Pass exams with confidence using this complete nursing study guide
and practice pack. Unlock your nursing potential with this NCLEX‑style
prep and student success resource for the 2025/2026 academic year.
---
## 🏆 Critical Care & Emergency Nursing Success Pack – 2026 Ultimate
Prep Guide | NCLEX-Style Revision Notes & Practice Questions Bundle
---
**1. A nurse in the intensive care unit (ICU) is caring for a client with a pulmonary artery (Swan-Ganz)
catheter. Which reading reflects the client's left ventricular preload?**
A) Central venous pressure (CVP)
B) Pulmonary artery wedge pressure (PAWP)
C) Cardiac output (CO)
D) Systemic vascular resistance (SVR)
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: The pulmonary artery wedge pressure (PAWP) reflects left ventricular end-diastolic
pressure and serves as an indicator of left ventricular preload (Option B). CVP (Option A) reflects right
ventricular preload. Cardiac output (Option C) is the amount of blood pumped by the heart per minute.
SVR (Option D) reflects afterload. This nursing study guide emphasizes hemodynamic monitoring for
student success.
---
**2. A client is admitted to the emergency department with status epilepticus. Which medication should
the nurse anticipate administering first?**
,A) Phenytoin (Dilantin) intravenously
B) Lorazepam (Ativan) intravenously
C) Carbamazepine (Tegretol) orally
D) Valproic acid (Depakote) orally
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: Status epilepticus is a life-threatening emergency requiring immediate intervention.
Lorazepam (or diazepam) is a benzodiazepine that is the first-line treatment for rapid seizure cessation
(Option B). Phenytoin (Option A) is a second-line agent. Oral medications (Options C and D) are not
appropriate for acute seizure control. These NCLEX‑style prep questions reinforce emergency
pharmacology.
---
**3. A nurse is caring for a client with a chest tube. The nurse notes continuous bubbling in the water
seal chamber. Which action is most appropriate?**
A) Clamp the chest tube immediately
B) Assess the system for an air leak
C) Notify the healthcare provider immediately
D) Document the finding as a normal variation
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: Continuous bubbling in the water seal chamber indicates an air leak, which must be
assessed to locate the source (Option B). Clamping the tube (Option A) can cause a tension
pneumothorax and is not the first step. While notifying the provider (Option C) may be necessary, the
initial action is to assess the system. Continuous bubbling is not a normal variation (Option D). This
nursing exam prep is essential for chest tube management.
---
**4. A client with severe sepsis has a lactate level of 4.5 mmol/L. This finding indicates:**
A) Adequate tissue perfusion
,B) Tissue hypoperfusion and anaerobic metabolism
C) A normal metabolic state
D) The client is responding well to fluid resuscitation
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: Elevated lactate (> 4 mmol/L) indicates tissue hypoperfusion and anaerobic
metabolism, a hallmark of severe sepsis and septic shock (Option B). It indicates inadequate perfusion
(Option A), is not a normal state (Option C), and suggests the client is not responding well to
resuscitation (Option D). This nursing study guide is critical for recognizing sepsis.
---
**5. A nurse is preparing to administer a rapid sequence intubation (RSI) medication. Which medication
is most commonly used to facilitate intubation by providing sedation and amnesia?**
A) Succinylcholine
B) Rocuronium
C) Etomidate
D) Propofol
💫ANSWER✔️✔️: C
💫RATIONALE✔️✔️: Etomidate is an induction agent used in RSI to provide sedation and amnesia while
maintaining hemodynamic stability (Option C). Succinylcholine (Option A) and rocuronium (Option B) are
neuromuscular blocking agents used for paralysis. Propofol (Option D) can be used but may cause
hypotension. These practice questions are key for emergency airway management.
---
**6. A client is admitted with a traumatic brain injury. Which assessment finding is most concerning for
increased intracranial pressure (ICP)?**
A) A decrease in level of consciousness
B) A headache that is relieved by rest
, C) A blood pressure of 120/80 mmHg
D) A respiratory rate of 18 breaths/min
💫ANSWER✔️✔️: A
💫RATIONALE✔️✔️: A change in level of consciousness is the earliest and most sensitive indicator of
increased ICP (Option A). Headache (Option B) is a common finding but not the most concerning. A
stable blood pressure (Option C) and normal respiratory rate (Option D) are not indicative of rising ICP.
This nursing exam prep is essential for neurological assessment.
---
**7. A client is experiencing an acute myocardial infarction (STEMI). Which is the priority nursing
intervention?**
A) Administer morphine for chest pain
B) Administer aspirin and call the catheterization lab
C) Obtain a 12-lead EKG
D) Start an IV infusion of nitroglycerin
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: In a STEMI, the priority is to restore blood flow to the affected area. Administering
aspirin and activating the catheterization lab for percutaneous coronary intervention (PCI) is the priority
(Option B). Morphine (Option A), EKG (Option C), and nitroglycerin (Option D) are important but
secondary to reperfusion. This nursing study guide is key for acute coronary syndrome management.
---
**8. A client with a massive pulmonary embolism has a blood pressure of 70/40 mmHg. Which
medication is the nurse most likely to administer?**
A) Heparin bolus
B) Normal saline bolus
C) Norepinephrine (Levophed)
and practice pack. Unlock your nursing potential with this NCLEX‑style
prep and student success resource for the 2025/2026 academic year.
