HESI RN Critical
Care | Complete
Test Bank | All
Domain | Latest
2025/2026
,Table of Contents
HESI RN Critical Care | Complete Test Bank | All Domain | Latest 2025/2026 ......................... 1
Domain 1: Hemodynamics & Shock ................................................................................................... 2
Domain 2: Mechanical Ventilation & ABG Interpretation ........................................................... 11
Domain 3: Cardiac Critical Care (MI, Arrhythmias, Heart Failure, Post-Cardiac Arrest)...... 20
Domain 4: Neurologic Critical Care (Stroke, TBI, ICP, Seizures)................................................ 28
Domain 5: Respiratory Critical Care (ARDS, PE, Pneumothorax, Respiratory Failure) ........ 37
Domain 6: Renal Critical Care (AKI, CRRT, Dialysis, Electrolytes) ............................................ 46
Domain 7: Endocrine Critical Care (DKA, HHS, Adrenal Crisis, Thyroid Storm, SIADH) ....... 54
Domain 8: Multisystem Critical Care (Sepsis, DIC, MODS, Burns) ............................................. 63
Domain 9: Gastrointestinal/Nutritional Critical Care (Bleeding, Pancreatitis, Hepatic
Encephalopathy) ................................................................................................................................. 71
Domain 10: Critical Care Pharmacology & Monitoring ............................................................... 80
Domain 1: Hemodynamics & Shock
Question 1
A nurse is caring for a client in septic shock. Which hemodynamic parameter
is expected?
A) Increased systemic vascular resistance (SVR)
B) Decreased cardiac output (CO)
C) Decreased systemic vascular resistance (SVR)
D) Increased pulmonary artery wedge pressure (PAWP)
Correct Answer: C
Rationale:
Correct (C): Septic shock is a distributive shock characterized by
,vasodilation, leading to decreased systemic vascular resistance (SVR). This
causes hypotension despite normal or increased cardiac output initially.
Incorrect (A): SVR is decreased, not increased (increased SVR is seen in
cardiogenic or hypovolemic shock).
Incorrect (B): Cardiac output is typically normal or increased in early
septic shock (warm shock).
Incorrect (D): PAWP is normal or decreased in septic shock (not
increased).
Study Tip: "Septic shock = low SVR + normal/high CO. Cardiogenic shock =
high SVR + low CO."
Question 2
A client with cardiogenic shock has a pulmonary artery catheter in place.
Which finding indicates worsening cardiogenic shock?
A) Cardiac index (CI) 2.8 L/min/m²
B) Pulmonary artery wedge pressure (PAWP) 22 mmHg
C) Systemic vascular resistance (SVR) 800 dynes/sec/cm⁻⁵
D) Mixed venous oxygen saturation (SvO₂) 70%
Correct Answer: B
Rationale:
Correct (B): PAWP (normal 4-12 mmHg) is elevated in cardiogenic shock
due to increased left ventricular end-diastolic pressure from pump failure.
PAWP >20 mmHg indicates worsening.
Incorrect (A): Normal CI is >2.2 L/min/m²; 2.8 is acceptable.
Incorrect (C): Normal SVR is 800-1200; 800 is borderline low.
Incorrect (D): Normal SvO₂ is 60-80%; 70% is normal.
, Study Tip: "Cardiogenic shock = increased PAWP (backward failure) +
decreased CI + increased SVR."
Question 3
A nurse is assessing a client with hypovolemic shock. Which finding does the
nurse expect?
A) Bounding pulses
B) Decreased urine output
C) Increased central venous pressure (CVP)
D) Crackles in lung bases
Correct Answer: B
Rationale:
Correct (B): Hypovolemic shock causes decreased renal perfusion, leading
to decreased urine output (<0.5 mL/kg/hour).
Incorrect (A): Pulses are weak and thready, not bounding (bounding
pulses occur in distributive shock).
Incorrect (C): CVP is decreased (low preload), not increased.
Incorrect (D): Crackles suggest fluid overload (cardiogenic shock), not
hypovolemia.
Study Tip: "Hypovolemic shock = low preload (low CVP/PAWP) + low CO +
high SVR + decreased urine output."
Question 4
A client is receiving norepinephrine (Levophed) for septic shock. Which
finding indicates the medication is effective?
Care | Complete
Test Bank | All
Domain | Latest
2025/2026
,Table of Contents
HESI RN Critical Care | Complete Test Bank | All Domain | Latest 2025/2026 ......................... 1
Domain 1: Hemodynamics & Shock ................................................................................................... 2
Domain 2: Mechanical Ventilation & ABG Interpretation ........................................................... 11
Domain 3: Cardiac Critical Care (MI, Arrhythmias, Heart Failure, Post-Cardiac Arrest)...... 20
Domain 4: Neurologic Critical Care (Stroke, TBI, ICP, Seizures)................................................ 28
Domain 5: Respiratory Critical Care (ARDS, PE, Pneumothorax, Respiratory Failure) ........ 37
Domain 6: Renal Critical Care (AKI, CRRT, Dialysis, Electrolytes) ............................................ 46
Domain 7: Endocrine Critical Care (DKA, HHS, Adrenal Crisis, Thyroid Storm, SIADH) ....... 54
Domain 8: Multisystem Critical Care (Sepsis, DIC, MODS, Burns) ............................................. 63
Domain 9: Gastrointestinal/Nutritional Critical Care (Bleeding, Pancreatitis, Hepatic
Encephalopathy) ................................................................................................................................. 71
Domain 10: Critical Care Pharmacology & Monitoring ............................................................... 80
Domain 1: Hemodynamics & Shock
Question 1
A nurse is caring for a client in septic shock. Which hemodynamic parameter
is expected?
A) Increased systemic vascular resistance (SVR)
B) Decreased cardiac output (CO)
C) Decreased systemic vascular resistance (SVR)
D) Increased pulmonary artery wedge pressure (PAWP)
Correct Answer: C
Rationale:
Correct (C): Septic shock is a distributive shock characterized by
,vasodilation, leading to decreased systemic vascular resistance (SVR). This
causes hypotension despite normal or increased cardiac output initially.
Incorrect (A): SVR is decreased, not increased (increased SVR is seen in
cardiogenic or hypovolemic shock).
Incorrect (B): Cardiac output is typically normal or increased in early
septic shock (warm shock).
Incorrect (D): PAWP is normal or decreased in septic shock (not
increased).
Study Tip: "Septic shock = low SVR + normal/high CO. Cardiogenic shock =
high SVR + low CO."
Question 2
A client with cardiogenic shock has a pulmonary artery catheter in place.
Which finding indicates worsening cardiogenic shock?
A) Cardiac index (CI) 2.8 L/min/m²
B) Pulmonary artery wedge pressure (PAWP) 22 mmHg
C) Systemic vascular resistance (SVR) 800 dynes/sec/cm⁻⁵
D) Mixed venous oxygen saturation (SvO₂) 70%
Correct Answer: B
Rationale:
Correct (B): PAWP (normal 4-12 mmHg) is elevated in cardiogenic shock
due to increased left ventricular end-diastolic pressure from pump failure.
PAWP >20 mmHg indicates worsening.
Incorrect (A): Normal CI is >2.2 L/min/m²; 2.8 is acceptable.
Incorrect (C): Normal SVR is 800-1200; 800 is borderline low.
Incorrect (D): Normal SvO₂ is 60-80%; 70% is normal.
, Study Tip: "Cardiogenic shock = increased PAWP (backward failure) +
decreased CI + increased SVR."
Question 3
A nurse is assessing a client with hypovolemic shock. Which finding does the
nurse expect?
A) Bounding pulses
B) Decreased urine output
C) Increased central venous pressure (CVP)
D) Crackles in lung bases
Correct Answer: B
Rationale:
Correct (B): Hypovolemic shock causes decreased renal perfusion, leading
to decreased urine output (<0.5 mL/kg/hour).
Incorrect (A): Pulses are weak and thready, not bounding (bounding
pulses occur in distributive shock).
Incorrect (C): CVP is decreased (low preload), not increased.
Incorrect (D): Crackles suggest fluid overload (cardiogenic shock), not
hypovolemia.
Study Tip: "Hypovolemic shock = low preload (low CVP/PAWP) + low CO +
high SVR + decreased urine output."
Question 4
A client is receiving norepinephrine (Levophed) for septic shock. Which
finding indicates the medication is effective?
