ICU EXAM FINAL SCRIPT 2026 SOLVED
QUESTIONS WITH FULL SOLUTIONS
◉ A nurse is caring for a patient 36 hours after a Whipple procedure.
The nurse notes an increase in drainage from the surgical drain that
is thin and bile colored. Which action should the nurse take first?
A. Document the finding as expected post op drainage
B. Flush the drain with sterile saline
C. Notify the surgeon immediately
D. Administer antiemetic and reassess in one hour. Answer: Notify
the surgeon immediately- indicates a possible pancreatic or biliary
leak which can rapidly lead to peritonitis or sepsis. Requires prompt
surgical intervention
◉ Which nursing intervention is a priority for a patient with a GI
hemorrhage?
A. Maintaining venous access so that mannitol can be administered
B. Irrigating the NG tube with saline
C. Positioning the patient in a high Fowler's position
D. Ensuring the patient has a patent airway. Answer: Ensuring the
patient has a patent airway
,◉ Best description of a Roux-en-Y procedure
A. An Esophagectomy performed using the transthoracic approach
B. A combination of restrictive and malabsorption types of bariatric
surgery
C. An Esophagectomy performed using the transhiatal approach
D. A standard operation for pancreatic cancer. Answer: A
combination of restrictive and malabsorption types of bariatric
surgery
◉ Which statement best defines countrecoup brain injury?
A. Primary impact of force against the skull
B. Rebound injury on the side opposite of initial impact
C. Penetration of the skull by a foreign object
D. Diffuse injury from axonal shearing. Answer: Rebound injury on
the side opposite of initial impact- occurs when the brain rebounds
and strikes the opposite side of the skull, secondary impact
◉ Which findings indicate hemorrhagic shock in the trauma patient?
Select all that apply.
,A. Hypotension
B. Bradycardia
C. Cool, clammy skin
D. Elevated cardiac output
E. Increased PVR
F. Altered LOC. Answer: Hypotension, Cool, clammy skin, Increased
PVR, Altered LOC- tachycardia and decreased cardiac output
◉ Why are packed red blood cells administered during a massive
transfusion protocol?
A. They restore coagulation factors
B. They expand plasma volume only
C. They reduce potassium levels
D. They provide oxygen carrying hemoglobin. Answer: They provide
oxygen carrying hemoglobin
◉ A trauma patient with a GSW to the abdomen is at risk of
hemorrhagic shock. The nurse is maintaining his BP at a systolic of
90mmHg to control bleeding. Which of the following supports this
management approach?
A. Permissive hypotension
, B. Neurogenic shock management
C. Massive Transfusion Protocol
D. Hyperperfusion of the spine. Answer: Permissive hypotension
◉ Which of the following describes diffuse axonal injury (DAI)?
A. Laceration of meninges with hemorrhage
B. Shearing and twisting of neuronal axons
C. Contusion from direct impact
D. Ischemic necrosis of the cerebellum. Answer: Shearing and
twisting of neuronal axons
◉ What is the primary action of mannitol in treating elevated ICP?
A. Expands plasma volume
B. Increases sodium reabsorption
C. Pulls fluid from cerebral tissue via osmotic diuresis
D. Induces vasoconstriction. Answer: Pulls fluid from cerebral tissue
via osmotic diuresis
◉ Which nursing action is priority when suctioning a patient with a
C spine injury?
QUESTIONS WITH FULL SOLUTIONS
◉ A nurse is caring for a patient 36 hours after a Whipple procedure.
The nurse notes an increase in drainage from the surgical drain that
is thin and bile colored. Which action should the nurse take first?
A. Document the finding as expected post op drainage
B. Flush the drain with sterile saline
C. Notify the surgeon immediately
D. Administer antiemetic and reassess in one hour. Answer: Notify
the surgeon immediately- indicates a possible pancreatic or biliary
leak which can rapidly lead to peritonitis or sepsis. Requires prompt
surgical intervention
◉ Which nursing intervention is a priority for a patient with a GI
hemorrhage?
A. Maintaining venous access so that mannitol can be administered
B. Irrigating the NG tube with saline
C. Positioning the patient in a high Fowler's position
D. Ensuring the patient has a patent airway. Answer: Ensuring the
patient has a patent airway
,◉ Best description of a Roux-en-Y procedure
A. An Esophagectomy performed using the transthoracic approach
B. A combination of restrictive and malabsorption types of bariatric
surgery
C. An Esophagectomy performed using the transhiatal approach
D. A standard operation for pancreatic cancer. Answer: A
combination of restrictive and malabsorption types of bariatric
surgery
◉ Which statement best defines countrecoup brain injury?
A. Primary impact of force against the skull
B. Rebound injury on the side opposite of initial impact
C. Penetration of the skull by a foreign object
D. Diffuse injury from axonal shearing. Answer: Rebound injury on
the side opposite of initial impact- occurs when the brain rebounds
and strikes the opposite side of the skull, secondary impact
◉ Which findings indicate hemorrhagic shock in the trauma patient?
Select all that apply.
,A. Hypotension
B. Bradycardia
C. Cool, clammy skin
D. Elevated cardiac output
E. Increased PVR
F. Altered LOC. Answer: Hypotension, Cool, clammy skin, Increased
PVR, Altered LOC- tachycardia and decreased cardiac output
◉ Why are packed red blood cells administered during a massive
transfusion protocol?
A. They restore coagulation factors
B. They expand plasma volume only
C. They reduce potassium levels
D. They provide oxygen carrying hemoglobin. Answer: They provide
oxygen carrying hemoglobin
◉ A trauma patient with a GSW to the abdomen is at risk of
hemorrhagic shock. The nurse is maintaining his BP at a systolic of
90mmHg to control bleeding. Which of the following supports this
management approach?
A. Permissive hypotension
, B. Neurogenic shock management
C. Massive Transfusion Protocol
D. Hyperperfusion of the spine. Answer: Permissive hypotension
◉ Which of the following describes diffuse axonal injury (DAI)?
A. Laceration of meninges with hemorrhage
B. Shearing and twisting of neuronal axons
C. Contusion from direct impact
D. Ischemic necrosis of the cerebellum. Answer: Shearing and
twisting of neuronal axons
◉ What is the primary action of mannitol in treating elevated ICP?
A. Expands plasma volume
B. Increases sodium reabsorption
C. Pulls fluid from cerebral tissue via osmotic diuresis
D. Induces vasoconstriction. Answer: Pulls fluid from cerebral tissue
via osmotic diuresis
◉ Which nursing action is priority when suctioning a patient with a
C spine injury?
