Critical Care Nursing
Comprehensive Quiz Guide: 100% Verified Questions with Answers
Section 1: Hemodynamic Monitoring (Questions 1-15)
1. What is normal central venous pressure (CVP)?
• Answer: 2-8 mmHg (or 5-10 cmH2O). CVP reflects right ventricular preload
and right atrial pressure. Elevated CVP suggests fluid overload, right heart
failure, or pulmonary hypertension. Low CVP indicates hypovolemia.
2. What is normal pulmonary artery pressure (PAP)?
• Answer: Systolic: 15-30 mmHg, Diastolic: 5-15 mmHg, Mean: 10-20 mmHg.
Elevated PAP indicates pulmonary hypertension, left heart failure,
pulmonary embolism, or ARDS.
3. What is normal pulmonary artery wedge pressure (PAWP)?
• Answer: 6-12 mmHg. PAWP (also called pulmonary capillary wedge
pressure) reflects left ventricular end-diastolic pressure and left atrial
pressure. Elevated PAWP suggests left ventricular failure or fluid overload.
4. What is normal cardiac output (CO)?
• Answer: 4-8 L/min. Calculated as Heart Rate × Stroke Volume. Measures
blood volume pumped by heart per minute. Low CO indicates heart failure,
hypovolemia, or cardiogenic shock.
5. What is normal cardiac index (CI)?
• Answer: 2.5-4.0 L/min/m². Cardiac output adjusted for body surface area.
More accurate than CO for comparing between patients. CI <2.2 indicates
cardiogenic shock.
6. What is normal systemic vascular resistance (SVR)?
, • Answer: 800-1200 dynes/sec/cm⁵. Measures left ventricular afterload.
Elevated SVR: hypertension, hypothermia, vasoconstriction. Low SVR: septic
shock, neurogenic shock, vasodilators.
7. What is mean arterial pressure (MAP) and its normal range?
• Answer: Average arterial pressure during one cardiac cycle. Normal: 70-100
mmHg. Calculated: (SBP + 2×DBP) ÷ 3. MAP ≥65 mmHg needed for
adequate organ perfusion. MAP <60 associated with organ hypoperfusion.
8. What does a pulmonary artery catheter measure?
• Answer: Right atrial pressure (RAP/CVP), pulmonary artery pressures
(systolic, diastolic, mean), PAWP, cardiac output, mixed venous oxygen
saturation (SvO2). Allows calculation of cardiac index, SVR, stroke volume,
oxygen delivery/consumption.
9. What is mixed venous oxygen saturation (SvO2)?
• Answer: Normal: 60-80%. Measured from pulmonary artery. Reflects
balance between oxygen delivery and consumption. Low SvO2 (<60%):
inadequate oxygen delivery (decreased CO, low Hgb, hypoxemia) or
increased consumption (fever, pain). High SvO2 (>80%): sepsis,
hypothermia, wedged catheter.
10. What are complications of pulmonary artery catheters?
• Answer: Infection, pneumothorax, hemothorax, arrhythmias (especially
during insertion), pulmonary artery rupture (balloon overinflation),
thrombosis, pulmonary infarction, catheter knotting, valve damage, air
embolism. Risk vs benefit must be considered.
11. What is the Levine sign?
• Answer: Patient clutching fist to chest, classic sign of angina or myocardial
infarction. Important non-verbal cue of cardiac ischemia requiring
immediate assessment and intervention.
12. What is Beck's triad?
, • Answer: Three classic signs of cardiac tamponade: Hypotension (decreased
CO), Jugular venous distension (elevated CVP), Muffled heart sounds (fluid
in pericardial sac). Requires emergency pericardiocentesis.
13. What is Cushing's triad?
• Answer: Three late signs of increased intracranial pressure: Hypertension
(widened pulse pressure), Bradycardia, Irregular respirations (Cheyne-
Stokes). Indicates brainstem compression - medical emergency requiring
immediate intervention.
14. What is pulsus paradoxus?
• Answer: Abnormal drop in systolic BP >10 mmHg during inspiration. Seen in
cardiac tamponade, severe asthma, COPD exacerbation, constrictive
pericarditis. Indicates impaired ventricular filling.
15. What is the Allen test?
• Answer: Assessment of collateral blood flow before radial arterial line
insertion. Occlude radial and ulnar arteries, release ulnar - hand should pink
up within 5-15 seconds (positive test = adequate collateral flow). If hand
remains pale >15 seconds (negative test), don't use that radial artery.
Section 2: Cardiac Emergencies (Questions 16-30)
16. What is acute coronary syndrome (ACS)?
• Answer: Spectrum of conditions caused by reduced coronary blood flow:
Unstable angina (chest pain at rest, no troponin elevation), NSTEMI (non-ST
elevation MI with troponin elevation), STEMI (ST elevation MI with troponin
elevation). All require immediate intervention.
17. What are the immediate interventions for STEMI?
• Answer: MONA: Morphine (pain relief), Oxygen (if SpO2 <90%),
Nitroglycerin (if no contraindications), Aspirin 160-325 mg chewed. Add: 12-
lead ECG within 10 minutes, IV access, continuous monitoring, dual
Comprehensive Quiz Guide: 100% Verified Questions with Answers
Section 1: Hemodynamic Monitoring (Questions 1-15)
1. What is normal central venous pressure (CVP)?
• Answer: 2-8 mmHg (or 5-10 cmH2O). CVP reflects right ventricular preload
and right atrial pressure. Elevated CVP suggests fluid overload, right heart
failure, or pulmonary hypertension. Low CVP indicates hypovolemia.
2. What is normal pulmonary artery pressure (PAP)?
• Answer: Systolic: 15-30 mmHg, Diastolic: 5-15 mmHg, Mean: 10-20 mmHg.
Elevated PAP indicates pulmonary hypertension, left heart failure,
pulmonary embolism, or ARDS.
3. What is normal pulmonary artery wedge pressure (PAWP)?
• Answer: 6-12 mmHg. PAWP (also called pulmonary capillary wedge
pressure) reflects left ventricular end-diastolic pressure and left atrial
pressure. Elevated PAWP suggests left ventricular failure or fluid overload.
4. What is normal cardiac output (CO)?
• Answer: 4-8 L/min. Calculated as Heart Rate × Stroke Volume. Measures
blood volume pumped by heart per minute. Low CO indicates heart failure,
hypovolemia, or cardiogenic shock.
5. What is normal cardiac index (CI)?
• Answer: 2.5-4.0 L/min/m². Cardiac output adjusted for body surface area.
More accurate than CO for comparing between patients. CI <2.2 indicates
cardiogenic shock.
6. What is normal systemic vascular resistance (SVR)?
, • Answer: 800-1200 dynes/sec/cm⁵. Measures left ventricular afterload.
Elevated SVR: hypertension, hypothermia, vasoconstriction. Low SVR: septic
shock, neurogenic shock, vasodilators.
7. What is mean arterial pressure (MAP) and its normal range?
• Answer: Average arterial pressure during one cardiac cycle. Normal: 70-100
mmHg. Calculated: (SBP + 2×DBP) ÷ 3. MAP ≥65 mmHg needed for
adequate organ perfusion. MAP <60 associated with organ hypoperfusion.
8. What does a pulmonary artery catheter measure?
• Answer: Right atrial pressure (RAP/CVP), pulmonary artery pressures
(systolic, diastolic, mean), PAWP, cardiac output, mixed venous oxygen
saturation (SvO2). Allows calculation of cardiac index, SVR, stroke volume,
oxygen delivery/consumption.
9. What is mixed venous oxygen saturation (SvO2)?
• Answer: Normal: 60-80%. Measured from pulmonary artery. Reflects
balance between oxygen delivery and consumption. Low SvO2 (<60%):
inadequate oxygen delivery (decreased CO, low Hgb, hypoxemia) or
increased consumption (fever, pain). High SvO2 (>80%): sepsis,
hypothermia, wedged catheter.
10. What are complications of pulmonary artery catheters?
• Answer: Infection, pneumothorax, hemothorax, arrhythmias (especially
during insertion), pulmonary artery rupture (balloon overinflation),
thrombosis, pulmonary infarction, catheter knotting, valve damage, air
embolism. Risk vs benefit must be considered.
11. What is the Levine sign?
• Answer: Patient clutching fist to chest, classic sign of angina or myocardial
infarction. Important non-verbal cue of cardiac ischemia requiring
immediate assessment and intervention.
12. What is Beck's triad?
, • Answer: Three classic signs of cardiac tamponade: Hypotension (decreased
CO), Jugular venous distension (elevated CVP), Muffled heart sounds (fluid
in pericardial sac). Requires emergency pericardiocentesis.
13. What is Cushing's triad?
• Answer: Three late signs of increased intracranial pressure: Hypertension
(widened pulse pressure), Bradycardia, Irregular respirations (Cheyne-
Stokes). Indicates brainstem compression - medical emergency requiring
immediate intervention.
14. What is pulsus paradoxus?
• Answer: Abnormal drop in systolic BP >10 mmHg during inspiration. Seen in
cardiac tamponade, severe asthma, COPD exacerbation, constrictive
pericarditis. Indicates impaired ventricular filling.
15. What is the Allen test?
• Answer: Assessment of collateral blood flow before radial arterial line
insertion. Occlude radial and ulnar arteries, release ulnar - hand should pink
up within 5-15 seconds (positive test = adequate collateral flow). If hand
remains pale >15 seconds (negative test), don't use that radial artery.
Section 2: Cardiac Emergencies (Questions 16-30)
16. What is acute coronary syndrome (ACS)?
• Answer: Spectrum of conditions caused by reduced coronary blood flow:
Unstable angina (chest pain at rest, no troponin elevation), NSTEMI (non-ST
elevation MI with troponin elevation), STEMI (ST elevation MI with troponin
elevation). All require immediate intervention.
17. What are the immediate interventions for STEMI?
• Answer: MONA: Morphine (pain relief), Oxygen (if SpO2 <90%),
Nitroglycerin (if no contraindications), Aspirin 160-325 mg chewed. Add: 12-
lead ECG within 10 minutes, IV access, continuous monitoring, dual
