NGN HESI RN Critical Care Exam V2 (2025/2026) – Verified Actual Exam | Graded A+ with Correct Questions and Expert Answers

NGN HESI RN Critical Care Exam V2
(2025/2026) – Verified Actual Exam |
Graded A+ with Correct Questions
and Expert Answers

Section 1: Shock and Multisystem Disorders (Questions 1-
25)
Question 1
A client in septic shock has a BP of 80/50 mmHg, HR 120 bpm, and urine output of 20 mL/hr.
The nurse should prioritize:
A. Administering antibiotics
B. Starting vasopressors
C. Giving a fluid bolus
D. Inserting a urinary catheter

C. Giving a fluid bolus
Rationale: Fluid resuscitation is the priority to restore perfusion (Surviving Sepsis Guidelines).
A is next; B follows if fluids fail; D is not urgent.

Question 2
A client with hypovolemic shock receives 2 L of normal saline. Which finding indicates
improved perfusion?
A. HR 110 bpm
B. BP 90/60 mmHg
C. Urine output 40 mL/hr
D. Lactate 4 mmol/L

C. Urine output 40 mL/hr
Rationale: Urine output >30 mL/hr indicates renal perfusion (Saunders). A, B show persistent
shock; D indicates ongoing acidosis.

Question 3
In anaphylactic shock, the nurse expects:
A. Bradycardia
B. Bronchoconstriction
C. Hypertension
D. Increased SVR

,B. Bronchoconstriction
Rationale: Anaphylaxis causes airway narrowing (HESI). A, C, D are incorrect (tachycardia,
hypotension, low SVR occur).

Question 4
Select all that apply: Which are signs of cardiogenic shock?
A. Jugular vein distention
B. Crackles in lungs
C. Warm, dry skin
D. Hypotension
E. Oliguria

A, B, D, E
Rationale: Cardiogenic shock shows JVD, pulmonary edema, hypotension, and low urine output
(Saunders). C is incorrect (skin is cool, clammy).

Question 5
A client with septic shock is prescribed norepinephrine. The nurse monitors for:
A. Bradycardia
B. Decreased urine output
C. Hypoglycemia
D. Hyperthermia

B. Decreased urine output
Rationale: Norepinephrine causes vasoconstriction, risking renal perfusion (HESI). A, C, D are
not primary effects.

Question 6
The nurse assesses a client in shock with a lactate level of 5 mmol/L. This indicates:
A. Adequate oxygenation
B. Tissue hypoperfusion
C. Normal metabolism
D. Fluid overload

B. Tissue hypoperfusion
Rationale: Elevated lactate reflects anaerobic metabolism (Surviving Sepsis). A, C, D are
incorrect.

Question 7
A client in distributive shock has a MAP of 55 mmHg. The nurse expects to administer:
A. Dobutamine
B. Dopamine
C. Norepinephrine
D. Milrinone

, C. Norepinephrine
Rationale: Norepinephrine is first-line for distributive shock to raise MAP (Sepsis Guidelines).
A, B, D are less effective.

Question 8
Case Study (NGN): A client presents with fever, tachycardia, and hypotension. Labs show
WBC 18,000, lactate 4.2 mmol/L.
Question: What is the priority intervention?
A. Administer broad-spectrum antibiotics
B. Obtain blood cultures
C. Give 30 mL/kg fluid bolus
D. Start vasopressors

C. Give 30 mL/kg fluid bolus
Rationale: Fluid resuscitation is priority in septic shock (Surviving Sepsis). B is next; A follows;
D is last if MAP <65 mmHg.

Question 9
A client with hemorrhagic shock loses 30% of blood volume. The nurse expects:
A. Hypertension
B. Tachycardia
C. Increased urine output
D. Warm extremities

B. Tachycardia
Rationale: Class II shock causes tachycardia to compensate (Saunders). A, C, D are incorrect
(hypotension, oliguria, cool skin).

Question 10
The antidote for heparin overdose in shock is:
A. Vitamin K
B. Protamine sulfate
C. Flumazenil
D. Naloxone

B. Protamine sulfate
Rationale: Protamine reverses heparin (HESI). A is for warfarin; C, D are unrelated.

Question 11
A client in shock has a CVP of 2 mmHg. This suggests:
A. Fluid overload
B. Hypovolemia
C. Heart failure
D. Normal volume