibrillation)?
A. Atrial Fibrillation with RVR
B. Supraventricular Tachycardia
C. Pulseless Ventricular Tachycardia
D. Second-degree AV Block Type II
, Answer: C
Conceptual Explanation: Pulseless Ventricular Tachycardia and Ventricular Fibrillation
are shockable rhythms requiring immediate defibrillation. Synchronized cardioversion is
used for stable tachycardias with a pulse.
5. A patient with Acute Respiratory Distress Syndrome (ARDS) is placed in the prone position.
What is the primary physiological benefit of this intervention?
A. To improve recruitment of posterior lung segments and oxygenation
B. To decrease the work of breathing for the patient
C. To prevent ventilator-associated pneumonia (VAP)
D. To facilitate easier suctioning of the airway
Answer: A
Conceptual Explanation: Prone positioning shifts the heart and abdominal contents away
from the posterior lungs, allowing alveoli in those areas to reopen (recruitment) and
improving V/Q matching.
6. A patient is admitted with Cardiogenic Shock. Which hemodynamic parameter is the nurse
most likely to observe?
A. PCWP of 4 mmHg
B. Cardiac Index of 1.8 L/min/m2
C. SVR of 600 dynes/sec/cm-5
EXAM 2026/2027 QUESTIONS AND
CORRECT ANSWERS
1. A patient in the ICU is diagnosed with Septic Shock. Which of the following hemodynamic
findings is most characteristic of the early (hyperdynamic) phase?
A. Decreased Cardiac Output and increased Systemic Vascular Resistance (SVR)
B. Decreased Central Venous Pressure (CVP) and increased SVR
C. Increased Pulmonary Capillary Wedge Pressure (PCWP) and bradycardia
D. Increased Cardiac Output and decreased Systemic Vascular Resistance (SVR)
Answer: D
Conceptual Explanation: In early septic shock, the body compensates for vasodilation by
increasing cardiac output. SVR is low due to massive peripheral vasodilation caused by
inflammatory mediators.
2. A nurse is caring for a patient on mechanical ventilation. The high-pressure alarm sounds.
Which action should the nurse take first?
A. Check for a leak in the ventilator circuit
B. Decrease the PEEP setting
C. Suction the patient to clear secretions
,D. Increase the oxygen concentration to 100%
Answer: C
Conceptual Explanation: High-pressure alarms are triggered by increased resistance,
such as secretions, biting the tube, or kinks. Suctioning is the priority intervention to clear
the airway.
3. A patient with a traumatic brain injury has an ICP of 22 mmHg and a MAP of 85 mmHg.
What is the calculated Cerebral Perfusion Pressure (CPP)?
A. 107 mmHg
B. 63 mmHg
C. 60 mmHg
D. 110 mmHg
Answer: B
Conceptual Explanation: CPP is calculated as MAP minus ICP (85 - 22 = 63). A normal CPP
is typically 60-100 mmHg.
4. Which cardiac rhythm requires immediate unsynchronized cardioversion (defibrillation)?
A. Atrial Fibrillation with RVR
B. Supraventricular Tachycardia
C. Pulseless Ventricular Tachycardia
D. Second-degree AV Block Type II
, Answer: C
Conceptual Explanation: Pulseless Ventricular Tachycardia and Ventricular Fibrillation
are shockable rhythms requiring immediate defibrillation. Synchronized cardioversion is
used for stable tachycardias with a pulse.
5. A patient with Acute Respiratory Distress Syndrome (ARDS) is placed in the prone position.
What is the primary physiological benefit of this intervention?
A. To improve recruitment of posterior lung segments and oxygenation
B. To decrease the work of breathing for the patient
C. To prevent ventilator-associated pneumonia (VAP)
D. To facilitate easier suctioning of the airway
Answer: A
Conceptual Explanation: Prone positioning shifts the heart and abdominal contents away
from the posterior lungs, allowing alveoli in those areas to reopen (recruitment) and
improving V/Q matching.
6. A patient is admitted with Cardiogenic Shock. Which hemodynamic parameter is the nurse
most likely to observe?
A. PCWP of 4 mmHg
B. Cardiac Index of 1.8 L/min/m2
C. SVR of 600 dynes/sec/cm-5
