NSG 180 CRITICAL CARE NURSING EXAM 2 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
    Core Domains
    - Hemodynamic Monitoring and Shock Management
    - Mechanical Ventilation and Airway Management
    - Acute Kidney Injury and Fluid/Electrolyte Balance
    - Sepsis and Infectious Disease Protocols
    - Cardiovascular Emergencies and ECG Interpretation
    - Neurological Critical Care and ICP Management
    - Ethical, Legal, and Professional Standards in Critical Care
    - Pain Management and Sedation in the ICU
    - Postoperative Critical Care and Complication Prevention
    - End-of-Life Care and Palliative Interventions
    Introduction**
    This exam assesses advanced critical care nursing competence for clinical practice and certification preparation. It
evaluates knowledge of hemodynamic monitoring, mechanical ventilation, acute organ dysfunction, sepsis management, cardiovascular
emergencies, neurological critical care, and ethical decision-making. The 200 multiple-choice questions include scenario-based items requiring
critical thinking, prioritization, and real-world clinical judgment. Emphasis is placed on evidence-based interventions, regulatory compliance,
patient safety, and professional standards. Successful performance demonstrates readiness for high-acuity nursing practice in intensive care
settings.
SECTION ONE: QUESTIONS 1–100
Question 1
A client with septic shock has a mean arterial pressure (MAP) of 52 mmHg despite fluid resuscitation. Which medication should the nurse anticipate
being administered first?
A. Furosemide IV
B. Norepinephrine IV
C. Metoprolol oral
D. Insulin subcutaneous
,🟢 B. Norepinephrine IV
🔴 RATIONALE: Norepinephrine is the first-line vasopressor for septic shock when MAP remains <65 mmHg after adequate fluid resuscitation. It
increases vascular tone and improves perfusion pressure.
Question 2
A mechanically ventilated client has an arterial blood gas showing pH 7.28, PaCO₂ 52 mmHg, HCO₃⁻ 24 mEq/L, PaO₂ 68 mmHg. How should the
nurse interpret these results?
A. Respiratory alkalosis
B. Metabolic acidosis
C. Respiratory acidosis
D. Metabolic alkalosis
🟢 C. Respiratory acidosis
🔴 RATIONALE: Low pH (<7.35) with elevated PaCO₂ (>45 mmHg) and normal HCO₃⁻ indicates acute respiratory acidosis, commonly seen in
hypoventilation or ventilator dysfunction.
Question 3
Which assessment finding is the earliest indicator of decreased cardiac output in a postoperative client?
A. Hypotension
B. Tachycardia
C. Decreased urine output
D. Altered mental status
🟢 B. Tachycardia
,🔴 RATIONALE: Tachycardia is typically the earliest compensatory response to decreased cardiac output, preceding hypotension and other signs of
shock.
Question 4
A client with a Glasgow Coma Scale (GCS) score of 6 requires which immediate intervention?
A. Nasogastric tube placement
B. Intubation with mechanical ventilation
C. 12-lead ECG
D. Advanced cardiac life support
🟢 B. Intubation with mechanical ventilation
🔴 RATIONALE: A GCS ≤8 indicates severe brain injury and inability to protect the airway, necessitating immediate intubation and mechanical
ventilation.
Question 5
Which electrolyte abnormality is most associated with peaked T waves and widened QRS complex on ECG?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypocalcemia
🟢 B. Hyperkalemia
🔴 RATIONALE: Hyperkalemia causes characteristic ECG changes including peaked T waves, widened QRS, and flattened P waves, which can
progress to ventricular fibrillation.
, Question 6
A client with acute respiratory distress syndrome (ARDS) on mechanical ventilation has continuous high-pressure alarms. What is the most likely
cause?
A. Increased lung compliance
B. Decreased lung compliance
C. Low tidal volume
D. High respiratory rate
🟢 B. Decreased lung compliance
🔴 RATIONALE: ARDS causes stiff, non-compliant lungs, increasing airway pressures and triggering high-pressure ventilator alarms.
Question 7
Which action is most important for preventing life-threatening complications during pulmonary artery catheter insertion?
A. Fast flush the PA distal port for no more than 2 seconds
B. Avoid infusing blood products through the PA catheter
C. Clear pressure tubing of blood after withdrawal
D. Maintain 300 mmHg pressure around flush bag
🟢 A. Fast flush the PA distal port for no more than 2 seconds
🔴 RATIONALE: Prolonged fast flushing can cause pulmonary artery rupture or wedge position complications; limiting to 2 seconds prevents this.
Question 8
A client with diabetic ketoacidosis (DKA) presents with Kussmaul respirations. What is the purpose of this breathing pattern?
RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
    Core Domains
    - Hemodynamic Monitoring and Shock Management
    - Mechanical Ventilation and Airway Management
    - Acute Kidney Injury and Fluid/Electrolyte Balance
    - Sepsis and Infectious Disease Protocols
    - Cardiovascular Emergencies and ECG Interpretation
    - Neurological Critical Care and ICP Management
    - Ethical, Legal, and Professional Standards in Critical Care
    - Pain Management and Sedation in the ICU
    - Postoperative Critical Care and Complication Prevention
    - End-of-Life Care and Palliative Interventions
    Introduction**
    This exam assesses advanced critical care nursing competence for clinical practice and certification preparation. It
evaluates knowledge of hemodynamic monitoring, mechanical ventilation, acute organ dysfunction, sepsis management, cardiovascular
emergencies, neurological critical care, and ethical decision-making. The 200 multiple-choice questions include scenario-based items requiring
critical thinking, prioritization, and real-world clinical judgment. Emphasis is placed on evidence-based interventions, regulatory compliance,
patient safety, and professional standards. Successful performance demonstrates readiness for high-acuity nursing practice in intensive care
settings.
SECTION ONE: QUESTIONS 1–100
Question 1
A client with septic shock has a mean arterial pressure (MAP) of 52 mmHg despite fluid resuscitation. Which medication should the nurse anticipate
being administered first?
A. Furosemide IV
B. Norepinephrine IV
C. Metoprolol oral
D. Insulin subcutaneous
,🟢 B. Norepinephrine IV
🔴 RATIONALE: Norepinephrine is the first-line vasopressor for septic shock when MAP remains <65 mmHg after adequate fluid resuscitation. It
increases vascular tone and improves perfusion pressure.
Question 2
A mechanically ventilated client has an arterial blood gas showing pH 7.28, PaCO₂ 52 mmHg, HCO₃⁻ 24 mEq/L, PaO₂ 68 mmHg. How should the
nurse interpret these results?
A. Respiratory alkalosis
B. Metabolic acidosis
C. Respiratory acidosis
D. Metabolic alkalosis
🟢 C. Respiratory acidosis
🔴 RATIONALE: Low pH (<7.35) with elevated PaCO₂ (>45 mmHg) and normal HCO₃⁻ indicates acute respiratory acidosis, commonly seen in
hypoventilation or ventilator dysfunction.
Question 3
Which assessment finding is the earliest indicator of decreased cardiac output in a postoperative client?
A. Hypotension
B. Tachycardia
C. Decreased urine output
D. Altered mental status
🟢 B. Tachycardia
,🔴 RATIONALE: Tachycardia is typically the earliest compensatory response to decreased cardiac output, preceding hypotension and other signs of
shock.
Question 4
A client with a Glasgow Coma Scale (GCS) score of 6 requires which immediate intervention?
A. Nasogastric tube placement
B. Intubation with mechanical ventilation
C. 12-lead ECG
D. Advanced cardiac life support
🟢 B. Intubation with mechanical ventilation
🔴 RATIONALE: A GCS ≤8 indicates severe brain injury and inability to protect the airway, necessitating immediate intubation and mechanical
ventilation.
Question 5
Which electrolyte abnormality is most associated with peaked T waves and widened QRS complex on ECG?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypocalcemia
🟢 B. Hyperkalemia
🔴 RATIONALE: Hyperkalemia causes characteristic ECG changes including peaked T waves, widened QRS, and flattened P waves, which can
progress to ventricular fibrillation.
, Question 6
A client with acute respiratory distress syndrome (ARDS) on mechanical ventilation has continuous high-pressure alarms. What is the most likely
cause?
A. Increased lung compliance
B. Decreased lung compliance
C. Low tidal volume
D. High respiratory rate
🟢 B. Decreased lung compliance
🔴 RATIONALE: ARDS causes stiff, non-compliant lungs, increasing airway pressures and triggering high-pressure ventilator alarms.
Question 7
Which action is most important for preventing life-threatening complications during pulmonary artery catheter insertion?
A. Fast flush the PA distal port for no more than 2 seconds
B. Avoid infusing blood products through the PA catheter
C. Clear pressure tubing of blood after withdrawal
D. Maintain 300 mmHg pressure around flush bag
🟢 A. Fast flush the PA distal port for no more than 2 seconds
🔴 RATIONALE: Prolonged fast flushing can cause pulmonary artery rupture or wedge position complications; limiting to 2 seconds prevents this.
Question 8
A client with diabetic ketoacidosis (DKA) presents with Kussmaul respirations. What is the purpose of this breathing pattern?
