Critical Care Nursing
and Emergency
Management 2026
---
**Target Question Count: 55**
---
### Question 1
The nurse is caring for a patient with increased intracranial pressure (ICP) following a traumatic brain
injury. Which finding is an early sign of increased ICP?
A. Widening pulse pressure
B. Decreased level of consciousness
C. Bradycardia and hypertension
,D. Posturing (decerebrate or decorticate)
💫RATIONALE✔️✔️: Decreased level of consciousness is the earliest and most sensitive sign of
increased ICP. Widening pulse pressure, bradycardia, and hypertension (Cushing's triad) are late signs,
and posturing indicates severe neurological deterioration.
💫ANSWER✔️✔️: B. Decreased level of consciousness
---
### Question 2
A patient with septic shock is receiving intravenous fluids and vasopressors. Which hemodynamic
parameter indicates adequate resuscitation?
A. Mean arterial pressure (MAP) of 65 mmHg
B. Central venous pressure (CVP) of 4 mmHg
C. Urine output of 20 mL per hour
D. Heart rate of 120 beats per minute
💫RATIONALE✔️✔️: A MAP of 65 mmHg or greater is the target for adequate resuscitation in septic
shock, ensuring adequate perfusion to vital organs. Urine output should be at least 30 mL/hour, and CVP
should be 8-12 mmHg.
💫ANSWER✔️✔️: A. Mean arterial pressure (MAP) of 65 mmHg
---
,### Question 3
The nurse is caring for a patient who has just been intubated and placed on mechanical ventilation.
Which finding indicates proper endotracheal tube placement?
A. Equal bilateral breath sounds
B. Absence of breath sounds on the left side
C. Oxygen saturation of 88%
D. Gastric distension
💫RATIONALE✔️✔️: Equal bilateral breath sounds indicate proper placement of the endotracheal
tube in the trachea. Absence of breath sounds on one side may indicate placement in the right
mainstem bronchus, and oxygen saturation of 88% indicates inadequate oxygenation.
💫ANSWER✔️✔️: A. Equal bilateral breath sounds
---
### Question 4
A patient with acute respiratory distress syndrome (ARDS) is receiving mechanical ventilation with
positive end-expiratory pressure (PEEP). Which finding indicates a complication of PEEP?
A. Decreased cardiac output
B. Improved oxygenation
C. Increased lung compliance
, D. Decreased work of breathing
💫RATIONALE✔️✔️: PEEP can decrease cardiac output by increasing intrathoracic pressure and
reducing venous return. The nurse should monitor for hypotension, decreased urine output, and other
signs of reduced cardiac output.
💫ANSWER✔️✔️: A. Decreased cardiac output
---
### Question 5
The nurse is caring for a patient who is experiencing status epilepticus. Which medication should the
nurse anticipate administering first?
A. Lorazepam
B. Phenytoin
C. Levetiracetam
D. Valproic acid
💫RATIONALE✔️✔️: Lorazepam (or diazepam) is the first-line medication for status epilepticus
because of its rapid onset of action. If seizures continue, phenytoin or other anticonvulsants may be
administered.
💫ANSWER✔️✔️: A. Lorazepam
---
and Emergency
Management 2026
---
**Target Question Count: 55**
---
### Question 1
The nurse is caring for a patient with increased intracranial pressure (ICP) following a traumatic brain
injury. Which finding is an early sign of increased ICP?
A. Widening pulse pressure
B. Decreased level of consciousness
C. Bradycardia and hypertension
,D. Posturing (decerebrate or decorticate)
💫RATIONALE✔️✔️: Decreased level of consciousness is the earliest and most sensitive sign of
increased ICP. Widening pulse pressure, bradycardia, and hypertension (Cushing's triad) are late signs,
and posturing indicates severe neurological deterioration.
💫ANSWER✔️✔️: B. Decreased level of consciousness
---
### Question 2
A patient with septic shock is receiving intravenous fluids and vasopressors. Which hemodynamic
parameter indicates adequate resuscitation?
A. Mean arterial pressure (MAP) of 65 mmHg
B. Central venous pressure (CVP) of 4 mmHg
C. Urine output of 20 mL per hour
D. Heart rate of 120 beats per minute
💫RATIONALE✔️✔️: A MAP of 65 mmHg or greater is the target for adequate resuscitation in septic
shock, ensuring adequate perfusion to vital organs. Urine output should be at least 30 mL/hour, and CVP
should be 8-12 mmHg.
💫ANSWER✔️✔️: A. Mean arterial pressure (MAP) of 65 mmHg
---
,### Question 3
The nurse is caring for a patient who has just been intubated and placed on mechanical ventilation.
Which finding indicates proper endotracheal tube placement?
A. Equal bilateral breath sounds
B. Absence of breath sounds on the left side
C. Oxygen saturation of 88%
D. Gastric distension
💫RATIONALE✔️✔️: Equal bilateral breath sounds indicate proper placement of the endotracheal
tube in the trachea. Absence of breath sounds on one side may indicate placement in the right
mainstem bronchus, and oxygen saturation of 88% indicates inadequate oxygenation.
💫ANSWER✔️✔️: A. Equal bilateral breath sounds
---
### Question 4
A patient with acute respiratory distress syndrome (ARDS) is receiving mechanical ventilation with
positive end-expiratory pressure (PEEP). Which finding indicates a complication of PEEP?
A. Decreased cardiac output
B. Improved oxygenation
C. Increased lung compliance
, D. Decreased work of breathing
💫RATIONALE✔️✔️: PEEP can decrease cardiac output by increasing intrathoracic pressure and
reducing venous return. The nurse should monitor for hypotension, decreased urine output, and other
signs of reduced cardiac output.
💫ANSWER✔️✔️: A. Decreased cardiac output
---
### Question 5
The nurse is caring for a patient who is experiencing status epilepticus. Which medication should the
nurse anticipate administering first?
A. Lorazepam
B. Phenytoin
C. Levetiracetam
D. Valproic acid
💫RATIONALE✔️✔️: Lorazepam (or diazepam) is the first-line medication for status epilepticus
because of its rapid onset of action. If seizures continue, phenytoin or other anticonvulsants may be
administered.
💫ANSWER✔️✔️: A. Lorazepam
---
