2026/2027 TEST BANK
HESI RN
Critical Care
Examination
200 most commonly tested questions with verified answers and detailed
rationales, aligned with the 2026-2027 HESI testing standards and the RN
Critical Care specialty examination blueprint. Hemodynamic calculations,
ventilator management, shock differentiation, pharmacology, and NGN-
style clinical judgment scenarios.
Specialty Examination Preparation
Most Commonly Tested Questions and Answers • Latest Fall Edition
8 Blueprint Sections • 75% Scenario-Based • 25% Recall & Calculation
2 02 6/ 2 02 7 E D I T I O N • FA L L T E S T I N G C Y C L E
,HESI RN CRITICAL CARE - 2026/2027 TEST BANK SPECIALTY EXAMINATION PREPARATION
Table of Contents
SECTION 1: CRITICAL CARE FOUNDATIONS & HEMODYNAMIC MONITORING (Q1-Q30) 2
SECTION 2: SHOCK STATES (Q31-Q55) 12
SECTION 3: RESPIRATORY CRITICAL CARE & MECHANICAL VENTILATION (Q56-Q80) 20
SECTION 4: CARDIOVASCULAR EMERGENCIES (Q81-Q105) 28
SECTION 5: NEUROLOGIC CRITICAL CARE (Q106-Q130) 37
SECTION 6: MULTISYSTEM CRITICAL ILLNESS & PHARMACOLOGY (Q131-Q160) 45
SECTION 7: TRAUMA, BURNS, & EMERGENCY CRITICAL CARE (Q161-Q180) 55
SECTION 8: LEADERSHIP, PRIORITIZATION, ETHICS, & NGN CLINICAL JUDGMENT
(Q181-Q200) 62
Examination Blueprint
Section Focus Areas Questions
CRITICAL CARE FOUNDATIONS & HEMODYNAMIC MONITORING -
Section 1 ABCDE Assessment, ICU Patient Safety, Hemodynamic Basics, PA Catheter, and Q1-Q30
Arterial Lines
SHOCK STATES - Septic, Cardiogenic, Hypovolemic, Neurogenic, Anaphylactic,
Section 2 Q31-Q55
Obstructive, and MODS
RESPIRATORY CRITICAL CARE & MECHANICAL VENTILATION -
Section 3 Respiratory Assessment, Ventilator Modes and Alarms, ARDS, Oxygen Therapy, Q56-Q80
Airway Management, and Chest Tubes
CARDIOVASCULAR EMERGENCIES - Acute Coronary Syndromes,
Section 4 Q81-Q105
Dysrhythmias, Heart Failure, Cardiac Arrest, IABP, and Temporary Pacing
NEUROLOGIC CRITICAL CARE - Stroke, ICP Management, Head Injury, Neuro
Section 5 Q106-Q130
Assessment, Seizure Emergencies, and Spinal Cord Injury
MULTISYSTEM CRITICAL ILLNESS & PHARMACOLOGY - Sepsis, AKI,
Section 6 Endocrine Emergencies, DKA, Electrolyte and Acid-Base, Vasopressors, Inotropes, Q131-Q160
Sedation and Analgesia, High-Alert Medications
TRAUMA, BURNS, & EMERGENCY CRITICAL CARE - Trauma Survey,
Section 7 Q161-Q180
Hemorrhagic Shock, Burn Care, and Chest and Abdominal Trauma
LEADERSHIP, PRIORITIZATION, ETHICS, & NGN CLINICAL JUDGMENT
Section 8 Q181-Q200
- Delegation, SBAR, Advocacy, End-of-Life, and NGN Case-Based Scenarios
Complete HESI RN Critical Care specialty examination test bank, aligned with the
Total 200 items
2026-2027 HESI testing standards and specialty blueprint
Item format: four-option multiple choice (A-D) with one best answer; 75% scenario-based items and 25% recall and
calculation items. Cognitive level distribution: 25% recall, 50% application, 25% analysis. Each item includes the correct
answer marked [CORRECT] and a detailed rationale with HESI Critical Care-specific clinical reasoning.
