NSG 304 — Critical Care Nursing exam
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Answers) Plus Rationale 2027 Q&A|
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1. A patient in the intensive care unit develops severe hypotension,
tachycardia, and cool, clammy skin following a massive
gastrointestinal bleed. Which type of shock is most likely?
A. Cardiogenic shock
B. Distributive shock
C. Hypovolemic shock
D. Obstructive shock
Rationale: Hypovolemic shock occurs when there is a significant loss of
circulating blood or fluid volume. The resulting decrease in venous
return and cardiac output produces hypotension, tachycardia,
peripheral vasoconstriction, and cool, clammy skin.
, 2. A patient with septic shock has a blood pressure of 78/42 mmHg
despite receiving an adequate fluid bolus. Which medication
would the nurse anticipate administering to support blood
pressure?
A. Furosemide
B. Norepinephrine
C. Metoprolol
D. Nitroglycerin
Rationale: Norepinephrine is a first-line vasopressor for persistent
hypotension associated with septic shock after adequate fluid
resuscitation. It produces vasoconstriction and increases vascular
tone, helping restore adequate mean arterial pressure.
3. Which assessment finding is most concerning in a mechanically
ventilated patient?
A. Respiratory rate of 18 breaths/min
B. Oxygen saturation of 96%
C. Sudden unilateral absence of breath sounds
D. Heart rate of 88 beats/min
Rationale: Sudden unilateral absence of breath sounds may indicate
pneumothorax, particularly in a mechanically ventilated patient. A
,tension pneumothorax can rapidly compromise ventilation, venous
return, and cardiac output and requires immediate intervention.
4. A patient with acute respiratory distress syndrome (ARDS) is
receiving mechanical ventilation. Which intervention is commonly
used to improve oxygenation while reducing ventilator-induced
lung injury?
A. High tidal volumes
B. Low tidal-volume ventilation
C. Routine hyperventilation
D. Elimination of positive end-expiratory pressure
Rationale: Low tidal-volume ventilation helps limit alveolar
overdistention and ventilator-induced lung injury. ARDS management
commonly uses lung-protective ventilation along with appropriate
PEEP and oxygen therapy.
5. The nurse is caring for a patient with increased intracranial
pressure (ICP). Which finding requires immediate attention?
A. Temperature of 37.2°C
B. Heart rate of 88 beats/min
C. Newly unequal pupils
D. Blood pressure of 128/76 mmHg
, Rationale: Newly unequal pupils may indicate compression or
displacement of cranial nerves caused by increasing intracranial
pressure. This can signal neurological deterioration and possible
impending brain herniation.
6. Which position is generally most appropriate for a patient with
increased intracranial pressure?
A. Flat with the neck flexed
B. Trendelenburg
C. Head of bed elevated with the neck in neutral alignment
D. Prone with the head turned sharply to one side
Rationale: Elevating the head of the bed and maintaining neutral neck
alignment promotes cerebral venous drainage. Flexion or rotation of
the neck can impair venous outflow and potentially increase ICP.
7. A patient develops ventricular fibrillation and becomes
unresponsive with no pulse. What is the priority intervention?
A. Administer oral aspirin
B. Obtain a 12-lead ECG
C. Begin CPR and defibrillate as soon as possible
D. Administer a beta blocker
Questions and Correct Answers (Verified
Answers) Plus Rationale 2027 Q&A|
Instant Download Pdf
1. A patient in the intensive care unit develops severe hypotension,
tachycardia, and cool, clammy skin following a massive
gastrointestinal bleed. Which type of shock is most likely?
A. Cardiogenic shock
B. Distributive shock
C. Hypovolemic shock
D. Obstructive shock
Rationale: Hypovolemic shock occurs when there is a significant loss of
circulating blood or fluid volume. The resulting decrease in venous
return and cardiac output produces hypotension, tachycardia,
peripheral vasoconstriction, and cool, clammy skin.
, 2. A patient with septic shock has a blood pressure of 78/42 mmHg
despite receiving an adequate fluid bolus. Which medication
would the nurse anticipate administering to support blood
pressure?
A. Furosemide
B. Norepinephrine
C. Metoprolol
D. Nitroglycerin
Rationale: Norepinephrine is a first-line vasopressor for persistent
hypotension associated with septic shock after adequate fluid
resuscitation. It produces vasoconstriction and increases vascular
tone, helping restore adequate mean arterial pressure.
3. Which assessment finding is most concerning in a mechanically
ventilated patient?
A. Respiratory rate of 18 breaths/min
B. Oxygen saturation of 96%
C. Sudden unilateral absence of breath sounds
D. Heart rate of 88 beats/min
Rationale: Sudden unilateral absence of breath sounds may indicate
pneumothorax, particularly in a mechanically ventilated patient. A
,tension pneumothorax can rapidly compromise ventilation, venous
return, and cardiac output and requires immediate intervention.
4. A patient with acute respiratory distress syndrome (ARDS) is
receiving mechanical ventilation. Which intervention is commonly
used to improve oxygenation while reducing ventilator-induced
lung injury?
A. High tidal volumes
B. Low tidal-volume ventilation
C. Routine hyperventilation
D. Elimination of positive end-expiratory pressure
Rationale: Low tidal-volume ventilation helps limit alveolar
overdistention and ventilator-induced lung injury. ARDS management
commonly uses lung-protective ventilation along with appropriate
PEEP and oxygen therapy.
5. The nurse is caring for a patient with increased intracranial
pressure (ICP). Which finding requires immediate attention?
A. Temperature of 37.2°C
B. Heart rate of 88 beats/min
C. Newly unequal pupils
D. Blood pressure of 128/76 mmHg
, Rationale: Newly unequal pupils may indicate compression or
displacement of cranial nerves caused by increasing intracranial
pressure. This can signal neurological deterioration and possible
impending brain herniation.
6. Which position is generally most appropriate for a patient with
increased intracranial pressure?
A. Flat with the neck flexed
B. Trendelenburg
C. Head of bed elevated with the neck in neutral alignment
D. Prone with the head turned sharply to one side
Rationale: Elevating the head of the bed and maintaining neutral neck
alignment promotes cerebral venous drainage. Flexion or rotation of
the neck can impair venous outflow and potentially increase ICP.
7. A patient develops ventricular fibrillation and becomes
unresponsive with no pulse. What is the priority intervention?
A. Administer oral aspirin
B. Obtain a 12-lead ECG
C. Begin CPR and defibrillate as soon as possible
D. Administer a beta blocker
