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NGN HESI RN Critical Care Exam V2 (2025) –
Verified Actual Exam | Graded A+ with Correct
Questions and Expert Answers
Hemodynamic Monitoring & Shock Management
1. A patient in the ICU with septic shock has a mean arterial pressure (MAP) of 52 mmHg. Which
medication should the nurse prepare to administer first?
A) Furosemide
B) Norepinephrine
C) Metoprolol
D) Insulin
Correct answer: B) Norepinephrine
Rationale: Norepinephrine is the first-line vasopressor for septic shock. The goal is to achieve a MAP
of ≥65 mmHg to ensure adequate organ perfusion. Norepinephrine causes vasoconstriction,
increasing systemic vascular resistance (SVR) and blood pressure.
2. A patient with a pulmonary artery catheter has a cardiac output (CO) of 3.2 L/min and a
systemic vascular resistance (SVR) of 1800 dynes/sec/cm⁻⁵. What does the nurse interpret these
values to indicate?
A) Distributive shock
B) Cardiogenic shock
C) Hypovolemic shock
D) Obstructive shock
Correct answer: B) Cardiogenic shock
Rationale: Low CO with high SVR indicates the heart is failing to pump effectively (low CO), and the
peripheral vessels are vasoconstricting (high SVR) to compensate, which is classic for cardiogenic
shock.
3. The nurse is calculating fluid resuscitation for a young adult male who was burned in an
accident. The healthcare provider determines the client has burns over 30% of his body. Using the
Parkland formula, the client is to receive 7000 mL of fluid in 24 hours. Which goal should the nurse
establish for this client’s plan of care?
A) By 1800, the client will have received 3500 mL of fluid
B) By 2000, the client will have received 3500 mL of fluid
C) By 1400, the client will have received 7000 mL of fluid
D) By 0200, the client will have received 7000 mL of fluid
Correct answer: B) By 2000, the client will have received 3500 mL of fluid
Rationale: The Parkland formula prescribes half of the total 24-hour fluid volume within the first 8
hours post-burn. If the burn occurred at 1200, half (3500 mL) should be infused by 2000 (8 hours
after the injury).
, 2
4. A patient in the ICU has a central venous pressure (CVP) of 2 mmHg. What is the priority nursing
intervention?
A) Administer diuretics
B) Increase the vasopressor dose
C) Administer intravenous fluids
D) Prepare for intubation
Correct answer: C) Administer intravenous fluids
Rationale: A low CVP indicates hypovolemia. The priority is fluid resuscitation with isotonic
crystalloids (normal saline or lactated Ringer's) to restore intravascular volume and improve
perfusion.
5. A patient in distributive shock has a cardiac output of 8.5 L/min and low systemic vascular
resistance. Which type of shock is this consistent with?
A) Hypovolemic shock
B) Cardiogenic shock
C) Obstructive shock
D) Warm shock (early septic shock)
Correct answer: D) Warm shock (early septic shock)
Rationale: Early septic shock (a distributive shock) is characterized by high cardiac output (due to
compensatory tachycardia) and low SVR (due to vasodilation). The patient may present with warm,
flushed skin and bounding pulses.
6. A patient with a pulmonary artery catheter has a PAWP of 24 mmHg. What does this finding
indicate?
A) Hypovolemia
B) Left ventricular failure
C) Right ventricular failure
D) Normal filling pressure
Correct answer: B) Left ventricular failure
Rationale: Normal PAWP is 4-12 mmHg. An elevated PAWP (>18 mmHg) indicates left ventricular
failure and fluid backup into the pulmonary circulation.
7. (NGN Bow-Tie) The nurse is assessing a patient 2 hours after a percutaneous coronary
intervention (PCI) via the femoral artery. The patient reports severe groin pain and the nurse
notes a rapidly expanding hematoma at the insertion site.
• Condition: The patient is most likely experiencing a ________.
• Action to Take: ________.
• Parameter to Monitor: ________.
Correct Answers: Condition: Retroperitoneal Bleed; Action to Take: Apply manual pressure
above the insertion site; Parameter to Monitor: Hemoglobin and Hematocrit.
Rationale: A rapidly expanding hematoma post-femoral PCI suggests arterial bleeding.
Manual pressure is the immediate intervention to stop blood loss. Retroperitoneal bleeding
is a life-threatening complication; monitoring H&H confirms blood loss severity.
