HESI Critical Care RN Exit Exam
Actual Exam Questions And Answers
Practice Questions with Solutions
Newest 2026-2027 Already Graded A+ |
HESI Critical Care RN Exit Exam Actual | Comprehensive
Examination
HESI Critical Care RN Exit Exam Actual Exam Questions
And Answers Practice Questions with Solutions Newest
2026-2027 Already Graded A+ actual exam preparation
INTRODUCTION
This document is an important and very helpful preparation
resource for HESI Critical Care RN Exit Exam Actual Exam
Questions And Answers Practice Questions with Solutions
Newest 2026-2027 Already Graded A+. Every item uses a
focused exam stem, four response options, a keyed response,
and a clear rationale, making it easier to understand the
subject, spot distractors, and build real exam confidence.
Page 1
, Question 1
A patient with septic shock has a MAP of 58 mm Hg, CVP 14 mm Hg, and
ScvO2 58% despite 30 mL/kg crystalloid and norepinephrine at 0.3
mcg/kg/min. Which intervention best addresses the most likely persistent
pathophysiology?
A. Administer a 1 L bolus of 0.9% sodium chloride
B. Start dobutamine infusion and reassess ScvO2
C. Increase norepinephrine to achieve MAP 65 mm Hg
D. Transfuse packed red blood cells to a hemoglobin of 10 g/dL
Correct Answer: B - Start dobutamine infusion and reassess
ScvO2
RATIONALE
Low ScvO2 with elevated CVP after adequate fluids and vasopressors
indicates impaired cardiac output/oxygen delivery, so inotropic
support with dobutamine is indicated. Additional fluid risks
pulmonary edema given high CVP; simply raising MAP does not
correct low ScvO2; transfusion is not indicated without anemia or
ischemia.
Question 2
A patient on volume-control ventilation has peak airway pressure 48 cm H2O
and plateau pressure 34 cm H2O. Which action is the priority?
A. Suction the endotracheal tube and reassess
B. Reduce tidal volume and evaluate for pneumothorax
C. Increase inspiratory flow rate to shorten inspiratory time
D. Administer a bronchodilator and reassess peak pressure
Correct Answer: B - Reduce tidal volume and evaluate for
pneumothorax
Page 2
, RATIONALE
A plateau pressure >30 cm H2O signals alveolar overdistension and
high risk for ventilator-induced lung injury, so lung-protective tidal
volume reduction and evaluation for barotrauma are priority. The
elevated peak with narrower gradient suggests some airway
component, but the critical danger is the high plateau; flow increase
and bronchodilators do not address alveolar strain.
Question 3
Which finding most specifically indicates effective CPR during a cardiac arrest
resuscitation?
A. Palpable carotid pulse during compressions
B. End-tidal CO2 persistently above 20 mm Hg
C. Pupils remain constricted and reactive
D. Compression rate maintained at 120/min
Correct Answer: B - End-tidal CO2 persistently above 20 mm Hg
RATIONALE
A sustained ETCO2 >20 mm Hg correlates with adequate pulmonary
blood flow and is the most reliable quantitative indicator of
compression quality. Palpated pulses are unreliable, pupil reactivity
reflects brainstem perfusion but is nonspecific, and rate alone does not
ensure depth or recoil.
Question 4
A patient with acute decompensated heart failure is started on
sacubitril/valsartan. Which parameter requires the most vigilant monitoring in
the first 48 hours?
A. Serum potassium and creatinine
B. Liver transaminases
C. Platelet count
D. Fasting blood glucose
Page 3
, Correct Answer: A - Serum potassium and creatinine
RATIONALE
Sacubitril/valsartan causes vasodilation and renal effects that can
precipitate hyperkalemia, hypotension, and acute kidney injury, so
potassium and creatinine must be closely tracked. Transaminases,
platelets, and glucose are not the primary safety parameters for this
ARNI.
Question 5
A patient with acute respiratory distress syndrome is in the prone position.
Which complication is most important to prevent during repositioning and
maintenance?
A. Endotracheal tube dislodgement
B. Pressure injury to the forehead and chin
C. Facial and periorbital edema
D. Increased intra-abdominal pressure
Correct Answer: A - Endotracheal tube dislodgement
RATIONALE
Unplanned extubation is the most immediately life-threatening
complication during proning, requiring coordinated team positioning
and secure tube fixation. Pressure injury, edema, and intra-abdominal
pressure changes are important but not as acutely lethal.
Question 6
A patient with severe traumatic brain injury has ICP 22 mm Hg, MAP 70 mm
Hg, and PaCO2 30 mm Hg. Which change would most improve cerebral
perfusion pressure while adhering to current neurocritical care targets?
