NGN HESI RN CRITICAL CARE EXAM
REVIEW QUIZ QUESTIONS AND
CORRECT ANSWERS
1. A patient in the ICU has a Central Venous Pressure (CVP) of 1 mm Hg and a Mean Arterial
Pressure (MAP) of 55 mm Hg. Which intervention should the nurse anticipate first?
A. Rapid infusion of intravenous crystalloids
B. Administration of a loop diuretic
C. Starting a norepinephrine drip
D. Positioning the patient in high-Fowler’s
Answer: A
Conceptual Explanation: A CVP of 1 mm Hg (normal 2-8 mm Hg) and a low MAP indicate
hypovolemia. The priority is to restore volume with fluid resuscitation.
2. The low-pressure alarm sounds on the mechanical ventilator of a client with ARDS. Which
action should the nurse take first?
A. Check the ventilator tubing for disconnections
B. Suction the client for excessive secretions
C. Administer an ordered sedative
D. Increase the PEEP setting
,Answer: A
Conceptual Explanation: Low-pressure alarms are typically caused by a leak in the
system or a disconnection. Checking the tubing is the immediate assessment step.
3. A patient with septic shock is receiving aggressive fluid resuscitation. Which finding best
indicates that the therapy is effective?
A. CVP of 2 mm Hg
B. Mean Arterial Pressure (MAP) of 45 mm Hg
C. Urine output of 0.5 mL/kg/hr
D. Serum lactate level of 5 mmol/L
Answer: C
Conceptual Explanation: Adequate end-organ perfusion is best indicated by a urine
output of at least 0.5 mL/kg/hr. A MAP > 65 is also a goal, but B is the most definitive
clinical indicator of perfusion here.
4. Which clinical manifestation is a hallmark sign of the compensatory stage of shock?
A. Refractory hypotension
B. Anuria and metabolic acidosis
C. Petechiae and jaundice
D. Cool, clammy skin and tachycardia
Answer: D
, Conceptual Explanation: In the compensatory stage, the body attempts to maintain
homeostasis through the sympathetic nervous system, leading to tachycardia and
peripheral vasoconstriction (cool, clammy skin).
5. A client with a traumatic brain injury has an ICP of 22 mm Hg. Which nursing intervention is
contraindicated?
A. Elevating the head of the bed to 30 degrees
B. Administering Mannitol as ordered
C. Performing frequent nasopharyngeal suctioning
D. Maintaining the head in a neutral midline position
Answer: C
Conceptual Explanation: Suctioning increases intrathoracic pressure and can further
elevate ICP. It should be limited and only performed when necessary for airway patency.
6. A patient is experiencing pulseless ventricular tachycardia. After calling for help, what is
the nurse’s next action?
A. Defibrillate the patient immediately
B. Synchronized cardioversion at 50 Joules
C. Administer 1 mg Epinephrine IV
D. Perform a carotid sinus massage
Answer: A
REVIEW QUIZ QUESTIONS AND
CORRECT ANSWERS
1. A patient in the ICU has a Central Venous Pressure (CVP) of 1 mm Hg and a Mean Arterial
Pressure (MAP) of 55 mm Hg. Which intervention should the nurse anticipate first?
A. Rapid infusion of intravenous crystalloids
B. Administration of a loop diuretic
C. Starting a norepinephrine drip
D. Positioning the patient in high-Fowler’s
Answer: A
Conceptual Explanation: A CVP of 1 mm Hg (normal 2-8 mm Hg) and a low MAP indicate
hypovolemia. The priority is to restore volume with fluid resuscitation.
2. The low-pressure alarm sounds on the mechanical ventilator of a client with ARDS. Which
action should the nurse take first?
A. Check the ventilator tubing for disconnections
B. Suction the client for excessive secretions
C. Administer an ordered sedative
D. Increase the PEEP setting
,Answer: A
Conceptual Explanation: Low-pressure alarms are typically caused by a leak in the
system or a disconnection. Checking the tubing is the immediate assessment step.
3. A patient with septic shock is receiving aggressive fluid resuscitation. Which finding best
indicates that the therapy is effective?
A. CVP of 2 mm Hg
B. Mean Arterial Pressure (MAP) of 45 mm Hg
C. Urine output of 0.5 mL/kg/hr
D. Serum lactate level of 5 mmol/L
Answer: C
Conceptual Explanation: Adequate end-organ perfusion is best indicated by a urine
output of at least 0.5 mL/kg/hr. A MAP > 65 is also a goal, but B is the most definitive
clinical indicator of perfusion here.
4. Which clinical manifestation is a hallmark sign of the compensatory stage of shock?
A. Refractory hypotension
B. Anuria and metabolic acidosis
C. Petechiae and jaundice
D. Cool, clammy skin and tachycardia
Answer: D
, Conceptual Explanation: In the compensatory stage, the body attempts to maintain
homeostasis through the sympathetic nervous system, leading to tachycardia and
peripheral vasoconstriction (cool, clammy skin).
5. A client with a traumatic brain injury has an ICP of 22 mm Hg. Which nursing intervention is
contraindicated?
A. Elevating the head of the bed to 30 degrees
B. Administering Mannitol as ordered
C. Performing frequent nasopharyngeal suctioning
D. Maintaining the head in a neutral midline position
Answer: C
Conceptual Explanation: Suctioning increases intrathoracic pressure and can further
elevate ICP. It should be limited and only performed when necessary for airway patency.
6. A patient is experiencing pulseless ventricular tachycardia. After calling for help, what is
the nurse’s next action?
A. Defibrillate the patient immediately
B. Synchronized cardioversion at 50 Joules
C. Administer 1 mg Epinephrine IV
D. Perform a carotid sinus massage
Answer: A
