Critical Care HESI Practice
Questions and Answers Latest
2026&2027(Critical Care HESI test
bank graded A)
Course
Critical Care HESI Practice
1. A client with 30% total body surface area burns sustained the injury at 1200. The
prescribed 24-hour fluid replacement is 8,000 mL. By what time should the first 4,000
mL be administered?
A. 1600
B. 1800
C. 2000
D. 2400
Answer: C. 2000
Rationale: Half of the calculated 24-hour fluid requirement is administered during the first 8
hours after the burn. Eight hours after 1200 is 2000.
2. A client with septic shock remains hypotensive after adequate initial fluid resuscitation.
Which medication should the nurse anticipate administering?
A. Norepinephrine
B. Furosemide
C. Metoprolol
D. Digoxin
Answer: A. Norepinephrine
Rationale: Norepinephrine is a commonly used vasopressor for persistent hypotension in septic
shock after adequate fluid resuscitation.
3. A mechanically ventilated client develops a sudden high-pressure alarm. Which action
should the nurse take first?
A. Increase the tidal volume
B. Assess the tubing and airway for obstruction
C. Decrease the respiratory rate
D. Increase the PEEP
,Answer: B. Assess the tubing and airway for obstruction
Rationale: A high-pressure alarm may result from secretions, a kinked tube, biting the
endotracheal tube, bronchospasm, or decreased lung compliance. The airway and ventilator
circuit should be assessed immediately.
4. Which arterial blood gas result indicates respiratory acidosis?
A. pH 7.29, PaCO₂ 54 mm Hg, HCO₃⁻ 24 mEq/L
B. pH 7.49, PaCO₂ 29 mm Hg, HCO₃⁻ 23 mEq/L
C. pH 7.29, PaCO₂ 32 mm Hg, HCO₃⁻ 16 mEq/L
D. pH 7.42, PaCO₂ 40 mm Hg, HCO₃⁻ 24 mEq/L
Answer: A. pH 7.29, PaCO₂ 54 mm Hg, HCO₃⁻ 24 mEq/L
Rationale: The low pH indicates acidemia, while the elevated PaCO₂ indicates a respiratory
cause. The normal bicarbonate suggests little or no metabolic compensation.
5. A client with acute pulmonary edema is severely dyspneic with bilateral crackles. Which
intervention is the priority?
A. Place the client in high-Fowler position
B. Place the client supine
C. Encourage oral fluids
D. Encourage ambulation
Answer: A. Place the client in high-Fowler position
Rationale: High-Fowler positioning improves lung expansion and can reduce venous return,
helping decrease pulmonary congestion while additional treatment is initiated.
6. A client develops ventricular fibrillation and has no palpable pulse. What is the priority
intervention?
A. Administer oral aspirin
B. Initiate CPR and prepare for immediate defibrillation
C. Obtain a routine chest x-ray
D. Administer a beta blocker
Answer: B. Initiate CPR and prepare for immediate defibrillation
Rationale: Pulseless ventricular fibrillation is a shockable cardiac-arrest rhythm. High-quality
CPR and prompt defibrillation are critical interventions.
7. A client receiving potassium replacement develops muscle weakness and peaked T waves
on the ECG. Which complication should the nurse suspect?
,A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypernatremia
Answer: B. Hyperkalemia
Rationale: Peaked T waves are a classic ECG manifestation of hyperkalemia. Severe
hyperkalemia can cause life-threatening cardiac dysrhythmias.
8. A client with hypovolemic shock is being assessed. Which finding is most expected?
A. Bounding pulse and warm skin
B. Bradycardia and hypertension
C. Tachycardia and cool clammy skin
D. Severe hypertension and flushed skin
Answer: C. Tachycardia and cool clammy skin
Rationale: Loss of circulating volume activates the sympathetic nervous system, producing
tachycardia and peripheral vasoconstriction.
9. A client with diabetic ketoacidosis has a serum potassium of 2.9 mEq/L. Which action is
the priority?
A. Start insulin immediately
B. Administer potassium as prescribed before insulin therapy
C. Restrict IV fluids
D. Administer sodium bicarbonate routinely
Answer: B. Administer potassium as prescribed before insulin therapy
Rationale: Insulin drives potassium into cells and can further decrease serum potassium.
