KAPLAN CRITICAL CARE NURSING EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
Core Domains
Airway and ventilatory support
Hemodynamic monitoring and cardiovascular care
Neurologic assessment and emergencies
Renal, fluid, and electrolyte management
Sepsis, shock, and multisystem failure
Pharmacology and vasoactive medications
Infection control and patient safety
Ethical, legal, and professional practice
Introduction
This assessment is designed to evaluate core critical care nursing knowledge, clinical judgment, and bedside decision-making across common
intensive care scenarios. It measures understanding of physiologic monitoring, emergency interventions, medication management, patient safety,
and professional responsibilities in high-acuity settings. Questions combine foundational theory with scenario-based application to reflect the
realities of ICU practice. The format emphasizes prioritization, recognition of deterioration, and safe intervention, helping learners prepare for
real-world critical care responsibilities through multiple-choice decision-making that mirrors exam-style reasoning.
Section One: Questions 1–100
1. A patient receiving mechanical ventilation develops sudden high-pressure alarms and decreased oxygen saturation. What is the nurse’s first action?
A. Administer a sedative.
B. Assess the airway and tubing for obstruction.
C. Increase the tidal volume.
D. Notify the provider immediately.
🟢 Correct answer: B. Assess the airway and tubing for obstruction.
🔴 RATIONALE: The first priority is to identify and correct reversible causes of ventilator alarm changes, especially obstruction or disconnection.
,2. Which arterial blood gas indicates respiratory acidosis?
A. pH 7.30, PaCO2 55 mm Hg
B. pH 7.48, PaCO2 30 mm Hg
C. pH 7.46, HCO3 30 mEq/L
D. pH 7.52, PaCO2 48 mm Hg
🟢 Correct answer: A. pH 7.30, PaCO2 55 mm Hg
🔴 RATIONALE: A low pH with elevated PaCO2 reflects respiratory acidosis from hypoventilation.
3. A patient with chest pain and hypotension has ST-segment elevation on ECG. What is the nurse’s priority concern?
A. Hyperglycemia
B. Acute myocardial infarction
C. Pericarditis
D. Atrial fibrillation
🟢 Correct answer: B. Acute myocardial infarction
🔴 RATIONALE: ST-segment elevation with ischemic symptoms is strongly consistent with acute MI requiring urgent intervention.
4. Which finding most strongly suggests fluid volume overload?
A. Flat neck veins
B. Dry mucous membranes
C. Crackles in the lungs
D. Urine specific gravity 1.040
🟢 Correct answer: C. Crackles in the lungs
🔴 RATIONALE: Crackles indicate pulmonary congestion, a common manifestation of fluid overload.
5. A critically ill patient becomes restless, tachycardic, and hypotensive. What condition should the nurse suspect first?
, A. Hypoglycemia
B. Shock
C. Hypercalcemia
D. Urinary retention
🟢 Correct answer: B. Shock
🔴 RATIONALE: Restlessness, tachycardia, and hypotension are early signs of shock and poor tissue perfusion.
6. Which intervention best reduces the risk of ventilator-associated pneumonia?
A. Routine saline instillation before suctioning
B. Elevating the head of the bed
C. Limiting oral care
D. Keeping the patient flat after suctioning
🟢 Correct answer: B. Elevating the head of the bed
🔴 RATIONALE: Head-of-bed elevation lowers aspiration risk and is a key preventive measure for ventilator-associated pneumonia.
7. A patient on dopamine infusion develops frequent premature ventricular contractions. What is the nurse’s best action?
A. Slow the infusion and notify the provider.
B. Stop the infusion immediately without assessment.
C. Give a potassium supplement.
D. Place the patient in Trendelenburg position.
🟢 Correct answer: A. Slow the infusion and notify the provider.
🔴 RATIONALE: Dopamine can cause dysrhythmias; reducing the dose and alerting the provider is appropriate.
8. What is the most appropriate action for a patient with suspected sepsis?
A. Delay antibiotics until cultures return.
B. Start broad-spectrum antibiotics promptly after cultures.
C. Restrict fluids to prevent overload.
D. Give oral antipyretics only.
, 🟢 Correct answer: B. Start broad-spectrum antibiotics promptly after cultures.
🔴 RATIONALE: Early cultures and rapid antibiotic therapy are essential in sepsis management.
9. Which electrolyte abnormality is most associated with peaked T waves on ECG?
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypernatremia
🟢 Correct answer: B. Hyperkalemia
🔴 RATIONALE: Peaked T waves are a classic ECG sign of elevated potassium levels.
0. A patient with severe dyspnea is using accessory muscles and has stridor. What is the priority nursing action?
A. Encourage deep breathing.
B. Prepare for airway management.
C. Obtain a complete history first.
D. Administer a diuretic.
🟢 Correct answer: B. Prepare for airway management.
🔴 RATIONALE: Stridor indicates upper airway obstruction and requires immediate airway readiness.
1. Which assessment finding indicates decreased cardiac output?
A. Bounding pulses
B. Warm flushed skin
C. Urine output of 20 mL/hr
D. Hypertension
🟢 Correct answer: C. Urine output of 20 mL/hr
🔴 RATIONALE: Low urine output is a sign of poor renal perfusion from reduced cardiac output.
RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
Core Domains
Airway and ventilatory support
Hemodynamic monitoring and cardiovascular care
Neurologic assessment and emergencies
Renal, fluid, and electrolyte management
Sepsis, shock, and multisystem failure
Pharmacology and vasoactive medications
Infection control and patient safety
Ethical, legal, and professional practice
Introduction
This assessment is designed to evaluate core critical care nursing knowledge, clinical judgment, and bedside decision-making across common
intensive care scenarios. It measures understanding of physiologic monitoring, emergency interventions, medication management, patient safety,
and professional responsibilities in high-acuity settings. Questions combine foundational theory with scenario-based application to reflect the
realities of ICU practice. The format emphasizes prioritization, recognition of deterioration, and safe intervention, helping learners prepare for
real-world critical care responsibilities through multiple-choice decision-making that mirrors exam-style reasoning.
Section One: Questions 1–100
1. A patient receiving mechanical ventilation develops sudden high-pressure alarms and decreased oxygen saturation. What is the nurse’s first action?
A. Administer a sedative.
B. Assess the airway and tubing for obstruction.
C. Increase the tidal volume.
D. Notify the provider immediately.
🟢 Correct answer: B. Assess the airway and tubing for obstruction.
🔴 RATIONALE: The first priority is to identify and correct reversible causes of ventilator alarm changes, especially obstruction or disconnection.
,2. Which arterial blood gas indicates respiratory acidosis?
A. pH 7.30, PaCO2 55 mm Hg
B. pH 7.48, PaCO2 30 mm Hg
C. pH 7.46, HCO3 30 mEq/L
D. pH 7.52, PaCO2 48 mm Hg
🟢 Correct answer: A. pH 7.30, PaCO2 55 mm Hg
🔴 RATIONALE: A low pH with elevated PaCO2 reflects respiratory acidosis from hypoventilation.
3. A patient with chest pain and hypotension has ST-segment elevation on ECG. What is the nurse’s priority concern?
A. Hyperglycemia
B. Acute myocardial infarction
C. Pericarditis
D. Atrial fibrillation
🟢 Correct answer: B. Acute myocardial infarction
🔴 RATIONALE: ST-segment elevation with ischemic symptoms is strongly consistent with acute MI requiring urgent intervention.
4. Which finding most strongly suggests fluid volume overload?
A. Flat neck veins
B. Dry mucous membranes
C. Crackles in the lungs
D. Urine specific gravity 1.040
🟢 Correct answer: C. Crackles in the lungs
🔴 RATIONALE: Crackles indicate pulmonary congestion, a common manifestation of fluid overload.
5. A critically ill patient becomes restless, tachycardic, and hypotensive. What condition should the nurse suspect first?
, A. Hypoglycemia
B. Shock
C. Hypercalcemia
D. Urinary retention
🟢 Correct answer: B. Shock
🔴 RATIONALE: Restlessness, tachycardia, and hypotension are early signs of shock and poor tissue perfusion.
6. Which intervention best reduces the risk of ventilator-associated pneumonia?
A. Routine saline instillation before suctioning
B. Elevating the head of the bed
C. Limiting oral care
D. Keeping the patient flat after suctioning
🟢 Correct answer: B. Elevating the head of the bed
🔴 RATIONALE: Head-of-bed elevation lowers aspiration risk and is a key preventive measure for ventilator-associated pneumonia.
7. A patient on dopamine infusion develops frequent premature ventricular contractions. What is the nurse’s best action?
A. Slow the infusion and notify the provider.
B. Stop the infusion immediately without assessment.
C. Give a potassium supplement.
D. Place the patient in Trendelenburg position.
🟢 Correct answer: A. Slow the infusion and notify the provider.
🔴 RATIONALE: Dopamine can cause dysrhythmias; reducing the dose and alerting the provider is appropriate.
8. What is the most appropriate action for a patient with suspected sepsis?
A. Delay antibiotics until cultures return.
B. Start broad-spectrum antibiotics promptly after cultures.
C. Restrict fluids to prevent overload.
D. Give oral antipyretics only.
, 🟢 Correct answer: B. Start broad-spectrum antibiotics promptly after cultures.
🔴 RATIONALE: Early cultures and rapid antibiotic therapy are essential in sepsis management.
9. Which electrolyte abnormality is most associated with peaked T waves on ECG?
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypernatremia
🟢 Correct answer: B. Hyperkalemia
🔴 RATIONALE: Peaked T waves are a classic ECG sign of elevated potassium levels.
0. A patient with severe dyspnea is using accessory muscles and has stridor. What is the priority nursing action?
A. Encourage deep breathing.
B. Prepare for airway management.
C. Obtain a complete history first.
D. Administer a diuretic.
🟢 Correct answer: B. Prepare for airway management.
🔴 RATIONALE: Stridor indicates upper airway obstruction and requires immediate airway readiness.
1. Which assessment finding indicates decreased cardiac output?
A. Bounding pulses
B. Warm flushed skin
C. Urine output of 20 mL/hr
D. Hypertension
🟢 Correct answer: C. Urine output of 20 mL/hr
🔴 RATIONALE: Low urine output is a sign of poor renal perfusion from reduced cardiac output.
