BKAT CRITICAL CARE NURSING EXAM PRACTICE
QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT
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1. A patient with acute respiratory distress syndrome (ARDS) is on mechanical
ventilation. Which ventilator strategy is most appropriate to reduce ventilator-induced
lung injury?
A. High tidal volume ventilation
B. Low tidal volume ventilation (4–6 mL/kg)
C. High respiratory rate with large tidal volumes
D. Zero PEEP
Correct Answer: B
Rationale: Low tidal volume ventilation minimizes alveolar overdistention and
reduces ventilator-induced lung injury. High tidal volumes worsen ARDS, and PEEP
is necessary to prevent alveolar collapse.
2. A critically ill patient develops sudden hypotension, muffled heart sounds, and jugular
venous distension. What is the most likely diagnosis?
A. Pulmonary embolism
B. Cardiac tamponade
C. Septic shock
D. Myocardial infarction
Correct Answer: B
Rationale: Beck’s triad (hypotension, JVD, muffled heart sounds) is classic for
cardiac tamponade. Other conditions may cause hypotension but not this triad.
3. Which parameter best reflects left ventricular preload in a critically ill patient?
A. Cardiac output
B. Central venous pressure
C. Pulmonary artery wedge pressure
D. Systemic vascular resistance
Correct Answer: C
Rationale: Pulmonary artery wedge pressure reflects left ventricular end-diastolic
pressure (preload). CVP reflects right-sided preload.
4. A patient with septic shock is receiving norepinephrine. What is the primary action of
this medication?
, A. Decrease heart rate
B. Vasodilation
C. Vasoconstriction to increase blood pressure
D. Reduce cardiac output
Correct Answer: C
Rationale: Norepinephrine is a potent vasoconstrictor that increases systemic
vascular resistance and blood pressure in septic shock.
5. A nurse notes peaked T waves on a cardiac monitor. Which electrolyte imbalance is
most likely?
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypernatremia
Correct Answer: B
Rationale: Peaked T waves are a hallmark of hyperkalemia. Hypokalemia causes
flattened T waves and U waves.
6. Which arterial blood gas (ABG) result indicates respiratory acidosis?
A. pH 7.30, PaCO₂ 55 mmHg
B. pH 7.48, PaCO₂ 30 mmHg
C. pH 7.35, HCO₃⁻ 18 mEq/L
D. pH 7.50, HCO₃⁻ 30 mEq/L
Correct Answer: A
Rationale: Respiratory acidosis is indicated by low pH and elevated PaCO₂. Other
options reflect alkalosis or metabolic disorders.
7. A patient with head trauma has increased intracranial pressure (ICP). Which
intervention is priority?
A. Position flat
B. Hyperventilate aggressively
C. Elevate head of bed to 30 degrees
D. Administer hypotonic fluids
Correct Answer: C
Rationale: Elevating the head improves venous drainage and reduces ICP. Flat
positioning and hypotonic fluids increase ICP.
8. Which sign indicates worsening intracranial pressure?
A. Tachycardia
B. Hypotension
C. Bradycardia with hypertension
D. Warm skin
, Correct Answer: C
Rationale: Cushing’s triad includes bradycardia, hypertension, and irregular
respirations, indicating increased ICP.
9. A patient in hypovolemic shock presents with which finding?
A. Bounding pulses
B. Warm, flushed skin
C. Tachycardia and hypotension
D. Decreased heart rate
Correct Answer: C
Rationale: Hypovolemic shock leads to compensatory tachycardia and hypotension
due to decreased circulating volume.
10. Which drug is first-line for ventricular fibrillation?
A. Atropine
B. Epinephrine
C. Amiodarone
D. Defibrillation
Correct Answer: D
Rationale: Immediate defibrillation is the priority treatment for ventricular
fibrillation.
11. A patient with COPD is on oxygen therapy. What is the target oxygen saturation?
A. 100%
B. 95–100%
C. 88–92%
D. 70–80%
Correct Answer: C
Rationale: COPD patients require controlled oxygen therapy to prevent suppression
of hypoxic drive.
12. Which lab value is most indicative of renal failure?
A. Creatinine 0.8 mg/dL
B. BUN 10 mg/dL
C. Creatinine 3.5 mg/dL
D. Sodium 140 mEq/L
Correct Answer: C
Rationale: Elevated creatinine indicates impaired kidney function.
, 13. A patient is receiving heparin infusion. Which lab test should be monitored?
A. PT
B. INR
C. aPTT
D. Platelet count only
Correct Answer: C
Rationale: aPTT is used to monitor heparin therapy effectiveness.
14. Which is an early sign of sepsis?
A. Hypothermia
B. Tachycardia
C. Bradycardia
D. Hypotension
Correct Answer: B
Rationale: Tachycardia is an early compensatory response in sepsis.
15. A patient has urine output of 20 mL/hr. What is the nurse’s priority action?
A. Document and ignore
B. Increase fluids
C. Notify physician
D. Restrict fluids
Correct Answer: C
Rationale: Low urine output indicates possible renal hypoperfusion requiring urgent
evaluation.
16. Which electrolyte imbalance causes muscle weakness and arrhythmias?
A. Hyponatremia
B. Hyperkalemia
C. Hypocalcemia
D. Hypermagnesemia
Correct Answer: B
Rationale: Hyperkalemia affects cardiac conduction and muscle function.
17. What is the main purpose of PEEP in mechanical ventilation?
A. Increase CO₂ removal
B. Prevent alveolar collapse
C. Decrease oxygenation
D. Reduce tidal volume
Correct Answer: B
Rationale: PEEP keeps alveoli open, improving oxygenation.
QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF.
1. A patient with acute respiratory distress syndrome (ARDS) is on mechanical
ventilation. Which ventilator strategy is most appropriate to reduce ventilator-induced
lung injury?
A. High tidal volume ventilation
B. Low tidal volume ventilation (4–6 mL/kg)
C. High respiratory rate with large tidal volumes
D. Zero PEEP
Correct Answer: B
Rationale: Low tidal volume ventilation minimizes alveolar overdistention and
reduces ventilator-induced lung injury. High tidal volumes worsen ARDS, and PEEP
is necessary to prevent alveolar collapse.
2. A critically ill patient develops sudden hypotension, muffled heart sounds, and jugular
venous distension. What is the most likely diagnosis?
A. Pulmonary embolism
B. Cardiac tamponade
C. Septic shock
D. Myocardial infarction
Correct Answer: B
Rationale: Beck’s triad (hypotension, JVD, muffled heart sounds) is classic for
cardiac tamponade. Other conditions may cause hypotension but not this triad.
3. Which parameter best reflects left ventricular preload in a critically ill patient?
A. Cardiac output
B. Central venous pressure
C. Pulmonary artery wedge pressure
D. Systemic vascular resistance
Correct Answer: C
Rationale: Pulmonary artery wedge pressure reflects left ventricular end-diastolic
pressure (preload). CVP reflects right-sided preload.
4. A patient with septic shock is receiving norepinephrine. What is the primary action of
this medication?
, A. Decrease heart rate
B. Vasodilation
C. Vasoconstriction to increase blood pressure
D. Reduce cardiac output
Correct Answer: C
Rationale: Norepinephrine is a potent vasoconstrictor that increases systemic
vascular resistance and blood pressure in septic shock.
5. A nurse notes peaked T waves on a cardiac monitor. Which electrolyte imbalance is
most likely?
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypernatremia
Correct Answer: B
Rationale: Peaked T waves are a hallmark of hyperkalemia. Hypokalemia causes
flattened T waves and U waves.
6. Which arterial blood gas (ABG) result indicates respiratory acidosis?
A. pH 7.30, PaCO₂ 55 mmHg
B. pH 7.48, PaCO₂ 30 mmHg
C. pH 7.35, HCO₃⁻ 18 mEq/L
D. pH 7.50, HCO₃⁻ 30 mEq/L
Correct Answer: A
Rationale: Respiratory acidosis is indicated by low pH and elevated PaCO₂. Other
options reflect alkalosis or metabolic disorders.
7. A patient with head trauma has increased intracranial pressure (ICP). Which
intervention is priority?
A. Position flat
B. Hyperventilate aggressively
C. Elevate head of bed to 30 degrees
D. Administer hypotonic fluids
Correct Answer: C
Rationale: Elevating the head improves venous drainage and reduces ICP. Flat
positioning and hypotonic fluids increase ICP.
8. Which sign indicates worsening intracranial pressure?
A. Tachycardia
B. Hypotension
C. Bradycardia with hypertension
D. Warm skin
, Correct Answer: C
Rationale: Cushing’s triad includes bradycardia, hypertension, and irregular
respirations, indicating increased ICP.
9. A patient in hypovolemic shock presents with which finding?
A. Bounding pulses
B. Warm, flushed skin
C. Tachycardia and hypotension
D. Decreased heart rate
Correct Answer: C
Rationale: Hypovolemic shock leads to compensatory tachycardia and hypotension
due to decreased circulating volume.
10. Which drug is first-line for ventricular fibrillation?
A. Atropine
B. Epinephrine
C. Amiodarone
D. Defibrillation
Correct Answer: D
Rationale: Immediate defibrillation is the priority treatment for ventricular
fibrillation.
11. A patient with COPD is on oxygen therapy. What is the target oxygen saturation?
A. 100%
B. 95–100%
C. 88–92%
D. 70–80%
Correct Answer: C
Rationale: COPD patients require controlled oxygen therapy to prevent suppression
of hypoxic drive.
12. Which lab value is most indicative of renal failure?
A. Creatinine 0.8 mg/dL
B. BUN 10 mg/dL
C. Creatinine 3.5 mg/dL
D. Sodium 140 mEq/L
Correct Answer: C
Rationale: Elevated creatinine indicates impaired kidney function.
, 13. A patient is receiving heparin infusion. Which lab test should be monitored?
A. PT
B. INR
C. aPTT
D. Platelet count only
Correct Answer: C
Rationale: aPTT is used to monitor heparin therapy effectiveness.
14. Which is an early sign of sepsis?
A. Hypothermia
B. Tachycardia
C. Bradycardia
D. Hypotension
Correct Answer: B
Rationale: Tachycardia is an early compensatory response in sepsis.
15. A patient has urine output of 20 mL/hr. What is the nurse’s priority action?
A. Document and ignore
B. Increase fluids
C. Notify physician
D. Restrict fluids
Correct Answer: C
Rationale: Low urine output indicates possible renal hypoperfusion requiring urgent
evaluation.
16. Which electrolyte imbalance causes muscle weakness and arrhythmias?
A. Hyponatremia
B. Hyperkalemia
C. Hypocalcemia
D. Hypermagnesemia
Correct Answer: B
Rationale: Hyperkalemia affects cardiac conduction and muscle function.
17. What is the main purpose of PEEP in mechanical ventilation?
A. Increase CO₂ removal
B. Prevent alveolar collapse
C. Decrease oxygenation
D. Reduce tidal volume
Correct Answer: B
Rationale: PEEP keeps alveoli open, improving oxygenation.