Significant hypokalemia must be corrected before insulin is initiated.
10. A client with acute kidney injury has a potassium level of 6.8 mEq/L and peaked T
waves. Which prescription should the nurse address first?
A. Low-protein diet
B. Continuous cardiac monitoring and emergency treatment of hyperkalemia
C. Oral multivitamin
D. Routine weight measurement
Answer: B. Continuous cardiac monitoring and emergency treatment of hyperkalemia
Rationale: Severe hyperkalemia with ECG changes can rapidly cause fatal dysrhythmias and
requires immediate intervention.
, 11. A client with acute myocardial infarction develops hypotension, pulmonary crackles, and
cool extremities. Which type of shock is most likely?
A. Hypovolemic shock
B. Cardiogenic shock
C. Neurogenic shock
D. Anaphylactic shock
Answer: B. Cardiogenic shock
Rationale: Myocardial infarction can severely impair cardiac pumping ability, producing low
cardiac output, hypotension, pulmonary congestion, and peripheral vasoconstriction.
12. A client suddenly develops dyspnea, pleuritic chest pain, tachycardia, and hypoxemia.
Pulmonary embolism is suspected. What should the nurse do first?
A. Apply supplemental oxygen
B. Encourage ambulation
C. Place the client flat
D. Offer oral fluids
Answer: A. Apply supplemental oxygen
Rationale: The immediate priority is supporting oxygenation and respiratory status while
emergency evaluation and treatment proceed.
13. Which finding is most concerning in a client with increased intracranial pressure?
A. New decrease in level of consciousness
B. Mild thirst
C. Increased appetite
D. Warm hands
Answer: A. New decrease in level of consciousness
Rationale: A change in level of consciousness is an important indicator of neurologic
deterioration and possible worsening intracranial pressure.
14. A client with a traumatic brain injury develops worsening neurologic status. Which
intervention is appropriate to help reduce secondary brain injury?
A. Maintain adequate oxygenation and ventilation
B. Allow prolonged hypoxemia
C. Encourage excessive coughing
D. Keep the head completely flat
Answer: A. Maintain adequate oxygenation and ventilation
Questions and Answers Latest
2026&2027(Critical Care HESI test
bank graded A)
Course
Critical Care HESI Practice
1. A client with 30% total body surface area burns sustained the injury at 1200. The
prescribed 24-hour fluid replacement is 8,000 mL. By what time should the first 4,000
mL be administered?
A. 1600
B. 1800
C. 2000
D. 2400
Answer: C. 2000
Rationale: Half of the calculated 24-hour fluid requirement is administered during the first 8
hours after the burn. Eight hours after 1200 is 2000.
2. A client with septic shock remains hypotensive after adequate initial fluid resuscitation.
Which medication should the nurse anticipate administering?
A. Norepinephrine
B. Furosemide
C. Metoprolol
D. Digoxin
Answer: A. Norepinephrine
Rationale: Norepinephrine is a commonly used vasopressor for persistent hypotension in septic
shock after adequate fluid resuscitation.
3. A mechanically ventilated client develops a sudden high-pressure alarm. Which action
should the nurse take first?
A. Increase the tidal volume
B. Assess the tubing and airway for obstruction
C. Decrease the respiratory rate
D. Increase the PEEP
,Answer: B. Assess the tubing and airway for obstruction
Rationale: A high-pressure alarm may result from secretions, a kinked tube, biting the
endotracheal tube, bronchospasm, or decreased lung compliance. The airway and ventilator
circuit should be assessed immediately.
4. Which arterial blood gas result indicates respiratory acidosis?
A. pH 7.29, PaCO₂ 54 mm Hg, HCO₃⁻ 24 mEq/L
B. pH 7.49, PaCO₂ 29 mm Hg, HCO₃⁻ 23 mEq/L
C. pH 7.29, PaCO₂ 32 mm Hg, HCO₃⁻ 16 mEq/L
D. pH 7.42, PaCO₂ 40 mm Hg, HCO₃⁻ 24 mEq/L
Answer: A. pH 7.29, PaCO₂ 54 mm Hg, HCO₃⁻ 24 mEq/L
Rationale: The low pH indicates acidemia, while the elevated PaCO₂ indicates a respiratory
cause. The normal bicarbonate suggests little or no metabolic compensation.
