1
HESI CRITICAL CARE EXAM 2026/2027 | VERSION 1
| 75 VERIFIED Q&A | DETAILED RATIONALES | NGN-
ALIGNED | PASS GUARANTEED – A+ GRADED
Q1: Hemodynamic Monitoring – Cardiac Output
A nurse is caring for a client with a pulmonary artery catheter. The nurse knows that cardiac output
is calculated using which formula?
A. Heart rate × stroke volume
B. Heart rate ÷ stroke volume
C. Stroke volume ÷ heart rate
D. Blood pressure × heart rate
Correct Answer: A
Rationale: Cardiac output (CO) = heart rate (HR) × stroke volume (SV). Normal CO is 4–8 L/min. CO is
the volume of blood pumped by the heart per minute. [100% CORRECT]
Q2: Hemodynamic Monitoring – Central Venous Pressure
A client has a CVP of 12 mmHg. The nurse interprets this as:
A. Normal
B. Low
C. High
D. Critically low
Correct Answer: C
Rationale: Normal CVP is 2–8 mmHg. CVP >8 mmHg indicates hypervolemia, right heart failure, or
increased intrathoracic pressure. [100% CORRECT]
Q3: Hemodynamic Monitoring – Pulmonary Artery Wedge Pressure
A nurse is monitoring a client's PAWP. The nurse knows that PAWP reflects:
A. Right ventricular preload
B. Left ventricular preload
C. Right ventricular afterload
D. Left ventricular afterload
Correct Answer: B
Rationale: PAWP (pulmonary artery wedge pressure) reflects left ventricular end-diastolic pressure
(preload). Normal PAWP is 6–12 mmHg. [100% CORRECT]
,2
Q4: Hemodynamic Monitoring – Systemic Vascular Resistance
A client has an SVR of 1800 dynes/sec/cm⁻⁵. The nurse interprets this as:
A. Normal
B. Low
C. High
D. Critically low
Correct Answer: C
Rationale: Normal SVR is 800–1200 dynes/sec/cm⁻⁵. SVR >1200 indicates vasoconstriction (e.g.,
shock, hypertension). [100% CORRECT]
Q5: Shock – Hypovolemic Shock
A client with hypovolemic shock has the following vital signs: BP 88/52, HR 122, RR 24, SpO₂ 94%.
The nurse should first:
A. Administer oxygen
B. Establish IV access and begin fluid resuscitation
C. Administer vasopressors
D. Insert a Foley catheter
Correct Answer: B
Rationale: Hypovolemic shock: priority is restoring circulating volume with IV fluids (crystalloids).
Oxygen and vasopressors may be needed, but fluid resuscitation is first. [100% CORRECT]
Q6: Shock – Cardiogenic Shock
A client with cardiogenic shock has BP 82/48, HR 118, and crackles in the lungs. The nurse should
anticipate administering:
A. IV fluids
B. Dobutamine
C. Norepinephrine
D. Furosemide
Correct Answer: B
Rationale: Cardiogenic shock: inotropic support (dobutamine) to improve contractility. Fluids are
contraindicated (pulmonary congestion). Diuretics may be used later. [100% CORRECT]
Q7: Shock – Septic Shock
A client with septic shock has a lactate level of 4 mmol/L. The nurse understands this indicates:
A. Normal finding
B. Tissue hypoperfusion
, 3
C. Adequate perfusion
D. Dehydration
Correct Answer: B
Rationale: Lactate >2 mmol/L indicates tissue hypoperfusion and anaerobic metabolism. Septic
shock: lactate levels guide resuscitation. [100% CORRECT]
Q8: Shock – Neurogenic Shock
A client with T4 spinal cord injury has BP 78/50 and HR 48. The nurse should:
A. Administer IV fluids and vasopressors
B. Administer diuretics
C. Place in Trendelenburg
D. Administer beta-blockers
Correct Answer: A
Rationale: Neurogenic shock: loss of sympathetic tone causes hypotension and bradycardia. Treat
with fluids and vasopressors (norepinephrine, phenylephrine). [100% CORRECT]
Q9: Shock – Anaphylactic Shock
A client develops anaphylaxis after a bee sting. The nurse should administer:
A. Epinephrine IM
B. Diphenhydramine IV
C. Corticosteroids IV
D. Albuterol
Correct Answer: A
Rationale: Anaphylaxis: epinephrine IM first-line. Then antihistamines, corticosteroids,
bronchodilators. [100% CORRECT]
Q10: Shock – Obstructive Shock
Which condition causes obstructive shock?
