Page 1 of 47
KAPLAN CRITICAL CARE ASSESSMENT 2026/2027
COMPLETE (100) CURRENT TESTING QUESTIONS AND
CORRECT ANSWERS WITH DETAILED RATIONALES.
CRITICAL CARE
Prepare for the Kaplan Critical Care Assessment with a focused study resource
covering essential concepts in critical care nursing and the management of acutely ill
patients. It supports review of patient assessment, hemodynamic monitoring,
respiratory and cardiovascular conditions, emergency interventions, prioritization,
and patient safety. Use the material to reinforce clinical knowledge, strengthen
critical-thinking skills, and identify areas that may require additional review. This
resource is best suited for nursing students and NCLEX candidates preparing for
critical care assessments.
MULTIPLE CHOICE.
HEMODYNAMIC MONITORING
1. A patient in the ICU has a pulmonary artery catheter (Swan-Ganz) in
place. The nurse notes a sudden increase in pulmonary artery wedge
pressure (PAWP) from 12 mmHg to 25 mmHg. Which of the following
conditions is most likely causing this change?
• A) Hypovolemia
• B) Left ventricular failure
• C) Pulmonary embolism
• D) Cardiac tamponade
Answer: B) Left ventricular failure
Rationale: PAWP reflects left ventricular end-diastolic pressure. An
increase in PAWP indicates increased left ventricular filling pressure,
which is consistent with left ventricular failure. Hypovolemia would
decrease PAWP. Pulmonary embolism and cardiac tamponade may affect
right heart pressures but do not directly elevate PAWP unless left heart
failure develops.
, Page 2 of 47
2. A patient with a pulmonary artery catheter has a cardiac output of 3.2
L/min and a cardiac index of 1.8 L/min/m². What does this indicate?
• A) Normal cardiac function
• B) Mildly decreased cardiac output
• C) Significantly decreased cardiac output
• D) Hyperdynamic state
Answer: C) Significantly decreased cardiac output
Rationale: Normal cardiac index is 2.5-4.0 L/min/m². A cardiac index of 1.8
indicates severely decreased cardiac output (< 2.2 L/min/m²) consistent
with cardiogenic shock. This requires immediate intervention to improve
perfusion.
3. A patient with a pulmonary artery catheter has a central venous
pressure (CVP) of 2 mmHg. This finding is most consistent with which
condition?
• A) Fluid overload
• B) Hypovolemia
• C) Right heart failure
• D) Pulmonary hypertension
Answer: B) Hypovolemia
Rationale: Normal CVP is 2-8 mmHg. A CVP of 2 mmHg is at the low end of
normal and suggests hypovolemia or decreased right ventricular preload.
Fluid overload, right heart failure, and pulmonary hypertension would
cause elevated CVP.
4. A patient with a pulmonary artery catheter has a pulmonary artery
pressure (PAP) of 45/25 mmHg. Which condition is most likely?
, Page 3 of 47
• A) Hypovolemia
• B) Pulmonary hypertension
• C) Left ventricular failure
• D) Cardiac tamponade
Answer: B) Pulmonary hypertension
Rationale: Normal PAP is 15-30/5-15 mmHg. Elevated PAP (45/25)
indicates pulmonary hypertension, which can be caused by COPD,
pulmonary embolism, left heart failure, or primary pulmonary
hypertension. Hypovolemia would cause decreased PAP.
5. A patient's arterial waveform shows a rapid upstroke, a systolic peak, a
dicrotic notch, and a diastolic component. Which of the following is most
important for the nurse to assess when interpreting an arterial line
waveform?
• A) The height of the systolic peak
• B) The presence of a dicrotic notch
• C) The square wave test to check damping
• D) The patient's respiratory rate
Answer: C) The square wave test to check damping
Rationale: The square wave test (fast flush test) is used to assess the
dynamic response of the arterial line system. An overdamped or
underdamped waveform can lead to inaccurate blood pressure readings.
The presence of a dicrotic notch is normal, and the systolic peak height
alone does not validate waveform accuracy.
6. An ICU patient has an arterial line that is showing a dampened
waveform. The nurse should first:
• A) Re-zero the transducer
, Page 4 of 47
• B) Assess for air bubbles or clots in the system
• C) Replace the arterial line
• D) Increase the flush solution pressure
Answer: B) Assess for air bubbles or clots in the system
Rationale: A dampened waveform is often caused by air bubbles, clots, or
kinks in the arterial line system. The nurse should first check the system
for these issues before re-zeroing or replacing the line. Re-zeroing may be
needed but only after physical problems are ruled out.
7. A patient's cardiac output measurement via thermodilution is 4.5
L/min. The patient's heart rate is 90 bpm. What is the patient's stroke
volume?
• A) 40 mL
• B) 50 mL
• C) 60 mL
• D) 80 mL
Answer: B) 50 mL
Rationale: Stroke volume = Cardiac output / Heart rate × 1000. 4.5 L/min ÷
90 bpm × 1000 = 50 mL/beat. Normal stroke volume is 60-100 mL/beat.
This patient has a decreased stroke volume.
8. A patient in the ICU has a systemic vascular resistance (SVR) of 1800
dynes/sec/cm⁻⁵. This finding is most consistent with which condition?
