NCLEX-RN Practice Questions & Rationales
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Description:
Prepare for your Critical Care Nursing Exam, NCLEX-RN, or CCRN certification with
our updated 2027 test bank featuring 55 targeted practice questions complete with detailed
rationales. This resource covers essential topics including patient prioritization, ventilator
management, sepsis protocols, hemodynamic monitoring, and post-op care—all aligned with
the latest evidence-based guidelines.
Each question is designed to mimic the real-world clinical judgment required in ICU and high-
acuity settings, helping you master critical thinking, test-taking strategies, and content
review. Whether you're a nursing student, new grad, or RN advancing into critical care, this
exam simulator provides the practice you need to excel.
Download your free copy now and prepare with confidence—your next exam breakthrough starts
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, Critical Care Nursing Exam 1: Practice Questions & Rationales
(2026/2027)
1. You have received the change-of-shift report for the following patients. Which one requires your
immediate assessment?
a. A 62-year-old male prepared for immediate transport to cardiac catheterization.
b. A 58-year-old female with COPD on 2L/min O2, maintaining 92% saturation, scheduled for
discharge with home oxygen.
c. A 36-year-old male admitted for asthma exacerbation, with a respiratory rate of 36 at rest and
diminished wheezing.
d. A 72-year-old female with a history of asthma, heart rate 90 bpm, and a scheduled beta-
blocker dose.
Answer: C
Explanation: A respiratory rate of 36 with diminished wheezing signals severe respiratory
distress and potential muscle fatigue or silent chest, which is an emergency requiring prompt
intervention to prevent respiratory failure.
2. During handover to the oncoming nurse, which patient’s situation demands the most urgent
follow-up?
a. A 62-year-old male with COPD who just received his scheduled bronchodilator.
b. A 68-year-old female with type 2 diabetes, status post-CVA 2 days ago.
c. A 72-year-old female with a history of asthma, heart rate 90 bpm, awaiting a beta-blocker.
d. A 48-year-old male admitted with cellulitis of the right hand, on IV antibiotics, with a current
temperature of 101.8°F.
Answer: D
Explanation: A fever of 101.8°F in a patient with cellulitis indicates a possible worsening or
systemic infection. This requires immediate reassessment of the infection site, vital signs, and
antibiotic efficacy to prevent sepsis.
, 3. You are preparing a 58-year-old male for a scheduled cardiac angiogram. Which actions are
essential? (Select all that apply)
a. Inform the patient he will be under general anesthesia.
b. Verify the patient’s allergy history, focusing on iodine or contrast media.
c. Instruct the patient that family must remain in the waiting area to avoid disrupting the
procedure team.
d. Perform medication reconciliation, specifically confirming the hold of anticoagulants like
warfarin.
e. Review recent laboratory results, with particular attention to PT/INR.
Answer: B, D, E
Explanation: Contrast dye allergies can precipitate anaphylaxis. Anticoagulants increase
bleeding risk and are typically held prior to the procedure. Reviewing PT/INR is crucial for
assessing coagulation status. Patients usually receive moderate sedation, not general anesthesia,
and family presence policies are institution-specific but not typically a pre-procedure nursing
action.
4. A 62-year-old patient is being transferred from the ICU to a cardiac stepdown unit post-coronary
artery bypass grafting. What is the most effective method for handoff communication?
a. A verbal report given face-to-face in a quiet room.
b. An audio-recorded report for documentation.
c. Thorough documentation in the electronic health record.
d. The ICU nurse accompanies the patient and gives a face-to-face report using a standardized
checklist.
Answer: D
Explanation: A face-to-face handoff at the point of transfer using a standardized tool (like
SBAR) minimizes errors, allows for immediate clarification, and facilitates a seamless transition
of care and responsibility.