Most Commonly Tested Questions and Answers - Latest Fall 1
,HESI RN CRITICAL CARE - 2026/2027 TEST BANK SPECIALTY EXAMINATION PREPARATION
SECTION 1: CRITICAL CARE FOUNDATIONS &
HEMODYNAMIC MONITORING
Questions 1-30 | ABCDE Assessment, ICU Patient Safety, Hemodynamic Basics, PA Catheter, and
Arterial Lines
Q1: The critical care nurse is performing an initial assessment on a newly admitted ICU patient using the
ABCDE approach. Which assessment is included in the D component?
A. Neurologic status, including level of consciousness, pupils, and glucose check [CORRECT]
B. Inspection of the posterior trunk for pressure injuries and wounds
C. Palpation of all peripheral pulses and capillary refill
D. Auscultation of anterior and posterior breath sounds
Correct Answer: A
Rationale: In the ABCDE approach, D stands for Disability, which means evaluating neurologic function through
the level of consciousness, pupil size and reactivity, and a point-of-care glucose measurement. Exposure (E)
requires undressing the patient to inspect the posterior surfaces, and Circulation (C) includes pulse and capillary
refill assessment. Breathing (B) involves auscultation of breath sounds and respiratory effort. Keeping the
sequence consistent prevents the most immediate threats to life from being missed.
Q2: A patient who fell from a ladder is found unresponsive with snoring respirations. Using the ABCDE
approach, what is the nurse's first action?
A. Expose the chest and auscultate breath sounds bilaterally
B. Manually open the airway using the jaw-thrust maneuver while maintaining cervical spine
immobilization [CORRECT]
C. Insert an oral airway and begin bag-valve-mask ventilation
D. Check the pupils and obtain a capillary blood glucose level
Correct Answer: B
Rationale: Airway is always the first priority in the ABCDE sequence, and a snoring sound indicates partial
airway obstruction, most commonly by the tongue. Because this patient sustained a fall, cervical spine injury must
be presumed, so the jaw-thrust maneuver is used instead of a head-tilt/chin-lift to open the airway. Bag-valve
ventilation may be needed afterward if the patient does not breathe adequately once the airway is opened.
Disability checks and exposure come only after Airway, Breathing, and Circulation are addressed.
Q3: A hemodynamic reading displays a central venous pressure (CVP) on the monitor. Which value falls
within the normal range for CVP?
A. 12 mm Hg
B. 16 mm Hg
C. 0 mm Hg
D. 4 mm Hg [CORRECT]
Correct Answer: D
Rationale: Normal CVP, which reflects right atrial preload, ranges from approximately 2 to 8 mm Hg, making 4
mm Hg the only normal value listed. A CVP of 12 or 16 mm Hg is elevated and suggests hypervolemia, right
ventricular failure, pulmonary hypertension, or positive-pressure ventilation effects. A CVP of 0 mm Hg is
abnormally low and is associated with hypovolemia and inadequate venous return. Trending CVP over time is
Most Commonly Tested Questions and Answers - Latest Fall 2
, HESI RN CRITICAL CARE - 2026/2027 TEST BANK SPECIALTY EXAMINATION PREPARATION
more meaningful than any single value because it reflects the patient's response to therapy.
Q4: A patient with heart failure has a CVP that has risen from 6 mm Hg to 16 mm Hg over several hours.
How should the nurse interpret this finding?
A. Volume overload or right ventricular failure causing increased venous pressure [CORRECT]
B. Tricuspid valve stenosis with decreased right atrial filling
C. Excessive diuresis leading to low intravascular volume
D. Improving preload as a result of effective fluid resuscitation
Correct Answer: A
Rationale: A rising CVP indicates elevated right atrial pressure, which is most commonly caused by
hypervolemia, right ventricular failure, or pulmonary hypertension. In heart failure, this trend suggests the patient
is retaining fluid and preload is excessive rather than improved. Excessive diuresis would lower the CVP, not raise
it. The nurse should anticipate orders for diuretics, fluid restriction, and reassessment of lung sounds, oxygenation,
and urine output.
