CRITICAL CARE HESI NEWEST 2026 ACTUAL EXAM
TEST BANK| 2 VERSIONS (VERSION A & B) WITH
COMPLETE 450 REAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
ALREADY GRADED A+| CRITICAL CARE HESI EXAM
PREP (MOST RECENT!!)
Question 1
A patient with septic shock has a mean arterial pressure (MAP) of
52 mm Hg after 30 mL/kg intravenous crystalloids. Which
vasopressor should the nurse prepare to administer first?
A. Dopamine
B. Vasopressin
C. Norepinephrine
D. Phenylephrine
Correct Answer: C
Rationale: Surviving Sepsis Campaign guidelines recommend
norepinephrine as the first-line vasopressor in septic shock to
achieve a MAP ≥65 mm Hg. Norepinephrine provides
alpha-adrenergic vasoconstriction with less tachycardia than
dopamine.
1
,Question 2
A patient with acute respiratory distress syndrome (ARDS) is
receiving mechanical ventilation with a tidal volume of 6 mL/kg
predicted body weight. The plateau pressure is 32 cm H₂O.
Which action should the nurse anticipate?
A. Increase the tidal volume to 8 mL/kg
B. Decrease the tidal volume to 4 mL/kg
C. Increase the respiratory rate to 35 breaths/min
D. Change to pressure-controlled ventilation
Correct Answer: B
Rationale: Lung-protective ventilation targets a plateau pressure
<30 cm H₂O to prevent ventilator-induced lung injury.
Decreasing tidal volume (even to 4 mL/kg) is appropriate;
permissive hypercapnia is acceptable.
Question 3
A patient with traumatic brain injury has an intracranial pressure
(ICP) of 24 mm Hg and a cerebral perfusion pressure (CPP) of
54 mm Hg. Which intervention should the nurse perform first?
2
,A. Elevate the head of the bed to 90 degrees
B. Administer IV mannitol 0.5-1 g/kg
C. Increase the propofol infusion
D. Hyperventilate to a PaCO₂ of 25 mm Hg
Correct Answer: B
Rationale: ICP >20 mm Hg with CPP <60 mm Hg requires
urgent reduction of ICP. Mannitol is an osmotic agent that
reduces cerebral edema. Head of bed should be 30 degrees
(not 90). Hyperventilation is reserved for impending herniation.
Question 4
A patient post-cardiac arrest has return of spontaneous
circulation (ROSC) but remains comatose. Targeted temperature
management (TTM) is initiated. Which complication requires
immediate intervention?
A. Heart rate of 55 beats/min
B. Serum potassium of 3.3 mEq/L
C. Shivering
D. Blood glucose of 150 mg/dL
3
, Correct Answer: C
Rationale: Shivering increases metabolic rate, oxygen
consumption, and ICP, counteracting the benefits of TTM. Treat
with sedation, neuromuscular blockade, or meperidine.
Hypokalemia is expected during cooling.
Question 5
A patient with a subarachnoid hemorrhage develops new-onset
left-sided weakness. What is the nurse’s priority action?
A. Reorient the patient
B. Notify the provider immediately for possible vasospasm
C. Administer lorazepam for seizure prophylaxis
D. Increase intravenous fluids to maintain euvolemia
Correct Answer: B
Rationale: A new focal neurologic deficit after subarachnoid
hemorrhage is vasospasm until proven otherwise. Immediate
notification is required for possible CT angiography and
interventions such as induced hypertension.
Question 6
4
TEST BANK| 2 VERSIONS (VERSION A & B) WITH
COMPLETE 450 REAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
ALREADY GRADED A+| CRITICAL CARE HESI EXAM
PREP (MOST RECENT!!)
Question 1
A patient with septic shock has a mean arterial pressure (MAP) of
52 mm Hg after 30 mL/kg intravenous crystalloids. Which
vasopressor should the nurse prepare to administer first?
A. Dopamine
B. Vasopressin
C. Norepinephrine
D. Phenylephrine
Correct Answer: C
Rationale: Surviving Sepsis Campaign guidelines recommend
norepinephrine as the first-line vasopressor in septic shock to
achieve a MAP ≥65 mm Hg. Norepinephrine provides
alpha-adrenergic vasoconstriction with less tachycardia than
dopamine.
1
,Question 2
A patient with acute respiratory distress syndrome (ARDS) is
receiving mechanical ventilation with a tidal volume of 6 mL/kg
predicted body weight. The plateau pressure is 32 cm H₂O.
Which action should the nurse anticipate?
A. Increase the tidal volume to 8 mL/kg
B. Decrease the tidal volume to 4 mL/kg
C. Increase the respiratory rate to 35 breaths/min
D. Change to pressure-controlled ventilation
Correct Answer: B
Rationale: Lung-protective ventilation targets a plateau pressure
<30 cm H₂O to prevent ventilator-induced lung injury.
Decreasing tidal volume (even to 4 mL/kg) is appropriate;
permissive hypercapnia is acceptable.
Question 3
A patient with traumatic brain injury has an intracranial pressure
(ICP) of 24 mm Hg and a cerebral perfusion pressure (CPP) of
54 mm Hg. Which intervention should the nurse perform first?
2
,A. Elevate the head of the bed to 90 degrees
B. Administer IV mannitol 0.5-1 g/kg
C. Increase the propofol infusion
D. Hyperventilate to a PaCO₂ of 25 mm Hg
Correct Answer: B
Rationale: ICP >20 mm Hg with CPP <60 mm Hg requires
urgent reduction of ICP. Mannitol is an osmotic agent that
reduces cerebral edema. Head of bed should be 30 degrees
(not 90). Hyperventilation is reserved for impending herniation.
Question 4
A patient post-cardiac arrest has return of spontaneous
circulation (ROSC) but remains comatose. Targeted temperature
management (TTM) is initiated. Which complication requires
immediate intervention?
A. Heart rate of 55 beats/min
B. Serum potassium of 3.3 mEq/L
C. Shivering
D. Blood glucose of 150 mg/dL
3
, Correct Answer: C
Rationale: Shivering increases metabolic rate, oxygen
consumption, and ICP, counteracting the benefits of TTM. Treat
with sedation, neuromuscular blockade, or meperidine.
Hypokalemia is expected during cooling.
Question 5
A patient with a subarachnoid hemorrhage develops new-onset
left-sided weakness. What is the nurse’s priority action?
A. Reorient the patient
B. Notify the provider immediately for possible vasospasm
C. Administer lorazepam for seizure prophylaxis
D. Increase intravenous fluids to maintain euvolemia
Correct Answer: B
Rationale: A new focal neurologic deficit after subarachnoid
hemorrhage is vasospasm until proven otherwise. Immediate
notification is required for possible CT angiography and
interventions such as induced hypertension.
Question 6
4
