NGN HESI RN Critical Care Exam V2
(2025) – 50+ Actual Questions with
Verified Answers | Latest Next Gen
Format | Graded A+
Question 1 (Multiple Choice)
A client in the ICU with acute respiratory distress syndrome (ARDS) is on mechanical
ventilation. The nurse notes a sudden drop in oxygen saturation to 88% and increased peak
airway pressures. Which action should the nurse take first?
A. Increase the fraction of inspired oxygen (FiO2) to 100%.
B. Check the endotracheal tube for obstruction or displacement.
C. Administer a bronchodilator per protocol.
D. Notify the respiratory therapist to adjust ventilator settings.
Correct Answer: B
Rationale: A sudden drop in oxygen saturation and increased peak airway pressures suggest an
obstruction or displacement of the endotracheal tube. Checking the airway ensures patency,
which is critical for oxygenation. Increasing FiO2 (A) may temporarily improve saturation but
does not address the cause. Administering a bronchodilator (C) is premature without confirming
the issue. Notifying the respiratory therapist (D) follows airway assessment.
Question 2 (Multiple Choice)
A client with septic shock is receiving norepinephrine to maintain a mean arterial pressure
(MAP) of 65 mmHg. Which parameter should the nurse monitor to evaluate the
therapeutic response?
A. Heart rate
B. Urine output
C. Blood glucose
D. Respiratory rate
Correct Answer: B
Rationale: Norepinephrine increases systemic vascular resistance to improve MAP and organ
perfusion. Urine output reflects renal perfusion, a key indicator of therapeutic response. Heart
,rate (A), blood glucose (C), and respiratory rate (D) are less directly tied to norepinephrine’s
effect.
Question 3 (Matrix)
A client with suspected myocardial infarction (MI) is assessed. Indicate whether the
following findings are expected (E) or unexpected (U).
Assessment Finding Expected (E) Unexpected (U)
Chest pain radiating to the left arm
Sinus bradycardia at 48 bpm
ST-segment elevation on ECG
Diaphoresis and nausea
Normal troponin levels
Correct Answers:
Chest pain radiating to the left arm: E
Sinus bradycardia at 48 bpm: U
ST-segment elevation on ECG: E
Diaphoresis and nausea: E
Normal troponin levels: U
Rationale:
Chest pain radiating to the left arm (E): Classic MI symptom due to ischemia.
Sinus bradycardia at 48 bpm (U): MI typically causes tachycardia; bradycardia suggests a
complication like heart block.
ST-segment elevation (E): Indicates acute myocardial injury in STEMI.
Diaphoresis and nausea (E): Autonomic responses to MI.
Normal troponin levels (U): Troponin rises within hours of MI, indicating damage.
Question 4 (Drag-and-Drop)
A client with a traumatic brain injury (TBI) is admitted. Prioritize interventions to prevent
secondary brain injury.
, Administer mannitol as prescribed.
Elevate the head of the bed to 30 degrees.
Monitor intracranial pressure (ICP).
Administer oxygen to maintain SpO2 > 94%.
Correct Order:
Administer oxygen to maintain SpO2 > 94%.
Elevate the head of the bed to 30 degrees.
Monitor intracranial pressure (ICP).
Administer mannitol as prescribed.
Rationale:
Oxygen administration: Hypoxia worsens brain injury; SpO2 > 94% ensures cerebral
oxygenation.
Elevate head of bed: Reduces ICP by promoting venous drainage.
Monitor ICP: Guides ongoing interventions.
Mannitol: Reduces cerebral edema but is secondary to oxygenation and positioning.
Question 5 (Case Study Scenario)
Case Study: A 62-year-old male presents with chest pain for 12 hours. ECG shows ST-
segment elevation in V1-V4. Vital signs: BP 90/60 mmHg, HR 110 bpm, RR 24/min, SpO2
92%. Troponin is elevated. Diagnosis: anterior wall MI.
Question 5.1 (Multiple Choice)
Which intervention should the nurse prioritize?