Q5: Before obtaining hemodynamic pressure readings, the nurse positions the transducer at the phlebostatic
axis. Where is this landmark located?
A. Fifth intercostal space at the left midclavicular line
B. Second intercostal space at the right sternal border
C. Fourth intercostal space at the midaxillary line [CORRECT]
D. Angle of Louis at the midclavicular line
Correct Answer: C
Rationale: The phlebostatic axis is located at the intersection of the fourth intercostal space and the midaxillary
line, which approximates the level of the right atrium. Positioning the transducer at this level ensures accurate,
reproducible pressure readings; if the transducer is too high, pressures read falsely low, and if too low, they read
falsely high. The fifth intercostal space at the left midclavicular line is the point of maximal impulse, not the
zeroing reference. Consistent leveling is essential before every CVP, arterial, or pulmonary artery measurement.
Q6: The nurse performs a square wave test on a patient's arterial line. What is the purpose of this maneuver?
A. To recalibrate the transducer to atmospheric pressure
B. To verify that the transducer is leveled at the phlebostatic axis
C. To evaluate the dynamic response of the monitoring system for damping or ringing [CORRECT]
D. To confirm the patency of the pressure bag on the flush system
Correct Answer: C
Rationale: The square wave test assesses the dynamic response of the arterial monitoring system by activating the
fast-flush device and observing the resulting waveform. An optimally responding system shows a crisp square
wave with one to two oscillations before returning to baseline. An overdamped system, often from clots, air
bubbles, or kinked tubing, shows a slurred downstroke, while an underdamped system shows excessive ringing that
falsely elevates systolic pressure. Leveling and zeroing are separate procedures and do not test the system's
dynamic response.
Most Commonly Tested Questions and Answers - Latest Fall 3
HESI RN
Critical Care
Examination
200 most commonly tested questions with verified answers and detailed
rationales, aligned with the 2026-2027 HESI testing standards and the RN
Critical Care specialty examination blueprint. Hemodynamic calculations,
ventilator management, shock differentiation, pharmacology, and NGN-
style clinical judgment scenarios.
Specialty Examination Preparation
Most Commonly Tested Questions and Answers • Latest Fall Edition
8 Blueprint Sections • 75% Scenario-Based • 25% Recall & Calculation
2 02 6/ 2 02 7 E D I T I O N • FA L L T E S T I N G C Y C L E
,HESI RN CRITICAL CARE - 2026/2027 TEST BANK SPECIALTY EXAMINATION PREPARATION
Table of Contents
SECTION 1: CRITICAL CARE FOUNDATIONS & HEMODYNAMIC MONITORING (Q1-Q30) 2
SECTION 2: SHOCK STATES (Q31-Q55) 12
SECTION 3: RESPIRATORY CRITICAL CARE & MECHANICAL VENTILATION (Q56-Q80) 20
SECTION 4: CARDIOVASCULAR EMERGENCIES (Q81-Q105) 28
SECTION 5: NEUROLOGIC CRITICAL CARE (Q106-Q130) 37
SECTION 6: MULTISYSTEM CRITICAL ILLNESS & PHARMACOLOGY (Q131-Q160) 45
SECTION 7: TRAUMA, BURNS, & EMERGENCY CRITICAL CARE (Q161-Q180) 55
SECTION 8: LEADERSHIP, PRIORITIZATION, ETHICS, & NGN CLINICAL JUDGMENT
(Q181-Q200) 62
Examination Blueprint
Section Focus Areas Questions
CRITICAL CARE FOUNDATIONS & HEMODYNAMIC MONITORING -
Section 1 ABCDE Assessment, ICU Patient Safety, Hemodynamic Basics, PA Catheter, and Q1-Q30
Arterial Lines
SHOCK STATES - Septic, Cardiogenic, Hypovolemic, Neurogenic, Anaphylactic,
Section 2 Q31-Q55
Obstructive, and MODS
RESPIRATORY CRITICAL CARE & MECHANICAL VENTILATION -
