HESI CRITICAL CARE EXIT EXAM TEST BANK WITH
7 VERSIONS (V1, V2, V3, V4, V5, V6, V7)
COMPREHENSIVE PRACTICE EXAM LATEST
UPDATED 2026-2027 ACTUAL FINAL EXAM WITH ALL
POSSIBLE AND WELL ELABORATED 300 PRACTICE
QUESTIONS AND 100% CORRECT VERIFIED
ANSWERS FULLY SOLVED PLUS DETAILED
RATIONALES INCLUDING EXPERT ANSWER KEY
(COMPLETE A+ SOLUTIONS) NEWLY UPDATED
VERSION FULL REVISED RATED A+ BRAND NEW!!!
1. A patient with acute respiratory distress
syndrome (ARDS) has a PaO2/FiO2 ratio of 150.
Which ventilator setting should the nurse
anticipate?
A. Increase FiO2 to 100%
B. Decrease PEEP to 5 cm H2O
C. Decrease tidal volume to 4 mL/kg
D. Increase respiratory rate to 35 breaths/min
Correct Answer: C
,Rationale: In ARDS, low tidal volume (4–6
mL/kg ideal body weight) is lung-protective. A
PaO2/FiO2 <200 indicates ARDS; high FiO2
alone is not first-line. PEEP should be
optimized, not decreased.
2. A patient with sepsis develops hypotension
unresponsive to fluid boluses. Which
vasopressor is first-line?
A. Dopamine
B. Epinephrine
C. Norepinephrine
D. Vasopressin
Correct Answer: C
Rationale: Norepinephrine is the first-line
vasopressor in septic shock per Surviving
Sepsis Campaign. Dopamine is reserved for
bradycardia; epinephrine is second-line.
3. The nurse assesses a patient with a
pulmonary artery catheter. The cardiac index is
2.0 L/min/m2 and pulmonary capillary wedge
,pressure (PCWP) is 4 mm Hg. Which
intervention is priority?
A. Administer dobutamine
B. Give 500 mL normal saline bolus
C. Start norepinephrine infusion
D. Increase PEEP
Correct Answer: B
Rationale: Low cardiac index with low PCWP
suggests hypovolemia; fluid resuscitation is
priority before inotropes or vasopressors.
4. A patient on mechanical ventilation has an
arterial blood gas: pH 7.28, PaCO2 55, HCO3 22.
What is the primary acid-base disturbance?
A. Metabolic acidosis
B. Acute respiratory acidosis
C. Chronic respiratory acidosis
D. Metabolic alkalosis
Correct Answer: B
Rationale: Low pH with high PaCO2 and
normal HCO3 indicates acute respiratory
, acidosis. Chronic would show compensatory
HCO3 elevation.
5. Which finding indicates impending
respiratory failure in a patient with Guillain-
Barré syndrome?
A. Forced vital capacity <15 mL/kg
B. Peripheral paresthesias
C. Bulbar weakness
D. Loss of deep tendon reflexes
Correct Answer: A
Rationale: FVC <15 mL/kg or <1 L indicates
need for mechanical ventilation. Bulbar
weakness is a sign but not as immediate a
predictor of respiratory failure.
6. A patient with acute myocardial infarction
develops a new murmur and hemodynamic
instability. Which complication is most likely?
A. Papillary muscle rupture
B. Ventricular septal rupture
C. Free wall rupture
7 VERSIONS (V1, V2, V3, V4, V5, V6, V7)
COMPREHENSIVE PRACTICE EXAM LATEST
UPDATED 2026-2027 ACTUAL FINAL EXAM WITH ALL
POSSIBLE AND WELL ELABORATED 300 PRACTICE
QUESTIONS AND 100% CORRECT VERIFIED
ANSWERS FULLY SOLVED PLUS DETAILED
RATIONALES INCLUDING EXPERT ANSWER KEY
(COMPLETE A+ SOLUTIONS) NEWLY UPDATED
VERSION FULL REVISED RATED A+ BRAND NEW!!!
1. A patient with acute respiratory distress
syndrome (ARDS) has a PaO2/FiO2 ratio of 150.
Which ventilator setting should the nurse
anticipate?
A. Increase FiO2 to 100%
B. Decrease PEEP to 5 cm H2O
C. Decrease tidal volume to 4 mL/kg
D. Increase respiratory rate to 35 breaths/min
Correct Answer: C
,Rationale: In ARDS, low tidal volume (4–6
mL/kg ideal body weight) is lung-protective. A
PaO2/FiO2 <200 indicates ARDS; high FiO2
alone is not first-line. PEEP should be
optimized, not decreased.
2. A patient with sepsis develops hypotension
unresponsive to fluid boluses. Which
vasopressor is first-line?
A. Dopamine
B. Epinephrine
C. Norepinephrine
D. Vasopressin
Correct Answer: C
Rationale: Norepinephrine is the first-line
vasopressor in septic shock per Surviving
Sepsis Campaign. Dopamine is reserved for
bradycardia; epinephrine is second-line.
3. The nurse assesses a patient with a
pulmonary artery catheter. The cardiac index is
2.0 L/min/m2 and pulmonary capillary wedge
,pressure (PCWP) is 4 mm Hg. Which
intervention is priority?
A. Administer dobutamine
B. Give 500 mL normal saline bolus
C. Start norepinephrine infusion
D. Increase PEEP
Correct Answer: B
Rationale: Low cardiac index with low PCWP
suggests hypovolemia; fluid resuscitation is
priority before inotropes or vasopressors.
4. A patient on mechanical ventilation has an
arterial blood gas: pH 7.28, PaCO2 55, HCO3 22.
What is the primary acid-base disturbance?
A. Metabolic acidosis
B. Acute respiratory acidosis
C. Chronic respiratory acidosis
D. Metabolic alkalosis
Correct Answer: B
Rationale: Low pH with high PaCO2 and
normal HCO3 indicates acute respiratory
, acidosis. Chronic would show compensatory
HCO3 elevation.
5. Which finding indicates impending
respiratory failure in a patient with Guillain-
Barré syndrome?
A. Forced vital capacity <15 mL/kg
B. Peripheral paresthesias
C. Bulbar weakness
D. Loss of deep tendon reflexes
Correct Answer: A
Rationale: FVC <15 mL/kg or <1 L indicates
need for mechanical ventilation. Bulbar
weakness is a sign but not as immediate a
predictor of respiratory failure.
6. A patient with acute myocardial infarction
develops a new murmur and hemodynamic
instability. Which complication is most likely?
A. Papillary muscle rupture
B. Ventricular septal rupture
C. Free wall rupture