A. Hyperventilate to PaCO2 25 mm Hg
B. Increase MAP to 80 mm Hg with norepinephrine
C. Administer mannitol 1 g/kg bolus
Page 4
Actual Exam Questions And Answers
Practice Questions with Solutions
Newest 2026-2027 Already Graded A+ |
HESI Critical Care RN Exit Exam Actual | Comprehensive
Examination
HESI Critical Care RN Exit Exam Actual Exam Questions
And Answers Practice Questions with Solutions Newest
2026-2027 Already Graded A+ actual exam preparation
INTRODUCTION
This document is an important and very helpful preparation
resource for HESI Critical Care RN Exit Exam Actual Exam
Questions And Answers Practice Questions with Solutions
Newest 2026-2027 Already Graded A+. Every item uses a
focused exam stem, four response options, a keyed response,
and a clear rationale, making it easier to understand the
subject, spot distractors, and build real exam confidence.
Page 1
, Question 1
A patient with septic shock has a MAP of 58 mm Hg, CVP 14 mm Hg, and
ScvO2 58% despite 30 mL/kg crystalloid and norepinephrine at 0.3
mcg/kg/min. Which intervention best addresses the most likely persistent
pathophysiology?
A. Administer a 1 L bolus of 0.9% sodium chloride
B. Start dobutamine infusion and reassess ScvO2
C. Increase norepinephrine to achieve MAP 65 mm Hg
D. Transfuse packed red blood cells to a hemoglobin of 10 g/dL
Correct Answer: B - Start dobutamine infusion and reassess
ScvO2
RATIONALE
Low ScvO2 with elevated CVP after adequate fluids and vasopressors
indicates impaired cardiac output/oxygen delivery, so inotropic
support with dobutamine is indicated. Additional fluid risks
pulmonary edema given high CVP; simply raising MAP does not
correct low ScvO2; transfusion is not indicated without anemia or
ischemia.
Question 2
A patient on volume-control ventilation has peak airway pressure 48 cm H2O
and plateau pressure 34 cm H2O. Which action is the priority?
A. Suction the endotracheal tube and reassess
B. Reduce tidal volume and evaluate for pneumothorax
C. Increase inspiratory flow rate to shorten inspiratory time
D. Administer a bronchodilator and reassess peak pressure
Correct Answer: B - Reduce tidal volume and evaluate for
pneumothorax
Page 2
, RATIONALE
A plateau pressure >30 cm H2O signals alveolar overdistension and
high risk for ventilator-induced lung injury, so lung-protective tidal
volume reduction and evaluation for barotrauma are priority. The
elevated peak with narrower gradient suggests some airway
component, but the critical danger is the high plateau; flow increase
and bronchodilators do not address alveolar strain.
Question 3
Which finding most specifically indicates effective CPR during a cardiac arrest
resuscitation?
A. Palpable carotid pulse during compressions
B. End-tidal CO2 persistently above 20 mm Hg
C. Pupils remain constricted and reactive
D. Compression rate maintained at 120/min
Correct Answer: B - End-tidal CO2 persistently above 20 mm Hg
RATIONALE
A sustained ETCO2 >20 mm Hg correlates with adequate pulmonary
blood flow and is the most reliable quantitative indicator of
compression quality. Palpated pulses are unreliable, pupil reactivity
reflects brainstem perfusion but is nonspecific, and rate alone does not
ensure depth or recoil.
Question 4
A patient with acute decompensated heart failure is started on
sacubitril/valsartan. Which parameter requires the most vigilant monitoring in
the first 48 hours?
A. Serum potassium and creatinine
B. Liver transaminases
C. Platelet count
D. Fasting blood glucose
Page 3
, Correct Answer: A - Serum potassium and creatinine
RATIONALE
Sacubitril/valsartan causes vasodilation and renal effects that can
precipitate hyperkalemia, hypotension, and acute kidney injury, so
potassium and creatinine must be closely tracked. Transaminases,
platelets, and glucose are not the primary safety parameters for this
ARNI.
Question 5
A patient with acute respiratory distress syndrome is in the prone position.
Which complication is most important to prevent during repositioning and
maintenance?
A. Endotracheal tube dislodgement
B. Pressure injury to the forehead and chin
C. Facial and periorbital edema
D. Increased intra-abdominal pressure
Correct Answer: A - Endotracheal tube dislodgement
RATIONALE
Unplanned extubation is the most immediately life-threatening
complication during proning, requiring coordinated team positioning
and secure tube fixation. Pressure injury, edema, and intra-abdominal
pressure changes are important but not as acutely lethal.
Question 6
A patient with severe traumatic brain injury has ICP 22 mm Hg, MAP 70 mm
Hg, and PaCO2 30 mm Hg. Which change would most improve cerebral
perfusion pressure while adhering to current neurocritical care targets?
A. Hyperventilate to PaCO2 25 mm Hg
B. Increase MAP to 80 mm Hg with norepinephrine
C. Administer mannitol 1 g/kg bolus
Page 4