Section 3 Respiratory Assessment, Ventilator Modes and Alarms, ARDS, Oxygen Therapy, Q56-Q80
Airway Management, and Chest Tubes
CARDIOVASCULAR EMERGENCIES - Acute Coronary Syndromes,
Section 4 Q81-Q105
Dysrhythmias, Heart Failure, Cardiac Arrest, IABP, and Temporary Pacing
NEUROLOGIC CRITICAL CARE - Stroke, ICP Management, Head Injury, Neuro
Section 5 Q106-Q130
Assessment, Seizure Emergencies, and Spinal Cord Injury
MULTISYSTEM CRITICAL ILLNESS & PHARMACOLOGY - Sepsis, AKI,
Section 6 Endocrine Emergencies, DKA, Electrolyte and Acid-Base, Vasopressors, Inotropes, Q131-Q160
Sedation and Analgesia, High-Alert Medications
TRAUMA, BURNS, & EMERGENCY CRITICAL CARE - Trauma Survey,
Section 7 Q161-Q180
Hemorrhagic Shock, Burn Care, and Chest and Abdominal Trauma
LEADERSHIP, PRIORITIZATION, ETHICS, & NGN CLINICAL JUDGMENT
Section 8 Q181-Q200
- Delegation, SBAR, Advocacy, End-of-Life, and NGN Case-Based Scenarios
Complete HESI RN Critical Care specialty examination test bank, aligned with the
Total 200 items
2026-2027 HESI testing standards and specialty blueprint
Item format: four-option multiple choice (A-D) with one best answer; 75% scenario-based items and 25% recall and
calculation items. Cognitive level distribution: 25% recall, 50% application, 25% analysis. Each item includes the correct
answer marked [CORRECT] and a detailed rationale with HESI Critical Care-specific clinical reasoning.
Most Commonly Tested Questions and Answers - Latest Fall 1
,HESI RN CRITICAL CARE - 2026/2027 TEST BANK SPECIALTY EXAMINATION PREPARATION
SECTION 1: CRITICAL CARE FOUNDATIONS &
HEMODYNAMIC MONITORING
Questions 1-30 | ABCDE Assessment, ICU Patient Safety, Hemodynamic Basics, PA Catheter, and
Arterial Lines
Q1: The critical care nurse is performing an initial assessment on a newly admitted ICU patient using the
ABCDE approach. Which assessment is included in the D component?
A. Neurologic status, including level of consciousness, pupils, and glucose check [CORRECT]
B. Inspection of the posterior trunk for pressure injuries and wounds
C. Palpation of all peripheral pulses and capillary refill
D. Auscultation of anterior and posterior breath sounds
Correct Answer: A
Rationale: In the ABCDE approach, D stands for Disability, which means evaluating neurologic function through
the level of consciousness, pupil size and reactivity, and a point-of-care glucose measurement. Exposure (E)
requires undressing the patient to inspect the posterior surfaces, and Circulation (C) includes pulse and capillary
refill assessment. Breathing (B) involves auscultation of breath sounds and respiratory effort. Keeping the
sequence consistent prevents the most immediate threats to life from being missed.
Q2: A patient who fell from a ladder is found unresponsive with snoring respirations. Using the ABCDE
approach, what is the nurse's first action?
A. Expose the chest and auscultate breath sounds bilaterally
B. Manually open the airway using the jaw-thrust maneuver while maintaining cervical spine
immobilization [CORRECT]
C. Insert an oral airway and begin bag-valve-mask ventilation
D. Check the pupils and obtain a capillary blood glucose level
Correct Answer: B
Rationale: Airway is always the first priority in the ABCDE sequence, and a snoring sound indicates partial
airway obstruction, most commonly by the tongue. Because this patient sustained a fall, cervical spine injury must
be presumed, so the jaw-thrust maneuver is used instead of a head-tilt/chin-lift to open the airway. Bag-valve
ventilation may be needed afterward if the patient does not breathe adequately once the airway is opened.