5. A client with acute pulmonary edema is severely dyspneic with bilateral crackles. Which
intervention is the priority?
A. Place the client in high-Fowler position
B. Place the client supine
C. Encourage oral fluids
D. Encourage ambulation
Answer: A. Place the client in high-Fowler position
Rationale: High-Fowler positioning improves lung expansion and can reduce venous return,
helping decrease pulmonary congestion while additional treatment is initiated.
6. A client develops ventricular fibrillation and has no palpable pulse. What is the priority
intervention?
A. Administer oral aspirin
B. Initiate CPR and prepare for immediate defibrillation
C. Obtain a routine chest x-ray
D. Administer a beta blocker
Answer: B. Initiate CPR and prepare for immediate defibrillation
Rationale: Pulseless ventricular fibrillation is a shockable cardiac-arrest rhythm. High-quality
CPR and prompt defibrillation are critical interventions.
7. A client receiving potassium replacement develops muscle weakness and peaked T waves
on the ECG. Which complication should the nurse suspect?
,A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypernatremia
Answer: B. Hyperkalemia
Rationale: Peaked T waves are a classic ECG manifestation of hyperkalemia. Severe
hyperkalemia can cause life-threatening cardiac dysrhythmias.
8. A client with hypovolemic shock is being assessed. Which finding is most expected?
A. Bounding pulse and warm skin
B. Bradycardia and hypertension
C. Tachycardia and cool clammy skin
D. Severe hypertension and flushed skin
Answer: C. Tachycardia and cool clammy skin
Rationale: Loss of circulating volume activates the sympathetic nervous system, producing
tachycardia and peripheral vasoconstriction.
9. A client with diabetic ketoacidosis has a serum potassium of 2.9 mEq/L. Which action is
the priority?
A. Start insulin immediately
B. Administer potassium as prescribed before insulin therapy
C. Restrict IV fluids
D. Administer sodium bicarbonate routinely
Answer: B. Administer potassium as prescribed before insulin therapy
Rationale: Insulin drives potassium into cells and can further decrease serum potassium.
Significant hypokalemia must be corrected before insulin is initiated.
10. A client with acute kidney injury has a potassium level of 6.8 mEq/L and peaked T
waves. Which prescription should the nurse address first?
A. Low-protein diet
B. Continuous cardiac monitoring and emergency treatment of hyperkalemia
C. Oral multivitamin
D. Routine weight measurement
Answer: B. Continuous cardiac monitoring and emergency treatment of hyperkalemia
Rationale: Severe hyperkalemia with ECG changes can rapidly cause fatal dysrhythmias and
requires immediate intervention.
, 11. A client with acute myocardial infarction develops hypotension, pulmonary crackles, and
cool extremities. Which type of shock is most likely?
A. Hypovolemic shock
B. Cardiogenic shock
C. Neurogenic shock
D. Anaphylactic shock
Answer: B. Cardiogenic shock
Rationale: Myocardial infarction can severely impair cardiac pumping ability, producing low
cardiac output, hypotension, pulmonary congestion, and peripheral vasoconstriction.
12. A client suddenly develops dyspnea, pleuritic chest pain, tachycardia, and hypoxemia.
Pulmonary embolism is suspected. What should the nurse do first?
A. Apply supplemental oxygen
B. Encourage ambulation
C. Place the client flat
D. Offer oral fluids
Answer: A. Apply supplemental oxygen
Rationale: The immediate priority is supporting oxygenation and respiratory status while
emergency evaluation and treatment proceed.
13. Which finding is most concerning in a client with increased intracranial pressure?
A. New decrease in level of consciousness
B. Mild thirst
C. Increased appetite
D. Warm hands
Answer: A. New decrease in level of consciousness
Rationale: A change in level of consciousness is an important indicator of neurologic
deterioration and possible worsening intracranial pressure.
14. A client with a traumatic brain injury develops worsening neurologic status. Which
intervention is appropriate to help reduce secondary brain injury?
A. Maintain adequate oxygenation and ventilation
B. Allow prolonged hypoxemia
C. Encourage excessive coughing
D. Keep the head completely flat
Answer: A. Maintain adequate oxygenation and ventilation