A. Cardiac tamponade
B. Sepsis
C. Hemorrhage
D. Myocardial infarction
Correct Answer: A
Rationale: Obstructive shock: mechanical obstruction of blood flow (cardiac tamponade, tension
pneumothorax, pulmonary embolism). [100% CORRECT]
HESI CRITICAL CARE EXAM 2026/2027 | VERSION 1
| 75 VERIFIED Q&A | DETAILED RATIONALES | NGN-
ALIGNED | PASS GUARANTEED – A+ GRADED
Q1: Hemodynamic Monitoring – Cardiac Output
A nurse is caring for a client with a pulmonary artery catheter. The nurse knows that cardiac output
is calculated using which formula?
A. Heart rate × stroke volume
B. Heart rate ÷ stroke volume
C. Stroke volume ÷ heart rate
D. Blood pressure × heart rate
Correct Answer: A
Rationale: Cardiac output (CO) = heart rate (HR) × stroke volume (SV). Normal CO is 4–8 L/min. CO is
the volume of blood pumped by the heart per minute. [100% CORRECT]
Q2: Hemodynamic Monitoring – Central Venous Pressure
A client has a CVP of 12 mmHg. The nurse interprets this as:
A. Normal
B. Low
C. High
D. Critically low
Correct Answer: C
Rationale: Normal CVP is 2–8 mmHg. CVP >8 mmHg indicates hypervolemia, right heart failure, or
increased intrathoracic pressure. [100% CORRECT]
Q3: Hemodynamic Monitoring – Pulmonary Artery Wedge Pressure
A nurse is monitoring a client's PAWP. The nurse knows that PAWP reflects:
A. Right ventricular preload
B. Left ventricular preload
C. Right ventricular afterload
D. Left ventricular afterload
Correct Answer: B
Rationale: PAWP (pulmonary artery wedge pressure) reflects left ventricular end-diastolic pressure
(preload). Normal PAWP is 6–12 mmHg. [100% CORRECT]
,2
Q4: Hemodynamic Monitoring – Systemic Vascular Resistance
A client has an SVR of 1800 dynes/sec/cm⁻⁵. The nurse interprets this as:
A. Normal
B. Low
C. High
D. Critically low
Correct Answer: C
Rationale: Normal SVR is 800–1200 dynes/sec/cm⁻⁵. SVR >1200 indicates vasoconstriction (e.g.,
shock, hypertension). [100% CORRECT]
Q5: Shock – Hypovolemic Shock
A client with hypovolemic shock has the following vital signs: BP 88/52, HR 122, RR 24, SpO₂ 94%.
The nurse should first:
A. Administer oxygen
B. Establish IV access and begin fluid resuscitation
C. Administer vasopressors
D. Insert a Foley catheter
Correct Answer: B
Rationale: Hypovolemic shock: priority is restoring circulating volume with IV fluids (crystalloids).
Oxygen and vasopressors may be needed, but fluid resuscitation is first. [100% CORRECT]
Q6: Shock – Cardiogenic Shock
A client with cardiogenic shock has BP 82/48, HR 118, and crackles in the lungs. The nurse should
anticipate administering:
A. IV fluids
B. Dobutamine
C. Norepinephrine
D. Furosemide
Correct Answer: B
Rationale: Cardiogenic shock: inotropic support (dobutamine) to improve contractility. Fluids are
contraindicated (pulmonary congestion). Diuretics may be used later. [100% CORRECT]
Q7: Shock – Septic Shock
A client with septic shock has a lactate level of 4 mmol/L. The nurse understands this indicates:
A. Normal finding
B. Tissue hypoperfusion
, 3
C. Adequate perfusion
D. Dehydration
Correct Answer: B
Rationale: Lactate >2 mmol/L indicates tissue hypoperfusion and anaerobic metabolism. Septic
shock: lactate levels guide resuscitation. [100% CORRECT]
Q8: Shock – Neurogenic Shock
A client with T4 spinal cord injury has BP 78/50 and HR 48. The nurse should:
A. Administer IV fluids and vasopressors
B. Administer diuretics
C. Place in Trendelenburg
D. Administer beta-blockers
Correct Answer: A
Rationale: Neurogenic shock: loss of sympathetic tone causes hypotension and bradycardia. Treat
with fluids and vasopressors (norepinephrine, phenylephrine). [100% CORRECT]
Q9: Shock – Anaphylactic Shock
A client develops anaphylaxis after a bee sting. The nurse should administer:
A. Epinephrine IM
B. Diphenhydramine IV
C. Corticosteroids IV
D. Albuterol
Correct Answer: A
Rationale: Anaphylaxis: epinephrine IM first-line. Then antihistamines, corticosteroids,
bronchodilators. [100% CORRECT]
Q10: Shock – Obstructive Shock
Which condition causes obstructive shock?
A. Cardiac tamponade
B. Sepsis
C. Hemorrhage
D. Myocardial infarction
Correct Answer: A
Rationale: Obstructive shock: mechanical obstruction of blood flow (cardiac tamponade, tension
pneumothorax, pulmonary embolism). [100% CORRECT]
