CRITICAL CARE NURSING 8TH
EDITION 2026 TEST BANK PDF – FULL
EXAM QUESTIONS & STUDY GUIDE
PDF/ LATEST VERIFIED!!!
(Chapter 1: Overview of Critical Care
Nursing -Test Bank
MULTIPLE CHOICE
A client in septic shock remains hypotensive after aggressive IV fluid therapy. Which medication
should the nurse anticipate administering next?
A. Furosemide
B. Norepinephrine
C. Acetaminophen
D. Insulin
✅ Correct Answer: B
Rationale:
When fluid resuscitation does not restore adequate blood pressure in septic shock, vasopressors
are required to increase systemic vascular resistance and improve organ perfusion.
Norepinephrine is the first-line agent because it raises blood pressure while maintaining blood
flow to critical organs. Diuretics would further decrease circulating volume and worsen
hypotension.
A mechanically ventilated client suddenly becomes restless, tachycardic, and experiences a drop
in oxygen saturation. What should the nurse do first?
A. Administer a sedative
B. Increase oxygen concentration
C. Assess airway patency and ventilator tubing
D. Call the provider immediately
✅ Correct Answer: C
Rationale:
Sudden respiratory compromise in ventilated patients is often due to airway obstruction,
,secretions, or equipment malfunction. The nurse should always assess the airway and ventilator
system before giving medications or escalating care. Sedation may mask worsening hypoxia.
A patient with increased intracranial pressure should be positioned how to promote venous
drainage?
A. Flat
B. Trendelenburg
C. Head elevated about 30 degrees
D. Knees flexed
✅ Correct Answer: C
Rationale:
Elevating the head of the bed facilitates venous outflow from the brain and reduces intracranial
pressure while preserving cerebral perfusion.
An arterial blood gas reveals a low pH with decreased bicarbonate levels. This finding indicates:
A. Respiratory alkalosis
B. Metabolic acidosis
C. Respiratory acidosis
D. Metabolic alkalosis
✅ Correct Answer: B
Rationale:
A low pH combined with low bicarbonate confirms metabolic acidosis, commonly seen in shock,
renal failure, and severe diarrhea.
A client with ARDS is receiving high levels of PEEP on the ventilator. Which complication
should the nurse monitor for most closely?
A. Hypertension
B. Decreased cardiac output
C. Increased urine output
D. Hyperglycemia
✅ Correct Answer: B
Rationale:
High PEEP increases intrathoracic pressure, reducing venous return to the heart and potentially
lowering cardiac output and blood pressure.
A client with hypovolemic shock has a blood pressure of 78/40 mmHg and a heart rate of 132
bpm. Which intervention should the nurse implement first?
,A. Administer IV isotonic fluids
B. Apply a cooling blanket
C. Administer morphine
D. Elevate the head of the bed
✅ Correct Answer: A
Rationale:
Hypovolemic shock results from decreased circulating blood volume. The priority intervention is
rapid restoration of intravascular volume using isotonic fluids such as normal saline or lactated
Ringer’s. Cooling blankets and morphine do not address the underlying volume deficit, and
elevating the head of the bed may worsen hypotension.
A client with a pulmonary embolism suddenly reports sharp chest pain and shortness of breath.
Which assessment finding requires immediate action?
A. Respiratory rate of 24/min
B. Oxygen saturation of 88%
C. Heart rate of 102 bpm
D. Mild anxiety
✅ Correct Answer:
Rationale:
An oxygen saturation of 88% indicates significant hypoxemia and requires immediate
intervention, such as supplemental oxygen. Pulmonary embolism impairs gas exchange, leading
to decreased oxygen levels. Mild tachycardia and anxiety are common findings but are less
immediately life-threatening than hypoxia.
A client with syndrome of inappropriate antidiuretic hormone (SIADH) has a sodium level of
118 mEq/L. Which symptom should the nurse expect?
A. Excessive thirst
B. Confusion and seizures
C. Increased urine output
D. Dry mucous membranes
✅ Correct Answer: B
Rationale:
SIADH causes water retention and dilutional hyponatremia. Severe hyponatremia (below 120
mEq/L) can lead to neurological symptoms such as confusion, decreased level of consciousness,
, and seizures due to cerebral edema. Patients with SIADH typically have decreased urine output
and fluid overload rather than dehydration.
A client receiving heparin therapy develops bleeding gums and hematuria. Which laboratory
value should the nurse review?
A. Platelet count
B. Hemoglobin level
C. aPTT
D. INR
✅ Correct Answer: C
Rationale:
Heparin therapy is monitored using activated partial thromboplastin time (aPTT). An elevated
aPTT indicates excessive anticoagulation and increased risk of bleeding. INR is used to monitor
warfarin therapy, not heparin.
A client with acute myocardial infarction suddenly develops crackles in the lungs and shortness
of breath. Which complication should the nurse suspect?
A. Cardiogenic shock
B. Pulmonary edema
C. Cardiac tamponade
D. Pericarditis
✅ Correct Answer: B
Rationale:
Crackles and shortness of breath following myocardial infarction suggest left ventricular failure
leading to pulmonary edema. When the left ventricle cannot effectively pump blood, fluid backs
up into the lungs, impairing gas exchange and causing respiratory distress.
A client with Addisonian crisis presents with severe hypotension and hyperkalemia. Which
medication should the nurse anticipate administering immediately?
A. Regular insulin
B. Hydrocortisone IV
C. Levothyroxine
D. Spironolactone
EDITION 2026 TEST BANK PDF – FULL
EXAM QUESTIONS & STUDY GUIDE
PDF/ LATEST VERIFIED!!!
(Chapter 1: Overview of Critical Care
Nursing -Test Bank
MULTIPLE CHOICE
A client in septic shock remains hypotensive after aggressive IV fluid therapy. Which medication
should the nurse anticipate administering next?
A. Furosemide
B. Norepinephrine
C. Acetaminophen
D. Insulin
✅ Correct Answer: B
Rationale:
When fluid resuscitation does not restore adequate blood pressure in septic shock, vasopressors
are required to increase systemic vascular resistance and improve organ perfusion.
Norepinephrine is the first-line agent because it raises blood pressure while maintaining blood
flow to critical organs. Diuretics would further decrease circulating volume and worsen
hypotension.
A mechanically ventilated client suddenly becomes restless, tachycardic, and experiences a drop
in oxygen saturation. What should the nurse do first?
A. Administer a sedative
B. Increase oxygen concentration
C. Assess airway patency and ventilator tubing
D. Call the provider immediately
✅ Correct Answer: C
Rationale:
Sudden respiratory compromise in ventilated patients is often due to airway obstruction,
,secretions, or equipment malfunction. The nurse should always assess the airway and ventilator
system before giving medications or escalating care. Sedation may mask worsening hypoxia.
A patient with increased intracranial pressure should be positioned how to promote venous
drainage?
A. Flat
B. Trendelenburg
C. Head elevated about 30 degrees
D. Knees flexed
✅ Correct Answer: C
Rationale:
Elevating the head of the bed facilitates venous outflow from the brain and reduces intracranial
pressure while preserving cerebral perfusion.
An arterial blood gas reveals a low pH with decreased bicarbonate levels. This finding indicates:
A. Respiratory alkalosis
B. Metabolic acidosis
C. Respiratory acidosis
D. Metabolic alkalosis
✅ Correct Answer: B
Rationale:
A low pH combined with low bicarbonate confirms metabolic acidosis, commonly seen in shock,
renal failure, and severe diarrhea.
A client with ARDS is receiving high levels of PEEP on the ventilator. Which complication
should the nurse monitor for most closely?
A. Hypertension
B. Decreased cardiac output
C. Increased urine output
D. Hyperglycemia
✅ Correct Answer: B
Rationale:
High PEEP increases intrathoracic pressure, reducing venous return to the heart and potentially
lowering cardiac output and blood pressure.
A client with hypovolemic shock has a blood pressure of 78/40 mmHg and a heart rate of 132
bpm. Which intervention should the nurse implement first?
,A. Administer IV isotonic fluids
B. Apply a cooling blanket
C. Administer morphine
D. Elevate the head of the bed
✅ Correct Answer: A
Rationale:
Hypovolemic shock results from decreased circulating blood volume. The priority intervention is
rapid restoration of intravascular volume using isotonic fluids such as normal saline or lactated
Ringer’s. Cooling blankets and morphine do not address the underlying volume deficit, and
elevating the head of the bed may worsen hypotension.
A client with a pulmonary embolism suddenly reports sharp chest pain and shortness of breath.
Which assessment finding requires immediate action?
A. Respiratory rate of 24/min
B. Oxygen saturation of 88%
C. Heart rate of 102 bpm
D. Mild anxiety
✅ Correct Answer:
Rationale:
An oxygen saturation of 88% indicates significant hypoxemia and requires immediate
intervention, such as supplemental oxygen. Pulmonary embolism impairs gas exchange, leading
to decreased oxygen levels. Mild tachycardia and anxiety are common findings but are less
immediately life-threatening than hypoxia.
A client with syndrome of inappropriate antidiuretic hormone (SIADH) has a sodium level of
118 mEq/L. Which symptom should the nurse expect?
A. Excessive thirst
B. Confusion and seizures
C. Increased urine output
D. Dry mucous membranes
✅ Correct Answer: B
Rationale:
SIADH causes water retention and dilutional hyponatremia. Severe hyponatremia (below 120
mEq/L) can lead to neurological symptoms such as confusion, decreased level of consciousness,
, and seizures due to cerebral edema. Patients with SIADH typically have decreased urine output
and fluid overload rather than dehydration.
A client receiving heparin therapy develops bleeding gums and hematuria. Which laboratory
value should the nurse review?
A. Platelet count
B. Hemoglobin level
C. aPTT
D. INR
✅ Correct Answer: C
Rationale:
Heparin therapy is monitored using activated partial thromboplastin time (aPTT). An elevated
aPTT indicates excessive anticoagulation and increased risk of bleeding. INR is used to monitor
warfarin therapy, not heparin.
A client with acute myocardial infarction suddenly develops crackles in the lungs and shortness
of breath. Which complication should the nurse suspect?
A. Cardiogenic shock
B. Pulmonary edema
C. Cardiac tamponade
D. Pericarditis
✅ Correct Answer: B
Rationale:
Crackles and shortness of breath following myocardial infarction suggest left ventricular failure
leading to pulmonary edema. When the left ventricle cannot effectively pump blood, fluid backs
up into the lungs, impairing gas exchange and causing respiratory distress.
A client with Addisonian crisis presents with severe hypotension and hyperkalemia. Which
medication should the nurse anticipate administering immediately?
A. Regular insulin
B. Hydrocortisone IV
C. Levothyroxine
D. Spironolactone
