PROPHECY GENERAL ICU A V3 – Exam Questions
PRACTICE QUESTIONS PLUS RATIONALES 2026
|INSTANT DOWNOAD PDF
1. A patient in the ICU develops sudden hypotension and
tachycardia. Which is the priority nursing action?
A. Administer IV fluids as prescribed
B. Assess airway, breathing, and circulation (ABC)
C. Call the physician immediately
D. Document the vital signs
Correct Answer: B. Assess airway, breathing, and circulation
(ABC)
Rationale: In ICU emergencies, ABC assessment takes priority to
identify life-threatening issues before interventions like fluids or
documentation.
2. Which parameter is most sensitive for detecting early sepsis
in critically ill patients?
A. Blood pressure
B. Heart rate
C. Serum lactate
D. Temperature
Correct Answer: C. Serum lactate
Rationale: Elevated serum lactate indicates tissue
hypoperfusion even before hypotension or fever develop.
,3. A patient on mechanical ventilation has a sudden drop in
SpO₂. What should the nurse assess first?
A. Check ventilator settings
B. Auscultate lung sounds
C. Suction the airway
D. Increase oxygen flow
Correct Answer: B. Auscultate lung sounds
Rationale: Assessing lung sounds identifies immediate causes
like pneumothorax, bronchospasm, or secretions before
adjusting the ventilator.
4. Which electrolyte imbalance is most likely to cause cardiac
arrhythmias in ICU patients?
A. Hypokalemia
B. Hypernatremia
C. Hypocalcemia
D. Hypermagnesemia
Correct Answer: A. Hypokalemia
Rationale: Low potassium disrupts cardiac electrical conduction,
increasing the risk of ventricular arrhythmias.
5. For a patient receiving high-dose vasopressors, which
assessment finding indicates improved perfusion?
A. Warm extremities
,B. Urine output > 0.5 mL/kg/hr
C. MAP ≥ 65 mmHg
D. Decreased heart rate
Correct Answer: B. Urine output > 0.5 mL/kg/hr
Rationale: Urine output is a direct indicator of renal perfusion
and tissue oxygenation in patients on vasopressors.
6. Which intervention prevents ventilator-associated
pneumonia (VAP)?
A. Keep HOB (head of bed) elevated 30–45°
B. Perform daily oral care with chlorhexidine
C. Change ventilator circuits daily
D. Limit suctioning to once per shift
Correct Answer: A & B
Rationale: Elevating the head and performing oral hygiene
reduce aspiration risk; routine circuit changes are not
recommended, and suctioning should be as needed.
7. In ICU sedation management, which scale is commonly used
to assess sedation depth?
A. Glasgow Coma Scale (GCS)
B. Richmond Agitation-Sedation Scale (RASS)
C. APACHE II score
D. Braden Scale
, Correct Answer: B. Richmond Agitation-Sedation Scale (RASS)
Rationale: RASS provides a standardized way to titrate sedation
and avoid oversedation or agitation.
8. A patient has a central venous catheter. Which action
reduces infection risk?
A. Change dressing every 48 hours
B. Perform hand hygiene before access
C. Flush with normal saline only
D. Use sterile technique for insertion
Correct Answer: B & D
Rationale: Hand hygiene and sterile technique are critical for
preventing catheter-related bloodstream infections. Dressings
are changed per protocol (usually every 5–7 days).
9. Which laboratory value best reflects renal function in ICU
patients?
A. Serum sodium
B. Blood urea nitrogen (BUN) and creatinine
C. Serum potassium
D. Serum albumin
Correct Answer: B. Blood urea nitrogen (BUN) and creatinine
Rationale: BUN and creatinine are primary markers for
glomerular filtration and kidney function.
PRACTICE QUESTIONS PLUS RATIONALES 2026
|INSTANT DOWNOAD PDF
1. A patient in the ICU develops sudden hypotension and
tachycardia. Which is the priority nursing action?
A. Administer IV fluids as prescribed
B. Assess airway, breathing, and circulation (ABC)
C. Call the physician immediately
D. Document the vital signs
Correct Answer: B. Assess airway, breathing, and circulation
(ABC)
Rationale: In ICU emergencies, ABC assessment takes priority to
identify life-threatening issues before interventions like fluids or
documentation.
2. Which parameter is most sensitive for detecting early sepsis
in critically ill patients?
A. Blood pressure
B. Heart rate
C. Serum lactate
D. Temperature
Correct Answer: C. Serum lactate
Rationale: Elevated serum lactate indicates tissue
hypoperfusion even before hypotension or fever develop.
,3. A patient on mechanical ventilation has a sudden drop in
SpO₂. What should the nurse assess first?
A. Check ventilator settings
B. Auscultate lung sounds
C. Suction the airway
D. Increase oxygen flow
Correct Answer: B. Auscultate lung sounds
Rationale: Assessing lung sounds identifies immediate causes
like pneumothorax, bronchospasm, or secretions before
adjusting the ventilator.
4. Which electrolyte imbalance is most likely to cause cardiac
arrhythmias in ICU patients?
A. Hypokalemia
B. Hypernatremia
C. Hypocalcemia
D. Hypermagnesemia
Correct Answer: A. Hypokalemia
Rationale: Low potassium disrupts cardiac electrical conduction,
increasing the risk of ventricular arrhythmias.
5. For a patient receiving high-dose vasopressors, which
assessment finding indicates improved perfusion?
A. Warm extremities
,B. Urine output > 0.5 mL/kg/hr
C. MAP ≥ 65 mmHg
D. Decreased heart rate
Correct Answer: B. Urine output > 0.5 mL/kg/hr
Rationale: Urine output is a direct indicator of renal perfusion
and tissue oxygenation in patients on vasopressors.
6. Which intervention prevents ventilator-associated
pneumonia (VAP)?
A. Keep HOB (head of bed) elevated 30–45°
B. Perform daily oral care with chlorhexidine
C. Change ventilator circuits daily
D. Limit suctioning to once per shift
Correct Answer: A & B
Rationale: Elevating the head and performing oral hygiene
reduce aspiration risk; routine circuit changes are not
recommended, and suctioning should be as needed.
7. In ICU sedation management, which scale is commonly used
to assess sedation depth?
A. Glasgow Coma Scale (GCS)
B. Richmond Agitation-Sedation Scale (RASS)
C. APACHE II score
D. Braden Scale
, Correct Answer: B. Richmond Agitation-Sedation Scale (RASS)
Rationale: RASS provides a standardized way to titrate sedation
and avoid oversedation or agitation.
8. A patient has a central venous catheter. Which action
reduces infection risk?
A. Change dressing every 48 hours
B. Perform hand hygiene before access
C. Flush with normal saline only
D. Use sterile technique for insertion
Correct Answer: B & D
Rationale: Hand hygiene and sterile technique are critical for
preventing catheter-related bloodstream infections. Dressings
are changed per protocol (usually every 5–7 days).
9. Which laboratory value best reflects renal function in ICU
patients?
A. Serum sodium
B. Blood urea nitrogen (BUN) and creatinine
C. Serum potassium
D. Serum albumin
Correct Answer: B. Blood urea nitrogen (BUN) and creatinine
Rationale: BUN and creatinine are primary markers for
glomerular filtration and kidney function.
