NGN HESI RN CRITICAL CARE V5
EXAM PREP QUESTIONS AND
CORRECT ANSWERS
1. A patient with ARDS is being mechanically ventilated with high PEEP. The nurse notes a
sudden drop in blood pressure and absent breath sounds on the right side. Which condition
should the nurse suspect?
A. Tension pneumothorax
B. Pulmonary embolism
C. Cardiac tamponade
D. Myocardial infarction
Answer: A
Conceptual Explanation: High PEEP levels increase the risk of barotrauma, leading to a
pneumothorax. A tension pneumothorax causes obstructive shock, characterized by
hypotension and absent breath sounds on the affected side.
2. Which hemodynamic finding is most consistent with a diagnosis of Septic Shock in its early
(hyperdynamic) phase?
A. Decreased Systemic Vascular Resistance (SVR)
B. Decreased Cardiac Output (CO)
,C. Increased Systemic Vascular Resistance (SVR)
D. Increased Pulmonary Capillary Wedge Pressure (PCWP)
Answer: A
Conceptual Explanation: Early septic shock involves massive vasodilation, which
significantly lowers SVR, often accompanied by an increased cardiac output as a
compensatory mechanism.
3. A patient is receiving Nitroprusside for a hypertensive crisis. The nurse should monitor for
which toxicity if the infusion lasts longer than 48 hours?
A. Cyanide toxicity
B. Digoxin toxicity
C. Magnesium toxicity
D. Ototoxicity
Answer: A
Conceptual Explanation: Nitroprusside is metabolized into thiocyanate and cyanide.
Prolonged use or high doses can lead to cyanide poisoning, presenting as metabolic
acidosis and mental status changes.
4. What is the primary goal of using an Intra-Aortic Balloon Pump (IABP) in a patient with
cardiogenic shock?
A. To increase systemic vascular resistance
, B. To increase coronary artery perfusion and decrease afterload
C. To provide permanent circulatory support
D. To increase preload to the right atrium
Answer: B
Conceptual Explanation: The IABP inflates during diastole to improve coronary perfusion
and deflates just before systole to reduce afterload (vacuum effect), decreasing myocardial
oxygen demand.
5. In a patient with a traumatic brain injury, the nurse calculates the Cerebral Perfusion
Pressure (CPP). If the BP is 110/70 and the ICP is 20 mmHg, what is the CPP?
A. 90 mmHg
B. 63 mmHg
C. 50 mmHg
D. 73 mmHg
Answer: B
Conceptual Explanation: MAP = [70 + (110-70)/3] = 83.3. CPP = MAP - ICP. 83.3 - 20 =
63.3 mmHg. A CPP between 60-80 is generally targeted.
6. Which electrolyte imbalance is a hallmark sign of Reeding Syndrome in a critically ill patient
starting parenteral nutrition?
A. Hyperkalemia
EXAM PREP QUESTIONS AND
CORRECT ANSWERS
1. A patient with ARDS is being mechanically ventilated with high PEEP. The nurse notes a
sudden drop in blood pressure and absent breath sounds on the right side. Which condition
should the nurse suspect?
A. Tension pneumothorax
B. Pulmonary embolism
C. Cardiac tamponade
D. Myocardial infarction
Answer: A
Conceptual Explanation: High PEEP levels increase the risk of barotrauma, leading to a
pneumothorax. A tension pneumothorax causes obstructive shock, characterized by
hypotension and absent breath sounds on the affected side.
2. Which hemodynamic finding is most consistent with a diagnosis of Septic Shock in its early
(hyperdynamic) phase?
A. Decreased Systemic Vascular Resistance (SVR)
B. Decreased Cardiac Output (CO)
,C. Increased Systemic Vascular Resistance (SVR)
D. Increased Pulmonary Capillary Wedge Pressure (PCWP)
Answer: A
Conceptual Explanation: Early septic shock involves massive vasodilation, which
significantly lowers SVR, often accompanied by an increased cardiac output as a
compensatory mechanism.
3. A patient is receiving Nitroprusside for a hypertensive crisis. The nurse should monitor for
which toxicity if the infusion lasts longer than 48 hours?
A. Cyanide toxicity
B. Digoxin toxicity
C. Magnesium toxicity
D. Ototoxicity
Answer: A
Conceptual Explanation: Nitroprusside is metabolized into thiocyanate and cyanide.
Prolonged use or high doses can lead to cyanide poisoning, presenting as metabolic
acidosis and mental status changes.
4. What is the primary goal of using an Intra-Aortic Balloon Pump (IABP) in a patient with
cardiogenic shock?
A. To increase systemic vascular resistance
, B. To increase coronary artery perfusion and decrease afterload
C. To provide permanent circulatory support
D. To increase preload to the right atrium
Answer: B
Conceptual Explanation: The IABP inflates during diastole to improve coronary perfusion
and deflates just before systole to reduce afterload (vacuum effect), decreasing myocardial
oxygen demand.
5. In a patient with a traumatic brain injury, the nurse calculates the Cerebral Perfusion
Pressure (CPP). If the BP is 110/70 and the ICP is 20 mmHg, what is the CPP?
A. 90 mmHg
B. 63 mmHg
C. 50 mmHg
D. 73 mmHg
Answer: B
Conceptual Explanation: MAP = [70 + (110-70)/3] = 83.3. CPP = MAP - ICP. 83.3 - 20 =
63.3 mmHg. A CPP between 60-80 is generally targeted.
6. Which electrolyte imbalance is a hallmark sign of Reeding Syndrome in a critically ill patient
starting parenteral nutrition?
A. Hyperkalemia