---
## 🏆 Critical Care & Emergency Nursing Success Pack – 2026 Ultimate
Prep Guide | NCLEX-Style Revision Notes & Practice Questions Bundle
---
**1. A nurse in the intensive care unit (ICU) is caring for a client with a pulmonary artery (Swan-Ganz)
catheter. Which reading reflects the client's left ventricular preload?**
A) Central venous pressure (CVP)
B) Pulmonary artery wedge pressure (PAWP)
C) Cardiac output (CO)
D) Systemic vascular resistance (SVR)
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: The pulmonary artery wedge pressure (PAWP) reflects left ventricular end-diastolic
pressure and serves as an indicator of left ventricular preload (Option B). CVP (Option A) reflects right
ventricular preload. Cardiac output (Option C) is the amount of blood pumped by the heart per minute.
SVR (Option D) reflects afterload. This nursing study guide emphasizes hemodynamic monitoring for
student success.
---
**2. A client is admitted to the emergency department with status epilepticus. Which medication should
the nurse anticipate administering first?**
,A) Phenytoin (Dilantin) intravenously
B) Lorazepam (Ativan) intravenously
C) Carbamazepine (Tegretol) orally
D) Valproic acid (Depakote) orally
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: Status epilepticus is a life-threatening emergency requiring immediate intervention.
Lorazepam (or diazepam) is a benzodiazepine that is the first-line treatment for rapid seizure cessation
(Option B). Phenytoin (Option A) is a second-line agent. Oral medications (Options C and D) are not
appropriate for acute seizure control. These NCLEX‑style prep questions reinforce emergency
pharmacology.
---
**3. A nurse is caring for a client with a chest tube. The nurse notes continuous bubbling in the water
seal chamber. Which action is most appropriate?**
A) Clamp the chest tube immediately
B) Assess the system for an air leak
C) Notify the healthcare provider immediately
D) Document the finding as a normal variation
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: Continuous bubbling in the water seal chamber indicates an air leak, which must be
assessed to locate the source (Option B). Clamping the tube (Option A) can cause a tension
pneumothorax and is not the first step. While notifying the provider (Option C) may be necessary, the
initial action is to assess the system. Continuous bubbling is not a normal variation (Option D). This
nursing exam prep is essential for chest tube management.
---
**4. A client with severe sepsis has a lactate level of 4.5 mmol/L. This finding indicates:**
A) Adequate tissue perfusion
,B) Tissue hypoperfusion and anaerobic metabolism
C) A normal metabolic state
D) The client is responding well to fluid resuscitation
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: Elevated lactate (> 4 mmol/L) indicates tissue hypoperfusion and anaerobic
metabolism, a hallmark of severe sepsis and septic shock (Option B). It indicates inadequate perfusion
(Option A), is not a normal state (Option C), and suggests the client is not responding well to
resuscitation (Option D). This nursing study guide is critical for recognizing sepsis.
---
**5. A nurse is preparing to administer a rapid sequence intubation (RSI) medication. Which medication
is most commonly used to facilitate intubation by providing sedation and amnesia?**
A) Succinylcholine
B) Rocuronium
C) Etomidate
D) Propofol
💫ANSWER✔️✔️: C
💫RATIONALE✔️✔️: Etomidate is an induction agent used in RSI to provide sedation and amnesia while
maintaining hemodynamic stability (Option C). Succinylcholine (Option A) and rocuronium (Option B) are
neuromuscular blocking agents used for paralysis. Propofol (Option D) can be used but may cause
hypotension. These practice questions are key for emergency airway management.
---
**6. A client is admitted with a traumatic brain injury. Which assessment finding is most concerning for
increased intracranial pressure (ICP)?**
A) A decrease in level of consciousness
B) A headache that is relieved by rest
, C) A blood pressure of 120/80 mmHg
D) A respiratory rate of 18 breaths/min
💫ANSWER✔️✔️: A
💫RATIONALE✔️✔️: A change in level of consciousness is the earliest and most sensitive indicator of
increased ICP (Option A). Headache (Option B) is a common finding but not the most concerning. A
stable blood pressure (Option C) and normal respiratory rate (Option D) are not indicative of rising ICP.
This nursing exam prep is essential for neurological assessment.
---
**7. A client is experiencing an acute myocardial infarction (STEMI). Which is the priority nursing
intervention?**
A) Administer morphine for chest pain
B) Administer aspirin and call the catheterization lab
C) Obtain a 12-lead EKG
D) Start an IV infusion of nitroglycerin
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: In a STEMI, the priority is to restore blood flow to the affected area. Administering
aspirin and activating the catheterization lab for percutaneous coronary intervention (PCI) is the priority
(Option B). Morphine (Option A), EKG (Option C), and nitroglycerin (Option D) are important but
secondary to reperfusion. This nursing study guide is key for acute coronary syndrome management.
---
**8. A client with a massive pulmonary embolism has a blood pressure of 70/40 mmHg. Which
medication is the nurse most likely to administer?**
A) Heparin bolus
B) Normal saline bolus
C) Norepinephrine (Levophed)