🫁 Respiratory Failure & Mechanical Ventilation
8. A patient with acute respiratory distress syndrome (ARDS) is on mechanical ventilation with the
following settings: FiO₂ 0.8, PEEP 10 cm H₂O, tidal volume 6 mL/kg. The patient's ABG results are:
NGN HESI RN Critical Care Exam V2 (2025) –
Verified Actual Exam | Graded A+ with Correct
Questions and Expert Answers
Hemodynamic Monitoring & Shock Management
1. A patient in the ICU with septic shock has a mean arterial pressure (MAP) of 52 mmHg. Which
medication should the nurse prepare to administer first?
A) Furosemide
B) Norepinephrine
C) Metoprolol
D) Insulin
Correct answer: B) Norepinephrine
Rationale: Norepinephrine is the first-line vasopressor for septic shock. The goal is to achieve a MAP
of ≥65 mmHg to ensure adequate organ perfusion. Norepinephrine causes vasoconstriction,
increasing systemic vascular resistance (SVR) and blood pressure.
2. A patient with a pulmonary artery catheter has a cardiac output (CO) of 3.2 L/min and a
systemic vascular resistance (SVR) of 1800 dynes/sec/cm⁻⁵. What does the nurse interpret these
values to indicate?
A) Distributive shock
B) Cardiogenic shock
C) Hypovolemic shock
D) Obstructive shock
Correct answer: B) Cardiogenic shock
Rationale: Low CO with high SVR indicates the heart is failing to pump effectively (low CO), and the
peripheral vessels are vasoconstricting (high SVR) to compensate, which is classic for cardiogenic
shock.
3. The nurse is calculating fluid resuscitation for a young adult male who was burned in an
accident. The healthcare provider determines the client has burns over 30% of his body. Using the
Parkland formula, the client is to receive 7000 mL of fluid in 24 hours. Which goal should the nurse
establish for this client’s plan of care?
A) By 1800, the client will have received 3500 mL of fluid
B) By 2000, the client will have received 3500 mL of fluid
C) By 1400, the client will have received 7000 mL of fluid
D) By 0200, the client will have received 7000 mL of fluid
Correct answer: B) By 2000, the client will have received 3500 mL of fluid
Rationale: The Parkland formula prescribes half of the total 24-hour fluid volume within the first 8
hours post-burn. If the burn occurred at 1200, half (3500 mL) should be infused by 2000 (8 hours
after the injury).
, 2
4. A patient in the ICU has a central venous pressure (CVP) of 2 mmHg. What is the priority nursing
intervention?
A) Administer diuretics
B) Increase the vasopressor dose
C) Administer intravenous fluids
D) Prepare for intubation
Correct answer: C) Administer intravenous fluids
Rationale: A low CVP indicates hypovolemia. The priority is fluid resuscitation with isotonic
crystalloids (normal saline or lactated Ringer's) to restore intravascular volume and improve
perfusion.
5. A patient in distributive shock has a cardiac output of 8.5 L/min and low systemic vascular
resistance. Which type of shock is this consistent with?
A) Hypovolemic shock
B) Cardiogenic shock
C) Obstructive shock
D) Warm shock (early septic shock)
Correct answer: D) Warm shock (early septic shock)
Rationale: Early septic shock (a distributive shock) is characterized by high cardiac output (due to
compensatory tachycardia) and low SVR (due to vasodilation). The patient may present with warm,
flushed skin and bounding pulses.
6. A patient with a pulmonary artery catheter has a PAWP of 24 mmHg. What does this finding
indicate?
A) Hypovolemia
B) Left ventricular failure
C) Right ventricular failure
D) Normal filling pressure
Correct answer: B) Left ventricular failure
Rationale: Normal PAWP is 4-12 mmHg. An elevated PAWP (>18 mmHg) indicates left ventricular
failure and fluid backup into the pulmonary circulation.
7. (NGN Bow-Tie) The nurse is assessing a patient 2 hours after a percutaneous coronary
intervention (PCI) via the femoral artery. The patient reports severe groin pain and the nurse
notes a rapidly expanding hematoma at the insertion site.
• Condition: The patient is most likely experiencing a ________.
• Action to Take: ________.
• Parameter to Monitor: ________.
Correct Answers: Condition: Retroperitoneal Bleed; Action to Take: Apply manual pressure
above the insertion site; Parameter to Monitor: Hemoglobin and Hematocrit.
Rationale: A rapidly expanding hematoma post-femoral PCI suggests arterial bleeding.
Manual pressure is the immediate intervention to stop blood loss. Retroperitoneal bleeding
is a life-threatening complication; monitoring H&H confirms blood loss severity.
🫁 Respiratory Failure & Mechanical Ventilation
8. A patient with acute respiratory distress syndrome (ARDS) is on mechanical ventilation with the
following settings: FiO₂ 0.8, PEEP 10 cm H₂O, tidal volume 6 mL/kg. The patient's ABG results are:
