CCRN (Adult) Certification Exam —
Comprehensive Test Bank, Part 1 of 5
Content Areas: Cardiovascular
Q1. A client in the ICU has a pulmonary artery catheter in place. The nurse notes CVP 4 mm Hg,
PCWP 8 mm Hg, cardiac index 1.8 L/min/m2, and SvO2 55%. Which type of shock is most consistent
with these values?
A. Hypovolemic shock
B. Cardiogenic shock
C. Septic shock
D. Obstructive shock
Correct Answer: Hypovolemic shock ✅
Rationale: Hypovolemic shock presents with low CVP, low PCWP, low cardiac index, and low
SvO2 because there is not enough volume to fill the heart. Cardiogenic shock would show elevated
CVP and PCWP because the heart cannot pump the volume it receives. Septic shock would show low
systemic vascular resistance with normal or high cardiac index in the early phase. Obstructive shock
would show elevated right-sided pressures depending on the cause. The concept is that preload
values distinguish hypovolemic from cardiogenic shock.
Q2. A client in the ICU has a CVP of 16 mm Hg, PCWP of 24 mm Hg, cardiac index of 1.6 L/min/m2,
and SvO2 of 50%. Which type of shock is most consistent with these values?
A. Cardiogenic shock
B. Hypovolemic shock
C. Septic shock
D. Neurogenic shock
Correct Answer: Cardiogenic shock ✅
,Rationale: Cardiogenic shock presents with elevated CVP, elevated PCWP, low cardiac index,
and low SvO2 because the heart cannot pump effectively and blood backs up. Hypovolemic shock
would show low CVP and low PCWP. Septic shock would show low systemic vascular resistance with
normal or high cardiac index. Neurogenic shock would show bradycardia and hypotension from loss
of sympathetic tone. The concept is that elevated filling pressures with low output indicate pump
failure.
Q3. A client in the ICU has a blood pressure of 78/40 mm Hg, heart rate of 122/min, cardiac index of
4.5 L/min/m2, and systemic vascular resistance of 450 dynes/sec/cm5. Which type of shock is most
consistent with these values?
A. Septic shock
B. Cardiogenic shock
C. Hypovolemic shock
D. Obstructive shock
Correct Answer: Septic shock ✅
Rationale: Septic shock presents with hypotension, tachycardia, elevated cardiac index, and
low systemic vascular resistance because of widespread vasodilation. Cardiogenic shock would show
low cardiac index and high systemic vascular resistance. Hypovolemic shock would show low cardiac
index and low preload. Obstructive shock would show elevated right-sided pressures. The concept is
that low systemic vascular resistance with high output suggests distributive shock.
Q4. A client in the ICU has a blood pressure of 82/50 mm Hg, heart rate of 48/min, and warm dry
skin. Which type of shock is most consistent with these findings?
A. Neurogenic shock
B. Septic shock
C. Cardiogenic shock
D. Hypovolemic shock
Correct Answer: Neurogenic shock ✅
,Rationale: Neurogenic shock presents with hypotension, bradycardia, and warm dry skin
because of loss of sympathetic tone. Septic shock would present with tachycardia and warm skin.
Cardiogenic shock would present with cool clammy skin and tachycardia. Hypovolemic shock would
present with cool clammy skin and tachycardia. The concept is that bradycardia with hypotension
suggests loss of sympathetic innervation.
Q5. A client in the ICU has a blood pressure of 84/52 mm Hg, heart rate of 128/min, and cool clammy
skin. Which type of shock is most consistent with these findings?
A. Hypovolemic shock
B. Neurogenic shock
C. Septic shock
D. Anaphylactic shock
Correct Answer: Hypovolemic shock ✅
Rationale: Hypovolemic shock presents with hypotension, tachycardia, and cool clammy skin
from compensatory vasoconstriction. Neurogenic shock would present with bradycardia and warm
dry skin. Septic shock would present with warm skin in the early phase. Anaphylactic shock would
present with urticaria, wheezing, and angioedema. The concept is that cool clammy skin with
tachycardia suggests compensatory vasoconstriction.