Disability checks and exposure come only after Airway, Breathing, and Circulation are addressed.
Q3: A hemodynamic reading displays a central venous pressure (CVP) on the monitor. Which value falls
within the normal range for CVP?
A. 12 mm Hg
B. 16 mm Hg
C. 0 mm Hg
D. 4 mm Hg [CORRECT]
Correct Answer: D
Rationale: Normal CVP, which reflects right atrial preload, ranges from approximately 2 to 8 mm Hg, making 4
mm Hg the only normal value listed. A CVP of 12 or 16 mm Hg is elevated and suggests hypervolemia, right
ventricular failure, pulmonary hypertension, or positive-pressure ventilation effects. A CVP of 0 mm Hg is
abnormally low and is associated with hypovolemia and inadequate venous return. Trending CVP over time is
Most Commonly Tested Questions and Answers - Latest Fall 2
, HESI RN CRITICAL CARE - 2026/2027 TEST BANK SPECIALTY EXAMINATION PREPARATION
more meaningful than any single value because it reflects the patient's response to therapy.
Q4: A patient with heart failure has a CVP that has risen from 6 mm Hg to 16 mm Hg over several hours.
How should the nurse interpret this finding?
A. Volume overload or right ventricular failure causing increased venous pressure [CORRECT]
B. Tricuspid valve stenosis with decreased right atrial filling
C. Excessive diuresis leading to low intravascular volume
D. Improving preload as a result of effective fluid resuscitation
Correct Answer: A
Rationale: A rising CVP indicates elevated right atrial pressure, which is most commonly caused by
hypervolemia, right ventricular failure, or pulmonary hypertension. In heart failure, this trend suggests the patient
is retaining fluid and preload is excessive rather than improved. Excessive diuresis would lower the CVP, not raise
it. The nurse should anticipate orders for diuretics, fluid restriction, and reassessment of lung sounds, oxygenation,
and urine output.
Q5: Before obtaining hemodynamic pressure readings, the nurse positions the transducer at the phlebostatic
axis. Where is this landmark located?
A. Fifth intercostal space at the left midclavicular line
B. Second intercostal space at the right sternal border
C. Fourth intercostal space at the midaxillary line [CORRECT]
D. Angle of Louis at the midclavicular line
Correct Answer: C
Rationale: The phlebostatic axis is located at the intersection of the fourth intercostal space and the midaxillary
line, which approximates the level of the right atrium. Positioning the transducer at this level ensures accurate,
reproducible pressure readings; if the transducer is too high, pressures read falsely low, and if too low, they read
falsely high. The fifth intercostal space at the left midclavicular line is the point of maximal impulse, not the
zeroing reference. Consistent leveling is essential before every CVP, arterial, or pulmonary artery measurement.
Q6: The nurse performs a square wave test on a patient's arterial line. What is the purpose of this maneuver?
A. To recalibrate the transducer to atmospheric pressure
B. To verify that the transducer is leveled at the phlebostatic axis
C. To evaluate the dynamic response of the monitoring system for damping or ringing [CORRECT]
D. To confirm the patency of the pressure bag on the flush system
Correct Answer: C
Rationale: The square wave test assesses the dynamic response of the arterial monitoring system by activating the
fast-flush device and observing the resulting waveform. An optimally responding system shows a crisp square
wave with one to two oscillations before returning to baseline. An overdamped system, often from clots, air
bubbles, or kinked tubing, shows a slurred downstroke, while an underdamped system shows excessive ringing that
falsely elevates systolic pressure. Leveling and zeroing are separate procedures and do not test the system's
dynamic response.
Most Commonly Tested Questions and Answers - Latest Fall 3