A. Administer morphine for pain relief.
B. Prepare for percutaneous coronary intervention (PCI).
C. Initiate a heparin infusion.
D. Administer a beta-blocker to reduce heart rate.
Correct Answer: B
Rationale: PCI is the priority for STEMI to restore coronary blood flow. Morphine (A) is
(2025) – 50+ Actual Questions with
Verified Answers | Latest Next Gen
Format | Graded A+
Question 1 (Multiple Choice)
A client in the ICU with acute respiratory distress syndrome (ARDS) is on mechanical
ventilation. The nurse notes a sudden drop in oxygen saturation to 88% and increased peak
airway pressures. Which action should the nurse take first?
A. Increase the fraction of inspired oxygen (FiO2) to 100%.
B. Check the endotracheal tube for obstruction or displacement.
C. Administer a bronchodilator per protocol.
D. Notify the respiratory therapist to adjust ventilator settings.
Correct Answer: B
Rationale: A sudden drop in oxygen saturation and increased peak airway pressures suggest an
obstruction or displacement of the endotracheal tube. Checking the airway ensures patency,
which is critical for oxygenation. Increasing FiO2 (A) may temporarily improve saturation but
does not address the cause. Administering a bronchodilator (C) is premature without confirming
the issue. Notifying the respiratory therapist (D) follows airway assessment.
Question 2 (Multiple Choice)
A client with septic shock is receiving norepinephrine to maintain a mean arterial pressure
(MAP) of 65 mmHg. Which parameter should the nurse monitor to evaluate the
therapeutic response?
A. Heart rate
B. Urine output
C. Blood glucose
D. Respiratory rate
Correct Answer: B
Rationale: Norepinephrine increases systemic vascular resistance to improve MAP and organ
perfusion. Urine output reflects renal perfusion, a key indicator of therapeutic response. Heart
,rate (A), blood glucose (C), and respiratory rate (D) are less directly tied to norepinephrine’s
effect.
Question 3 (Matrix)
A client with suspected myocardial infarction (MI) is assessed. Indicate whether the
following findings are expected (E) or unexpected (U).
Assessment Finding Expected (E) Unexpected (U)
Chest pain radiating to the left arm
Sinus bradycardia at 48 bpm
ST-segment elevation on ECG
Diaphoresis and nausea
Normal troponin levels
Correct Answers:
Chest pain radiating to the left arm: E
Sinus bradycardia at 48 bpm: U
ST-segment elevation on ECG: E
Diaphoresis and nausea: E
Normal troponin levels: U
Rationale:
Chest pain radiating to the left arm (E): Classic MI symptom due to ischemia.
Sinus bradycardia at 48 bpm (U): MI typically causes tachycardia; bradycardia suggests a
complication like heart block.
ST-segment elevation (E): Indicates acute myocardial injury in STEMI.
Diaphoresis and nausea (E): Autonomic responses to MI.
Normal troponin levels (U): Troponin rises within hours of MI, indicating damage.
Question 4 (Drag-and-Drop)
A client with a traumatic brain injury (TBI) is admitted. Prioritize interventions to prevent
secondary brain injury.
, Administer mannitol as prescribed.
Elevate the head of the bed to 30 degrees.
Monitor intracranial pressure (ICP).
Administer oxygen to maintain SpO2 > 94%.
Correct Order:
Administer oxygen to maintain SpO2 > 94%.
Elevate the head of the bed to 30 degrees.
Monitor intracranial pressure (ICP).
Administer mannitol as prescribed.
Rationale:
Oxygen administration: Hypoxia worsens brain injury; SpO2 > 94% ensures cerebral
oxygenation.
Elevate head of bed: Reduces ICP by promoting venous drainage.
Monitor ICP: Guides ongoing interventions.
Mannitol: Reduces cerebral edema but is secondary to oxygenation and positioning.
Question 5 (Case Study Scenario)
Case Study: A 62-year-old male presents with chest pain for 12 hours. ECG shows ST-
segment elevation in V1-V4. Vital signs: BP 90/60 mmHg, HR 110 bpm, RR 24/min, SpO2
92%. Troponin is elevated. Diagnosis: anterior wall MI.
Question 5.1 (Multiple Choice)
Which intervention should the nurse prioritize?
A. Administer morphine for pain relief.
B. Prepare for percutaneous coronary intervention (PCI).
C. Initiate a heparin infusion.
D. Administer a beta-blocker to reduce heart rate.
Correct Answer: B
Rationale: PCI is the priority for STEMI to restore coronary blood flow. Morphine (A) is