Q6. A client in the ICU develops hypotension, urticaria, wheezing, and swelling of the lips after
receiving an antibiotic. Which type of shock is most consistent with these findings?
A. Anaphylactic shock
B. Septic shock
C. Cardiogenic shock
D. Neurogenic shock
Correct Answer: Anaphylactic shock ✅
, Rationale: Anaphylactic shock presents with hypotension, urticaria, wheezing, and
angioedema from a severe allergic reaction. Septic shock would present with fever and warm skin.
Cardiogenic shock would present with cool clammy skin and pulmonary edema. Neurogenic shock
would present with bradycardia and warm dry skin. The concept is that anaphylaxis involves multi-
system allergic findings.
Q7. A client in the ICU is receiving norepinephrine for septic shock. Which finding indicates the
medication is effective?
A. Mean arterial pressure of 68 mm Hg
B. Heart rate of 140/min
C. Urine output of 15 mL per hour
D. Serum lactate of 4 mmol/L
Correct Answer: Mean arterial pressure of 68 mm Hg ✅
Rationale: Norepinephrine is a vasopressor used to raise mean arterial pressure in septic
shock, and a MAP of 68 mm Hg meets the target of 65 mm Hg or higher. A heart rate of 140/min
indicates ongoing tachycardia and is not a sign of effectiveness. A urine output of 15 mL per hour
indicates inadequate perfusion. A serum lactate of 4 mmol/L indicates ongoing tissue hypoperfusion.
The concept is that MAP is the primary endpoint for vasopressor therapy.
Q8. A client in the ICU is receiving dobutamine for cardiogenic shock. Which finding indicates the
medication is effective?
A. Increased cardiac index with decreased PCWP
B. Decreased cardiac index with increased PCWP
C. Increased heart rate with decreased blood pressure
D. Decreased urine output with increased lactate
Correct Answer: Increased cardiac index with decreased PCWP ✅
Comprehensive Test Bank, Part 1 of 5
Content Areas: Cardiovascular
Q1. A client in the ICU has a pulmonary artery catheter in place. The nurse notes CVP 4 mm Hg,
PCWP 8 mm Hg, cardiac index 1.8 L/min/m2, and SvO2 55%. Which type of shock is most consistent
with these values?
A. Hypovolemic shock
B. Cardiogenic shock
C. Septic shock
D. Obstructive shock
Correct Answer: Hypovolemic shock ✅
Rationale: Hypovolemic shock presents with low CVP, low PCWP, low cardiac index, and low
SvO2 because there is not enough volume to fill the heart. Cardiogenic shock would show elevated
CVP and PCWP because the heart cannot pump the volume it receives. Septic shock would show low
systemic vascular resistance with normal or high cardiac index in the early phase. Obstructive shock
would show elevated right-sided pressures depending on the cause. The concept is that preload
values distinguish hypovolemic from cardiogenic shock.
Q2. A client in the ICU has a CVP of 16 mm Hg, PCWP of 24 mm Hg, cardiac index of 1.6 L/min/m2,
and SvO2 of 50%. Which type of shock is most consistent with these values?
A. Cardiogenic shock
B. Hypovolemic shock
C. Septic shock
D. Neurogenic shock
Correct Answer: Cardiogenic shock ✅
,Rationale: Cardiogenic shock presents with elevated CVP, elevated PCWP, low cardiac index,
and low SvO2 because the heart cannot pump effectively and blood backs up. Hypovolemic shock
would show low CVP and low PCWP. Septic shock would show low systemic vascular resistance with
normal or high cardiac index. Neurogenic shock would show bradycardia and hypotension from loss
of sympathetic tone. The concept is that elevated filling pressures with low output indicate pump
failure.
Q3. A client in the ICU has a blood pressure of 78/40 mm Hg, heart rate of 122/min, cardiac index of
4.5 L/min/m2, and systemic vascular resistance of 450 dynes/sec/cm5. Which type of shock is most
consistent with these values?
A. Septic shock
B. Cardiogenic shock
C. Hypovolemic shock
D. Obstructive shock
Correct Answer: Septic shock ✅
Rationale: Septic shock presents with hypotension, tachycardia, elevated cardiac index, and
low systemic vascular resistance because of widespread vasodilation. Cardiogenic shock would show
low cardiac index and high systemic vascular resistance. Hypovolemic shock would show low cardiac
index and low preload. Obstructive shock would show elevated right-sided pressures. The concept is
that low systemic vascular resistance with high output suggests distributive shock.
Q4. A client in the ICU has a blood pressure of 82/50 mm Hg, heart rate of 48/min, and warm dry
skin. Which type of shock is most consistent with these findings?
A. Neurogenic shock
B. Septic shock
C. Cardiogenic shock
D. Hypovolemic shock
Correct Answer: Neurogenic shock ✅
,Rationale: Neurogenic shock presents with hypotension, bradycardia, and warm dry skin
because of loss of sympathetic tone. Septic shock would present with tachycardia and warm skin.
Cardiogenic shock would present with cool clammy skin and tachycardia. Hypovolemic shock would
present with cool clammy skin and tachycardia. The concept is that bradycardia with hypotension
suggests loss of sympathetic innervation.
Q5. A client in the ICU has a blood pressure of 84/52 mm Hg, heart rate of 128/min, and cool clammy
skin. Which type of shock is most consistent with these findings?
A. Hypovolemic shock
B. Neurogenic shock
C. Septic shock
D. Anaphylactic shock
Correct Answer: Hypovolemic shock ✅
Rationale: Hypovolemic shock presents with hypotension, tachycardia, and cool clammy skin
from compensatory vasoconstriction. Neurogenic shock would present with bradycardia and warm
dry skin. Septic shock would present with warm skin in the early phase. Anaphylactic shock would
present with urticaria, wheezing, and angioedema. The concept is that cool clammy skin with
tachycardia suggests compensatory vasoconstriction.
Q6. A client in the ICU develops hypotension, urticaria, wheezing, and swelling of the lips after
receiving an antibiotic. Which type of shock is most consistent with these findings?
A. Anaphylactic shock
B. Septic shock
C. Cardiogenic shock
D. Neurogenic shock
Correct Answer: Anaphylactic shock ✅
, Rationale: Anaphylactic shock presents with hypotension, urticaria, wheezing, and
angioedema from a severe allergic reaction. Septic shock would present with fever and warm skin.
Cardiogenic shock would present with cool clammy skin and pulmonary edema. Neurogenic shock
would present with bradycardia and warm dry skin. The concept is that anaphylaxis involves multi-
system allergic findings.
Q7. A client in the ICU is receiving norepinephrine for septic shock. Which finding indicates the
medication is effective?
A. Mean arterial pressure of 68 mm Hg
B. Heart rate of 140/min
C. Urine output of 15 mL per hour
D. Serum lactate of 4 mmol/L
Correct Answer: Mean arterial pressure of 68 mm Hg ✅
Rationale: Norepinephrine is a vasopressor used to raise mean arterial pressure in septic
shock, and a MAP of 68 mm Hg meets the target of 65 mm Hg or higher. A heart rate of 140/min
indicates ongoing tachycardia and is not a sign of effectiveness. A urine output of 15 mL per hour
indicates inadequate perfusion. A serum lactate of 4 mmol/L indicates ongoing tissue hypoperfusion.
The concept is that MAP is the primary endpoint for vasopressor therapy.
Q8. A client in the ICU is receiving dobutamine for cardiogenic shock. Which finding indicates the
medication is effective?
A. Increased cardiac index with decreased PCWP
B. Decreased cardiac index with increased PCWP
C. Increased heart rate with decreased blood pressure
D. Decreased urine output with increased lactate
Correct Answer: Increased cardiac index with decreased PCWP ✅
