HESI RN CRITICAL CARE EXAM PREPARATION GUIDE 2025/2026 - COMPREHENSIVE TEST BANK
BASED ON INTRODUCTION TO CRITICAL CARE NURSING 8TH EDITION BY MARY LOU SOLE,
DEBORAH G. KLEIN, AND MARTHE J. MOSELEY - 130] QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
*Core Domains*
Hemodynamic Monitoring and Assessment
Cardiac Rhythm Interpretation and Management
Respiratory Failure and Mechanical Ventilation
Neurological Assessment and Intracranial Pressure Management
Acute Renal Failure and Electrolyte Imbalance
Critical Care Ethics and Patient Advocacy
Pharmacological Interventions in Critical Care
Multisystem Organ Dysfunction Syndrome (MODS)
*Introduction*
,This comprehensive examination is designed to assess the clinical proficiency and critical thinking skills of
nursing students and practitioners preparing for the HESI RN Critical Care certification. The assessment
evaluates foundational theoretical knowledge and applied clinical reasoning across diverse high-acuity
patient populations. Featuring a blend of standard multiple-choice questions and complex clinical
scenarios, this test bank emphasizes real-world decision-making, regulatory compliance, and adherence
to professional ethical standards. Participants will be challenged to prioritize care, interpret diagnostic
data, and implement evidence-based interventions essential for navigating the dynamic, high-stakes
environment of the modern intensive care unit.
SECTION ONE: QUESTIONS 1-100
A patient in the ICU is being monitored with a pulmonary artery catheter. The nurse notes a
decrease in cardiac output and an increase in systemic vascular resistance (SVR). Which
intervention is most appropriate?
A. Administer a potent vasoconstrictor.
B. Increase intravenous fluid administration.
C. Assess the patient for signs of hypovolemia or cardiogenic shock.
D. Decrease the infusion of inotropic medications.
🟢C
🔴 RATIONALE: An increase in SVR combined with a decrease in cardiac output typically indicates
compensatory vasoconstriction to maintain perfusion, often seen in hypovolemic or cardiogenic
shock states.
Which acid-base imbalance is most commonly associated with a patient receiving mechanical
ventilation at a rate that is too high?
A. Respiratory acidosis.
B. Respiratory alkalosis.
C. Metabolic acidosis.
D. Metabolic alkalosis.
,🟢B
🔴 RATIONALE: Hyperventilation via mechanical ventilation causes excessive clearance of carbon
dioxide, leading to a decrease in partial pressure of arterial carbon dioxide (PaCO2) and resultant
respiratory alkalosis.
When caring for a patient with increased intracranial pressure (ICP), which nursing intervention is
contraindicated?
A. Elevating the head of the bed to 30 degrees.
B. Maintaining the neck in a neutral alignment.
C. Clustering nursing care to promote rest.
D. Performing routine suctioning of the endotracheal tube without pre-oxygenation.
🟢D
🔴 RATIONALE: Suctioning without adequate pre-oxygenation causes transient hypoxia and
potential coughing, both of which significantly increase ICP and are contraindicated in neurological
emergencies.
A patient with acute respiratory distress syndrome (ARDS) is placed in the prone position. What is
the primary physiological goal of this intervention?
A. To decrease the work of breathing.
B. To improve oxygenation by recruiting collapsed alveoli in the dependent areas of the lung.
C. To prevent the development of ventilator-associated pneumonia.
D. To facilitate easier access for chest physiotherapy.
🟢B
🔴 RATIONALE: Proning shifts the weight of the heart and abdominal organs, allowing for better
expansion of the dorsal lung segments and improved ventilation-perfusion matching in patients with
ARDS.
, A patient on a dopamine drip at 10 mcg/kg/min for hemodynamic support begins to experience skin
coolness and mottling at the peripheral IV site. What is the priority action?
A. Decrease the dopamine dose.
B. Discontinue the infusion immediately.
C. Assess for signs of extravasation and administer phentolamine if indicated.
D. Apply a warm compress to the area.
🟢C
🔴 RATIONALE: Dopamine is a vasopressor that can cause tissue necrosis if it extravasates.
Immediate assessment and administration of an antidote like phentolamine is required to prevent
sloughing.
Which laboratory finding would indicate that a patient is developing multiple organ dysfunction
syndrome (MODS)?
A. Elevated serum creatinine.
B. Normal white blood cell count.
C. Decreased bilirubin levels.
D. Stable platelet count.
🟢A
🔴 RATIONALE: The development of MODS is characterized by the progressive failure of two or
more organ systems; an elevated creatinine indicates renal system failure, a hallmark of MODS.
A patient is admitted with diabetic ketoacidosis (DKA). Which electrolyte shift should the nurse
anticipate during the initiation of insulin therapy?
A. Hyperkalemia.
B. Hypernatremia.
C. Hypokalemia.
D. Hypocalcemia.
BASED ON INTRODUCTION TO CRITICAL CARE NURSING 8TH EDITION BY MARY LOU SOLE,
DEBORAH G. KLEIN, AND MARTHE J. MOSELEY - 130] QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
*Core Domains*
Hemodynamic Monitoring and Assessment
Cardiac Rhythm Interpretation and Management
Respiratory Failure and Mechanical Ventilation
Neurological Assessment and Intracranial Pressure Management
Acute Renal Failure and Electrolyte Imbalance
Critical Care Ethics and Patient Advocacy
Pharmacological Interventions in Critical Care
Multisystem Organ Dysfunction Syndrome (MODS)
*Introduction*
,This comprehensive examination is designed to assess the clinical proficiency and critical thinking skills of
nursing students and practitioners preparing for the HESI RN Critical Care certification. The assessment
evaluates foundational theoretical knowledge and applied clinical reasoning across diverse high-acuity
patient populations. Featuring a blend of standard multiple-choice questions and complex clinical
scenarios, this test bank emphasizes real-world decision-making, regulatory compliance, and adherence
to professional ethical standards. Participants will be challenged to prioritize care, interpret diagnostic
data, and implement evidence-based interventions essential for navigating the dynamic, high-stakes
environment of the modern intensive care unit.
SECTION ONE: QUESTIONS 1-100
A patient in the ICU is being monitored with a pulmonary artery catheter. The nurse notes a
decrease in cardiac output and an increase in systemic vascular resistance (SVR). Which
intervention is most appropriate?
A. Administer a potent vasoconstrictor.
B. Increase intravenous fluid administration.
C. Assess the patient for signs of hypovolemia or cardiogenic shock.
D. Decrease the infusion of inotropic medications.
🟢C
🔴 RATIONALE: An increase in SVR combined with a decrease in cardiac output typically indicates
compensatory vasoconstriction to maintain perfusion, often seen in hypovolemic or cardiogenic
shock states.
Which acid-base imbalance is most commonly associated with a patient receiving mechanical
ventilation at a rate that is too high?
A. Respiratory acidosis.
B. Respiratory alkalosis.
C. Metabolic acidosis.
D. Metabolic alkalosis.
,🟢B
🔴 RATIONALE: Hyperventilation via mechanical ventilation causes excessive clearance of carbon
dioxide, leading to a decrease in partial pressure of arterial carbon dioxide (PaCO2) and resultant
respiratory alkalosis.
When caring for a patient with increased intracranial pressure (ICP), which nursing intervention is
contraindicated?
A. Elevating the head of the bed to 30 degrees.
B. Maintaining the neck in a neutral alignment.
C. Clustering nursing care to promote rest.
D. Performing routine suctioning of the endotracheal tube without pre-oxygenation.
🟢D
🔴 RATIONALE: Suctioning without adequate pre-oxygenation causes transient hypoxia and
potential coughing, both of which significantly increase ICP and are contraindicated in neurological
emergencies.
A patient with acute respiratory distress syndrome (ARDS) is placed in the prone position. What is
the primary physiological goal of this intervention?
A. To decrease the work of breathing.
B. To improve oxygenation by recruiting collapsed alveoli in the dependent areas of the lung.
C. To prevent the development of ventilator-associated pneumonia.
D. To facilitate easier access for chest physiotherapy.
🟢B
🔴 RATIONALE: Proning shifts the weight of the heart and abdominal organs, allowing for better
expansion of the dorsal lung segments and improved ventilation-perfusion matching in patients with
ARDS.
, A patient on a dopamine drip at 10 mcg/kg/min for hemodynamic support begins to experience skin
coolness and mottling at the peripheral IV site. What is the priority action?
A. Decrease the dopamine dose.
B. Discontinue the infusion immediately.
C. Assess for signs of extravasation and administer phentolamine if indicated.
D. Apply a warm compress to the area.
🟢C
🔴 RATIONALE: Dopamine is a vasopressor that can cause tissue necrosis if it extravasates.
Immediate assessment and administration of an antidote like phentolamine is required to prevent
sloughing.
Which laboratory finding would indicate that a patient is developing multiple organ dysfunction
syndrome (MODS)?
A. Elevated serum creatinine.
B. Normal white blood cell count.
C. Decreased bilirubin levels.
D. Stable platelet count.
🟢A
🔴 RATIONALE: The development of MODS is characterized by the progressive failure of two or
more organ systems; an elevated creatinine indicates renal system failure, a hallmark of MODS.
A patient is admitted with diabetic ketoacidosis (DKA). Which electrolyte shift should the nurse
anticipate during the initiation of insulin therapy?
A. Hyperkalemia.
B. Hypernatremia.
C. Hypokalemia.
D. Hypocalcemia.
