PROGRESSIVE CARE RN PRACTICE EXAM
2 QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES
2025
1. A patient with heart failure has a new prescription for enalapril. What
lab value should be monitored most closely?
A. Hemoglobin
B. Potassium
C. Magnesium
D. Glucose
ACE inhibitors can cause hyperkalemia due to reduced aldosterone
production. Monitoring potassium is critical.
2. A patient has atrial fibrillation with a rapid ventricular response. Which
drug is most appropriate initially?
,A. Amiodarone
B. Diltiazem
C. Atropine
D. Dobutamine
Diltiazem, a calcium channel blocker, is often first-line for rate control in
stable AFib.
3. The nurse notes the following ABG: pH 7.32, PaCO₂ 50, HCO₃ 24. What is
the most likely interpretation?
A. Metabolic acidosis
B. Respiratory acidosis
C. Respiratory alkalosis
D. Metabolic alkalosis
The pH is low and the PaCO₂ is high, indicating respiratory acidosis.
4. Which symptom is most concerning in a patient with DKA?
A. Fruity breath odor
B. Polydipsia
C. Tachycardia
D. Altered mental status
Altered mental status indicates cerebral edema or worsening acidosis,
requiring immediate intervention.
,5. A patient on a heparin drip has a PTT of 110 seconds. What is the best
nursing action?
A. Continue the infusion
B. Stop the infusion and notify the provider
C. Administer vitamin K
D. Administer protamine sulfate immediately
PTT >100 is considered critically high. The nurse should stop the infusion
and notify the provider before administering antidote.
6. A chest X-ray shows bilateral infiltrates. The patient is hypoxic despite
oxygen therapy. What syndrome is suspected?
A. COPD
B. ARDS
C. PE
D. CHF
ARDS presents with bilateral infiltrates and refractory hypoxemia.
7. What rhythm is most commonly associated with a sudden drop in
cardiac output and requires defibrillation?
A. Asystole
B. Ventricular fibrillation
, C. Sinus bradycardia
D. Atrial flutter
Ventricular fibrillation is a shockable, life-threatening rhythm.
8. A nurse receives a patient with sepsis. What initial order should be
performed first?
A. Administer broad-spectrum antibiotics
B. Obtain blood cultures
C. Administer IV fluids
D. Insert Foley catheter
Cultures must be drawn before antibiotics to ensure accurate identification
of pathogens.
9. The most reliable indicator of fluid volume status in a critically ill patient
is:
A. Daily weights
B. Urine output
C. Blood pressure
D. Capillary refill
Urine output is a key, immediate, and sensitive indicator of organ
perfusion and volume status.
2 QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES
2025
1. A patient with heart failure has a new prescription for enalapril. What
lab value should be monitored most closely?
A. Hemoglobin
B. Potassium
C. Magnesium
D. Glucose
ACE inhibitors can cause hyperkalemia due to reduced aldosterone
production. Monitoring potassium is critical.
2. A patient has atrial fibrillation with a rapid ventricular response. Which
drug is most appropriate initially?
,A. Amiodarone
B. Diltiazem
C. Atropine
D. Dobutamine
Diltiazem, a calcium channel blocker, is often first-line for rate control in
stable AFib.
3. The nurse notes the following ABG: pH 7.32, PaCO₂ 50, HCO₃ 24. What is
the most likely interpretation?
A. Metabolic acidosis
B. Respiratory acidosis
C. Respiratory alkalosis
D. Metabolic alkalosis
The pH is low and the PaCO₂ is high, indicating respiratory acidosis.
4. Which symptom is most concerning in a patient with DKA?
A. Fruity breath odor
B. Polydipsia
C. Tachycardia
D. Altered mental status
Altered mental status indicates cerebral edema or worsening acidosis,
requiring immediate intervention.
,5. A patient on a heparin drip has a PTT of 110 seconds. What is the best
nursing action?
A. Continue the infusion
B. Stop the infusion and notify the provider
C. Administer vitamin K
D. Administer protamine sulfate immediately
PTT >100 is considered critically high. The nurse should stop the infusion
and notify the provider before administering antidote.
6. A chest X-ray shows bilateral infiltrates. The patient is hypoxic despite
oxygen therapy. What syndrome is suspected?
A. COPD
B. ARDS
C. PE
D. CHF
ARDS presents with bilateral infiltrates and refractory hypoxemia.
7. What rhythm is most commonly associated with a sudden drop in
cardiac output and requires defibrillation?
A. Asystole
B. Ventricular fibrillation
, C. Sinus bradycardia
D. Atrial flutter
Ventricular fibrillation is a shockable, life-threatening rhythm.
8. A nurse receives a patient with sepsis. What initial order should be
performed first?
A. Administer broad-spectrum antibiotics
B. Obtain blood cultures
C. Administer IV fluids
D. Insert Foley catheter
Cultures must be drawn before antibiotics to ensure accurate identification
of pathogens.
9. The most reliable indicator of fluid volume status in a critically ill patient
is:
A. Daily weights
B. Urine output
C. Blood pressure
D. Capillary refill
Urine output is a key, immediate, and sensitive indicator of organ
perfusion and volume status.