• A) Septic shock
• B) Hypovolemic shock
• C) Cardiogenic shock
• D) Anaphylactic shock
KAPLAN CRITICAL CARE ASSESSMENT 2026/2027
COMPLETE (100) CURRENT TESTING QUESTIONS AND
CORRECT ANSWERS WITH DETAILED RATIONALES.
CRITICAL CARE
Prepare for the Kaplan Critical Care Assessment with a focused study resource
covering essential concepts in critical care nursing and the management of acutely ill
patients. It supports review of patient assessment, hemodynamic monitoring,
respiratory and cardiovascular conditions, emergency interventions, prioritization,
and patient safety. Use the material to reinforce clinical knowledge, strengthen
critical-thinking skills, and identify areas that may require additional review. This
resource is best suited for nursing students and NCLEX candidates preparing for
critical care assessments.
MULTIPLE CHOICE.
HEMODYNAMIC MONITORING
1. A patient in the ICU has a pulmonary artery catheter (Swan-Ganz) in
place. The nurse notes a sudden increase in pulmonary artery wedge
pressure (PAWP) from 12 mmHg to 25 mmHg. Which of the following
conditions is most likely causing this change?
• A) Hypovolemia
• B) Left ventricular failure
• C) Pulmonary embolism
• D) Cardiac tamponade
Answer: B) Left ventricular failure
Rationale: PAWP reflects left ventricular end-diastolic pressure. An
increase in PAWP indicates increased left ventricular filling pressure,
which is consistent with left ventricular failure. Hypovolemia would
decrease PAWP. Pulmonary embolism and cardiac tamponade may affect
right heart pressures but do not directly elevate PAWP unless left heart
failure develops.
, Page 2 of 47
2. A patient with a pulmonary artery catheter has a cardiac output of 3.2
L/min and a cardiac index of 1.8 L/min/m². What does this indicate?
• A) Normal cardiac function
• B) Mildly decreased cardiac output
• C) Significantly decreased cardiac output
• D) Hyperdynamic state
Answer: C) Significantly decreased cardiac output
Rationale: Normal cardiac index is 2.5-4.0 L/min/m². A cardiac index of 1.8
indicates severely decreased cardiac output (< 2.2 L/min/m²) consistent
with cardiogenic shock. This requires immediate intervention to improve
perfusion.
3. A patient with a pulmonary artery catheter has a central venous
pressure (CVP) of 2 mmHg. This finding is most consistent with which
condition?
• A) Fluid overload
• B) Hypovolemia
• C) Right heart failure
• D) Pulmonary hypertension
Answer: B) Hypovolemia
Rationale: Normal CVP is 2-8 mmHg. A CVP of 2 mmHg is at the low end of
normal and suggests hypovolemia or decreased right ventricular preload.
Fluid overload, right heart failure, and pulmonary hypertension would
cause elevated CVP.
4. A patient with a pulmonary artery catheter has a pulmonary artery
pressure (PAP) of 45/25 mmHg. Which condition is most likely?
, Page 3 of 47
• A) Hypovolemia
• B) Pulmonary hypertension
• C) Left ventricular failure
• D) Cardiac tamponade
Answer: B) Pulmonary hypertension
Rationale: Normal PAP is 15-30/5-15 mmHg. Elevated PAP (45/25)
indicates pulmonary hypertension, which can be caused by COPD,
pulmonary embolism, left heart failure, or primary pulmonary
hypertension. Hypovolemia would cause decreased PAP.
5. A patient's arterial waveform shows a rapid upstroke, a systolic peak, a
dicrotic notch, and a diastolic component. Which of the following is most
important for the nurse to assess when interpreting an arterial line
waveform?
• A) The height of the systolic peak
• B) The presence of a dicrotic notch
• C) The square wave test to check damping
• D) The patient's respiratory rate
Answer: C) The square wave test to check damping
Rationale: The square wave test (fast flush test) is used to assess the
dynamic response of the arterial line system. An overdamped or
underdamped waveform can lead to inaccurate blood pressure readings.
The presence of a dicrotic notch is normal, and the systolic peak height
alone does not validate waveform accuracy.
6. An ICU patient has an arterial line that is showing a dampened
waveform. The nurse should first:
• A) Re-zero the transducer
, Page 4 of 47
• B) Assess for air bubbles or clots in the system
• C) Replace the arterial line
• D) Increase the flush solution pressure
Answer: B) Assess for air bubbles or clots in the system
Rationale: A dampened waveform is often caused by air bubbles, clots, or
kinks in the arterial line system. The nurse should first check the system
for these issues before re-zeroing or replacing the line. Re-zeroing may be
needed but only after physical problems are ruled out.
7. A patient's cardiac output measurement via thermodilution is 4.5
L/min. The patient's heart rate is 90 bpm. What is the patient's stroke
volume?
• A) 40 mL
• B) 50 mL
• C) 60 mL
• D) 80 mL
Answer: B) 50 mL
Rationale: Stroke volume = Cardiac output / Heart rate × 1000. 4.5 L/min ÷
90 bpm × 1000 = 50 mL/beat. Normal stroke volume is 60-100 mL/beat.
This patient has a decreased stroke volume.
8. A patient in the ICU has a systemic vascular resistance (SVR) of 1800
dynes/sec/cm⁻⁵. This finding is most consistent with which condition?
• A) Septic shock
• B) Hypovolemic shock
• C) Cardiogenic shock
• D) Anaphylactic shock
