HESI RN CRITICAL CARE NEWEST 2026 ACTUAL EXAM
TEST BANK| CRITICAL CARE RN HESI EXIT EXAM WITH
COMPLETE 650 REAL EXAM QUESTIONS AND
CORRECT VERIFIED ANSWERS/ ALREADY GRADED A+
(MOST RECENT!!)
Question 1
A patient with septic shock has a mean arterial pressure (MAP) of
52 mm Hg despite adequate fluid resuscitation. Which
vasopressor should the nurse anticipate administering first?
A. Dopamine
B. Vasopressin
C. Norepinephrine
D. Phenylephrine
Correct Answer: C
Rationale: Current guidelines (SSC 2021) recommend
norepinephrine as first-line in septic shock to achieve MAP ≥65
mm Hg. It increases MAP via alpha-1 vasoconstriction with less
tachycardia than dopamine.
Question 2
1
,A patient with cardiogenic shock has a cardiac index (CI) of 1.8
L/min/m² and systemic vascular resistance (SVR) of 2,200
dynes/sec/cm⁻⁵. Which intervention does the nurse expect?
A. Dobutamine infusion
B. Norepinephrine infusion
C. Nitroprusside infusion
D. 500 mL normal saline bolus
Correct Answer: A
Rationale: Low CI with high SVR indicates poor contractility with
vasoconstriction. Dobutamine increases contractility and CI, with
some vasodilation. Nitroprusside would drop afterload
dangerously. Norepinephrine worsens afterload.
Question 3
A patient in hypovolemic shock has a heart rate of 130 bpm, BP
85/50, and CVP of 2 mm Hg. After 2 L of lactated Ringer's, BP
improves to 110/70 but HR remains 110. What is the next best
action?
A. Administer norepinephrine
B. Give a third liter of fluids
2
,C. Start dobutamine
D. Transfuse PRBCs
Correct Answer: B
Rationale: Ongoing tachycardia despite initial BP response
suggests continued hypovolemia. Give additional fluid bolus.
Vasopressors not indicated until euvolemia confirmed.
Question 4
A pulmonary artery catheter shows: CO 4.2 L/min, PAOP 22 mm
Hg, SVR 1,100. This profile is consistent with:
A. Hypovolemic shock
B. Distributive shock
C. Cardiogenic shock
D. Obstructive shock
Correct Answer: C
Rationale: High PAOP (>18) with normal/low CO suggests
cardiogenic shock. Low SVR is not typical but can occur in early
stages. Hypovolemic has low PAOP.
Question 5
3
, A patient with septic shock has a lactate of 6.2 mmol/L after
initial 30 mL/kg crystalloid. MAP is 58 mm Hg on norepinephrine
0.2 mcg/kg/min. Which intervention is most important within the
next hour?
A. Central line placement
B. Increase norepinephrine
C. Start hydrocortisone
D. Repeat lactate
Correct Answer: B
Rationale: MAP remains <65 despite norepinephrine. Increase
vasopressor. Hydrocortisone if refractory shock; central line not
urgent; lactate repeat is monitoring but not intervention.
Question 6
A patient with anaphylactic shock has stridor and hypotension
after penicillin administration. Which medication is priority?
A. Diphenhydramine IV
B. Methylprednisolone IV
C. Epinephrine IM
D. Albuterol nebulizer
4
TEST BANK| CRITICAL CARE RN HESI EXIT EXAM WITH
COMPLETE 650 REAL EXAM QUESTIONS AND
CORRECT VERIFIED ANSWERS/ ALREADY GRADED A+
(MOST RECENT!!)
Question 1
A patient with septic shock has a mean arterial pressure (MAP) of
52 mm Hg despite adequate fluid resuscitation. Which
vasopressor should the nurse anticipate administering first?
A. Dopamine
B. Vasopressin
C. Norepinephrine
D. Phenylephrine
Correct Answer: C
Rationale: Current guidelines (SSC 2021) recommend
norepinephrine as first-line in septic shock to achieve MAP ≥65
mm Hg. It increases MAP via alpha-1 vasoconstriction with less
tachycardia than dopamine.
Question 2
1
,A patient with cardiogenic shock has a cardiac index (CI) of 1.8
L/min/m² and systemic vascular resistance (SVR) of 2,200
dynes/sec/cm⁻⁵. Which intervention does the nurse expect?
A. Dobutamine infusion
B. Norepinephrine infusion
C. Nitroprusside infusion
D. 500 mL normal saline bolus
Correct Answer: A
Rationale: Low CI with high SVR indicates poor contractility with
vasoconstriction. Dobutamine increases contractility and CI, with
some vasodilation. Nitroprusside would drop afterload
dangerously. Norepinephrine worsens afterload.
Question 3
A patient in hypovolemic shock has a heart rate of 130 bpm, BP
85/50, and CVP of 2 mm Hg. After 2 L of lactated Ringer's, BP
improves to 110/70 but HR remains 110. What is the next best
action?
A. Administer norepinephrine
B. Give a third liter of fluids
2
,C. Start dobutamine
D. Transfuse PRBCs
Correct Answer: B
Rationale: Ongoing tachycardia despite initial BP response
suggests continued hypovolemia. Give additional fluid bolus.
Vasopressors not indicated until euvolemia confirmed.
Question 4
A pulmonary artery catheter shows: CO 4.2 L/min, PAOP 22 mm
Hg, SVR 1,100. This profile is consistent with:
A. Hypovolemic shock
B. Distributive shock
C. Cardiogenic shock
D. Obstructive shock
Correct Answer: C
Rationale: High PAOP (>18) with normal/low CO suggests
cardiogenic shock. Low SVR is not typical but can occur in early
stages. Hypovolemic has low PAOP.
Question 5
3
, A patient with septic shock has a lactate of 6.2 mmol/L after
initial 30 mL/kg crystalloid. MAP is 58 mm Hg on norepinephrine
0.2 mcg/kg/min. Which intervention is most important within the
next hour?
A. Central line placement
B. Increase norepinephrine
C. Start hydrocortisone
D. Repeat lactate
Correct Answer: B
Rationale: MAP remains <65 despite norepinephrine. Increase
vasopressor. Hydrocortisone if refractory shock; central line not
urgent; lactate repeat is monitoring but not intervention.
Question 6
A patient with anaphylactic shock has stridor and hypotension
after penicillin administration. Which medication is priority?
A. Diphenhydramine IV
B. Methylprednisolone IV
C. Epinephrine IM
D. Albuterol nebulizer
4
