CRITICAL CARE EXIT HESI EXAM QUESTIONS AND ANSWERS ALREADY GRADED A+. 100% VERIFIED
SOLUTIONS | UPDATED PER LATEST GUIDELINES | GRADED A+
Question 1
A patient in the intensive care unit (ICU) with acute respiratory distress syndrome (ARDS) is receiving mechanical
ventilation with positive end-expiratory pressure (PEEP). Which assessment finding indicates a potential
complication of PEEP therapy?
A. Increased cardiac output
B. Decreased urine output
C. Hypotension and decreased cardiac output
D. Increased pulmonary artery wedge pressure
🟢 Correct Answer:
C. Hypotension and decreased cardiac output
🔴 RATIONALE:
PEEP increases intrathoracic pressure, which can decrease venous return and cardiac output, leading to
hypotension. This is a known complication of PEEP therapy. The nurse should monitor for signs of decreased
cardiac output, such as hypotension, tachycardia, and decreased urine output. Increased cardiac output is not a
complication of PEEP.
,Question 2
The nurse is caring for a patient with a pulmonary artery catheter. The nurse notes a sudden increase in
pulmonary artery wedge pressure (PAWP). Which intervention is most appropriate?
A. Administer a fluid bolus
B. Administer a diuretic as prescribed
C. Increase the rate of vasopressor infusion
D. Decrease the rate of vasopressor infusion
🟢 Correct Answer:
B. Administer a diuretic as prescribed
🔴 RATIONALE:
An elevated PAWP indicates increased left ventricular end-diastolic pressure, which suggests fluid overload or
heart failure. The appropriate intervention is to administer a diuretic to reduce fluid volume and decrease the
PAWP. Administering a fluid bolus would worsen the condition. Vasopressors may be needed for hypotension
but do not directly address the elevated PAWP.
Question 3
A patient with severe sepsis is receiving norepinephrine infusion. Which assessment finding indicates the
medication is having the desired therapeutic effect?
A. Decreased heart rate
B. Increased mean arterial pressure (MAP)
C. Decreased urine output
D. Increased temperature
,🟢 Correct Answer:
B. Increased mean arterial pressure (MAP)
🔴 RATIONALE:
Norepinephrine is a potent vasopressor used in septic shock to increase systemic vascular resistance and
improve mean arterial pressure (MAP). A MAP of 65 mmHg or greater is the target for adequate tissue
perfusion. The desired therapeutic effect is an increase in MAP, which indicates improved perfusion. Decreased
heart rate and urine output are not desired effects.
Question 4
The nurse is caring for a patient with a traumatic brain injury (TBI) who has an intracranial pressure (ICP) monitor
in place. Which ICP reading requires immediate intervention?
A. 12 mmHg
B. 18 mmHg
C. 22 mmHg
D. 8 mmHg
🟢 Correct Answer:
C. 22 mmHg
🔴 RATIONALE:
Normal ICP is 5-15 mmHg. An ICP of 22 mmHg is elevated and indicates intracranial hypertension. This requires
immediate intervention to prevent further neurological injury. Interventions may include elevating the head of
, the bed, administering hyperosmotic agents, or providing sedation. ICP readings of 8, 12, and 18 mmHg are
within acceptable ranges, though 18 mmHg is borderline.
Question 5
A patient with acute myocardial infarction (AMI) is receiving a continuous infusion of tissue plasminogen
activator (tPA). Which assessment finding is most concerning during this therapy?
A. Chest pain
B. Bleeding from the intravenous site
C. Headache
D. Nausea
🟢 Correct Answer:
C. Headache
🔴 RATIONALE:
A headache in a patient receiving tPA can be a sign of intracranial hemorrhage, which is a life-threatening
complication. The nurse should immediately stop the infusion and notify the healthcare provider. Bleeding from
the IV site is a common side effect but is not as immediately concerning as a headache, which may indicate a
cerebral bleed. Chest pain is expected with AMI.
Question 6
The nurse is caring for a patient with status asthmaticus who is receiving continuous albuterol nebulization.
SOLUTIONS | UPDATED PER LATEST GUIDELINES | GRADED A+
Question 1
A patient in the intensive care unit (ICU) with acute respiratory distress syndrome (ARDS) is receiving mechanical
ventilation with positive end-expiratory pressure (PEEP). Which assessment finding indicates a potential
complication of PEEP therapy?
A. Increased cardiac output
B. Decreased urine output
C. Hypotension and decreased cardiac output
D. Increased pulmonary artery wedge pressure
🟢 Correct Answer:
C. Hypotension and decreased cardiac output
🔴 RATIONALE:
PEEP increases intrathoracic pressure, which can decrease venous return and cardiac output, leading to
hypotension. This is a known complication of PEEP therapy. The nurse should monitor for signs of decreased
cardiac output, such as hypotension, tachycardia, and decreased urine output. Increased cardiac output is not a
complication of PEEP.
,Question 2
The nurse is caring for a patient with a pulmonary artery catheter. The nurse notes a sudden increase in
pulmonary artery wedge pressure (PAWP). Which intervention is most appropriate?
A. Administer a fluid bolus
B. Administer a diuretic as prescribed
C. Increase the rate of vasopressor infusion
D. Decrease the rate of vasopressor infusion
🟢 Correct Answer:
B. Administer a diuretic as prescribed
🔴 RATIONALE:
An elevated PAWP indicates increased left ventricular end-diastolic pressure, which suggests fluid overload or
heart failure. The appropriate intervention is to administer a diuretic to reduce fluid volume and decrease the
PAWP. Administering a fluid bolus would worsen the condition. Vasopressors may be needed for hypotension
but do not directly address the elevated PAWP.
Question 3
A patient with severe sepsis is receiving norepinephrine infusion. Which assessment finding indicates the
medication is having the desired therapeutic effect?
A. Decreased heart rate
B. Increased mean arterial pressure (MAP)
C. Decreased urine output
D. Increased temperature
,🟢 Correct Answer:
B. Increased mean arterial pressure (MAP)
🔴 RATIONALE:
Norepinephrine is a potent vasopressor used in septic shock to increase systemic vascular resistance and
improve mean arterial pressure (MAP). A MAP of 65 mmHg or greater is the target for adequate tissue
perfusion. The desired therapeutic effect is an increase in MAP, which indicates improved perfusion. Decreased
heart rate and urine output are not desired effects.
Question 4
The nurse is caring for a patient with a traumatic brain injury (TBI) who has an intracranial pressure (ICP) monitor
in place. Which ICP reading requires immediate intervention?
A. 12 mmHg
B. 18 mmHg
C. 22 mmHg
D. 8 mmHg
🟢 Correct Answer:
C. 22 mmHg
🔴 RATIONALE:
Normal ICP is 5-15 mmHg. An ICP of 22 mmHg is elevated and indicates intracranial hypertension. This requires
immediate intervention to prevent further neurological injury. Interventions may include elevating the head of
, the bed, administering hyperosmotic agents, or providing sedation. ICP readings of 8, 12, and 18 mmHg are
within acceptable ranges, though 18 mmHg is borderline.
Question 5
A patient with acute myocardial infarction (AMI) is receiving a continuous infusion of tissue plasminogen
activator (tPA). Which assessment finding is most concerning during this therapy?
A. Chest pain
B. Bleeding from the intravenous site
C. Headache
D. Nausea
🟢 Correct Answer:
C. Headache
🔴 RATIONALE:
A headache in a patient receiving tPA can be a sign of intracranial hemorrhage, which is a life-threatening
complication. The nurse should immediately stop the infusion and notify the healthcare provider. Bleeding from
the IV site is a common side effect but is not as immediately concerning as a headache, which may indicate a
cerebral bleed. Chest pain is expected with AMI.
Question 6
The nurse is caring for a patient with status asthmaticus who is receiving continuous albuterol nebulization.
