NGN HESI RN Critical Care Exam V2 (2025) –
Verified Actual Exam | Graded A+ with Correct
Questions and Expert Answers
Cardiovascular Critical Care (20 Questions)
Case Study 1: Acute Myocardial Infarction
Scenario: A 62-year-old male presents to the ED with chest pain, diaphoresis, and nausea for 2
hours. ECG shows ST-elevation in leads V1–V4. Vital signs: BP 90/60 mmHg, HR 110 bpm,
RR 24/min, SpO2 92%. Troponin is elevated.
Which initial intervention should the nurse prioritize? (Select one)
A) Administer sublingual nitroglycerin
B) Initiate oxygen therapy
C) Administer morphine IV
D) Prepare for thrombolytic therapy
Answer: B) Initiate oxygen therapy
Rationale: Hypoxemia (SpO2 92%) indicates the need for oxygen to improve myocardial
oxygenation. Nitroglycerin is contraindicated in hypotension (BP 90/60 mmHg).
Morphine and thrombolytics are secondary considerations.
What additional data should the nurse collect? (Select all that apply)
A) History of recent cocaine use
B) Allergy to aspirin
C) Blood glucose level
D) Family history of diabetes
E) Recent weight loss
Answer: A, B, C
Rationale: Cocaine use can cause coronary vasospasm, impacting treatment. Aspirin
allergies affect antiplatelet therapy. Blood glucose is relevant due to stress response.
Family history and weight loss are less urgent.
Matrix Question: Match the intervention with its purpose in managing this client.
Intervention Purpose
1) Reduce
A) Aspirin myocardial oxygen
demand
, 2) Prevent platelet
B) Beta-blocker
aggregation
3) Prevent thrombus
C) Heparin
propagation
4) Relieve chest
D) Nitroglycerin
pain
Answer: A-2, B-1, C-3, D-4
Rationale: Aspirin prevents platelet aggregation, beta-blockers
reduce myocardial oxygen demand, heparin prevents thrombus
growth, and nitroglycerin relieves pain via vasodilation.
Ordered Response: Place the steps of preparing for percutaneous coronary intervention
(PCI) in order.
A) Obtain informed consent
B) Administer loading dose of clopidogrel
C) Check for contrast dye allergies
D) Ensure IV access is patent
Answer: C, A, D, B
Rationale: First, check for contrast dye allergies to ensure safety. Obtain consent next,
followed by ensuring IV access for medications. Administer clopidogrel last as part of
pre-PCI protocol.
Case Study 2: Heart Failure
Scenario: A 70-year-old female with heart failure is admitted with dyspnea, edema, and weight
gain of 5 kg in 3 days. BP 150/90 mmHg, HR 88 bpm, RR 28/min, SpO2 90%. She is prescribed
furosemide IV.
Which assessment finding indicates worsening heart failure? (Select one)
A) Crackles in lung bases
B) Heart rate of 88 bpm
C) BP of 150/90 mmHg
D) Clear lung sounds
Answer: A) Crackles in lung bases
Rationale: Crackles indicate pulmonary edema, a sign of worsening heart failure due to
fluid overload. Other findings are less specific.
What should the nurse monitor after administering furosemide? (Select all that apply)
A) Potassium levels
B) Urine output
C) Blood pressure
D) Blood glucose
E) Oxygen saturation
Answer: A, B, C, E
, Rationale: Furosemide can cause hypokalemia, hypotension, and increased urine output.
Oxygen saturation monitors respiratory status. Blood glucose is not directly affected.
Hot Spot: Identify the priority assessment area for this client.
Image: Diagram of human torso with labeled areas (lungs, heart, abdomen, extremities).
Answer: Lungs
Rationale: Pulmonary edema is a priority in heart failure, requiring lung assessment for
crackles or wheezing.
What is the nurse’s next action if the client develops hypokalemia? (Select one)
A) Administer potassium chloride IV
B) Increase furosemide dose
C) Notify the provider
D) Restrict fluid intake
Answer: C) Notify the provider
Rationale: Hypokalemia requires provider evaluation for potassium supplementation or
dose adjustment. Direct administration or other actions are unsafe without orders.
Additional Cardiovascular Questions
A client with atrial fibrillation is prescribed warfarin. What should the nurse teach?
(Select one)
A) Monitor for signs of bleeding
B) Increase dietary vitamin K
C) Take with grapefruit juice
D) Stop if bruising occurs
Answer: A) Monitor for signs of bleeding
Rationale: Warfarin increases bleeding risk, requiring monitoring. Vitamin K
antagonizes warfarin, and grapefruit juice is irrelevant. Stopping abruptly is unsafe.
A client post-PCI reports chest pain. What is the priority action? (Select one)
A) Administer morphine
B) Obtain a 12-lead ECG
C) Increase oxygen flow
D) Check vital signs
Answer: B) Obtain a 12-lead ECG
Rationale: Chest pain post-PCI may indicate stent thrombosis, requiring an ECG to
assess for ischemia.
Matrix Question: Match the medication with its adverse effect.
| Medication | Adverse Effect |
|--------------------|------------------------------------|
| A) Lisinopril | 1) Bradycardia |
| B) Metoprolol | 2) Hyperkalemia |
| C) Amiodarone | 3) Pulmonary toxicity |
| D) Digoxin | 4) Visual disturbances |
Verified Actual Exam | Graded A+ with Correct
Questions and Expert Answers
Cardiovascular Critical Care (20 Questions)
Case Study 1: Acute Myocardial Infarction
Scenario: A 62-year-old male presents to the ED with chest pain, diaphoresis, and nausea for 2
hours. ECG shows ST-elevation in leads V1–V4. Vital signs: BP 90/60 mmHg, HR 110 bpm,
RR 24/min, SpO2 92%. Troponin is elevated.
Which initial intervention should the nurse prioritize? (Select one)
A) Administer sublingual nitroglycerin
B) Initiate oxygen therapy
C) Administer morphine IV
D) Prepare for thrombolytic therapy
Answer: B) Initiate oxygen therapy
Rationale: Hypoxemia (SpO2 92%) indicates the need for oxygen to improve myocardial
oxygenation. Nitroglycerin is contraindicated in hypotension (BP 90/60 mmHg).
Morphine and thrombolytics are secondary considerations.
What additional data should the nurse collect? (Select all that apply)
A) History of recent cocaine use
B) Allergy to aspirin
C) Blood glucose level
D) Family history of diabetes
E) Recent weight loss
Answer: A, B, C
Rationale: Cocaine use can cause coronary vasospasm, impacting treatment. Aspirin
allergies affect antiplatelet therapy. Blood glucose is relevant due to stress response.
Family history and weight loss are less urgent.
Matrix Question: Match the intervention with its purpose in managing this client.
Intervention Purpose
1) Reduce
A) Aspirin myocardial oxygen
demand
, 2) Prevent platelet
B) Beta-blocker
aggregation
3) Prevent thrombus
C) Heparin
propagation
4) Relieve chest
D) Nitroglycerin
pain
Answer: A-2, B-1, C-3, D-4
Rationale: Aspirin prevents platelet aggregation, beta-blockers
reduce myocardial oxygen demand, heparin prevents thrombus
growth, and nitroglycerin relieves pain via vasodilation.
Ordered Response: Place the steps of preparing for percutaneous coronary intervention
(PCI) in order.
A) Obtain informed consent
B) Administer loading dose of clopidogrel
C) Check for contrast dye allergies
D) Ensure IV access is patent
Answer: C, A, D, B
Rationale: First, check for contrast dye allergies to ensure safety. Obtain consent next,
followed by ensuring IV access for medications. Administer clopidogrel last as part of
pre-PCI protocol.
Case Study 2: Heart Failure
Scenario: A 70-year-old female with heart failure is admitted with dyspnea, edema, and weight
gain of 5 kg in 3 days. BP 150/90 mmHg, HR 88 bpm, RR 28/min, SpO2 90%. She is prescribed
furosemide IV.
Which assessment finding indicates worsening heart failure? (Select one)
A) Crackles in lung bases
B) Heart rate of 88 bpm
C) BP of 150/90 mmHg
D) Clear lung sounds
Answer: A) Crackles in lung bases
Rationale: Crackles indicate pulmonary edema, a sign of worsening heart failure due to
fluid overload. Other findings are less specific.
What should the nurse monitor after administering furosemide? (Select all that apply)
A) Potassium levels
B) Urine output
C) Blood pressure
D) Blood glucose
E) Oxygen saturation
Answer: A, B, C, E
, Rationale: Furosemide can cause hypokalemia, hypotension, and increased urine output.
Oxygen saturation monitors respiratory status. Blood glucose is not directly affected.
Hot Spot: Identify the priority assessment area for this client.
Image: Diagram of human torso with labeled areas (lungs, heart, abdomen, extremities).
Answer: Lungs
Rationale: Pulmonary edema is a priority in heart failure, requiring lung assessment for
crackles or wheezing.
What is the nurse’s next action if the client develops hypokalemia? (Select one)
A) Administer potassium chloride IV
B) Increase furosemide dose
C) Notify the provider
D) Restrict fluid intake
Answer: C) Notify the provider
Rationale: Hypokalemia requires provider evaluation for potassium supplementation or
dose adjustment. Direct administration or other actions are unsafe without orders.
Additional Cardiovascular Questions
A client with atrial fibrillation is prescribed warfarin. What should the nurse teach?
(Select one)
A) Monitor for signs of bleeding
B) Increase dietary vitamin K
C) Take with grapefruit juice
D) Stop if bruising occurs
Answer: A) Monitor for signs of bleeding
Rationale: Warfarin increases bleeding risk, requiring monitoring. Vitamin K
antagonizes warfarin, and grapefruit juice is irrelevant. Stopping abruptly is unsafe.
A client post-PCI reports chest pain. What is the priority action? (Select one)
A) Administer morphine
B) Obtain a 12-lead ECG
C) Increase oxygen flow
D) Check vital signs
Answer: B) Obtain a 12-lead ECG
Rationale: Chest pain post-PCI may indicate stent thrombosis, requiring an ECG to
assess for ischemia.
Matrix Question: Match the medication with its adverse effect.
| Medication | Adverse Effect |
|--------------------|------------------------------------|
| A) Lisinopril | 1) Bradycardia |
| B) Metoprolol | 2) Hyperkalemia |
| C) Amiodarone | 3) Pulmonary toxicity |
| D) Digoxin | 4) Visual disturbances |
