NCLEX-RN Emergency & Critical Care Exam Pack
Part 5: Questions 201-250
50 Questions with Detailed Rationales
Shock, Code Blue, Airway Management, Trauma Care, Ventilator Alarms & Rapid Response Scenarios
Testable Area Emergency & Critical Care
Part 5 of 5
Question Range 201-250
Format Multiple choice with rationales and key terms
Primary Focus Advanced emergency prioritization, airway, shock, trauma,
sepsis, codes, and rapid response
This final part completes the Emergency & Critical Care exam pack. It emphasizes advanced
prioritization, rapid recognition of clinical deterioration, shock states, ventilator and airway
emergencies, trauma care, and code response principles.
Part 5 | Emergency & Critical Care | Page 1
,Table of Contents
Section Questions
Septic, Cardiogenic, Hypovolemic, and Obstructive Shock 201-205
Airway, Oxygenation, and Ventilator Emergencies 206-215
Trauma, Burns, and Neurologic Critical Care 216-225
Sepsis, Codes, and Rapid Response Communication 226-235
Final Comprehensive Emergency Prioritization 236-250
Part 5 | Emergency & Critical Care | Page 2
,Question 201
The nurse is caring for a client admitted with septic shock. The client remains hypotensive after
prescribed fluid resuscitation and is started on a vasopressor infusion through a central line. Which
assessment finding best indicates that perfusion is improving?
[X] A. Urine output increases from 10 mL/hr to 40 mL/hr
[ ] B. Skin becomes more mottled over both knees
[ ] C. The client becomes more difficult to arouse
[ ] D. Systolic blood pressure decreases by another 20 mm Hg
Answer: A. Urine output increases from 10 mL/hr to 40 mL/hr
RATIONALE
The correct answer is A. Improved urine output suggests improved renal perfusion and more effective
circulation. In shock, the nurse monitors blood pressure, mental status, skin signs, capillary refill, lactate
trends, and urine output to evaluate tissue perfusion. Worsening mottling, decreased alertness, and
falling blood pressure indicate deterioration.
KEY TERMS EXPLAINED
Term Meaning
Perfusion Delivery of oxygenated blood to body tissues.
Vasopressor Medication used to increase vascular tone and support blood
pressure.
Renal perfusion Blood flow to the kidneys.
Mottling Patchy skin discoloration often associated with poor circulation.
Part 5 | Emergency & Critical Care | Page 3
, Question 202
A client arrives after a high-speed motor vehicle collision. The nurse notes gurgling respirations, facial
trauma, and blood pooling in the mouth. Which priority action should guide initial care?
[X] A. Maintain airway patency while protecting the cervical spine
[ ] B. Complete the full health history before touching the client
[ ] C. Offer oral fluids to clear the blood from the mouth
[ ] D. Ask the client to sit upright and walk to radiology
Answer: A. Maintain airway patency while protecting the cervical spine
RATIONALE
The correct answer is A. Airway obstruction is the immediate concern, and cervical spine protection is
required because the mechanism of injury suggests possible spinal trauma. Trauma care follows a
primary survey approach focused on airway, breathing, circulation, disability, and exposure. Oral fluids
and ambulation are unsafe in this situation.
KEY TERMS EXPLAINED
Term Meaning
Airway patency An open airway that allows effective airflow.
Cervical spine protection Maintaining alignment to reduce risk of spinal cord injury.
Primary survey Rapid assessment of life-threatening trauma problems.
Gurgling respirations Breathing sounds suggesting fluid or blood in the airway.
Part 5 | Emergency & Critical Care | Page 4
Part 5: Questions 201-250
50 Questions with Detailed Rationales
Shock, Code Blue, Airway Management, Trauma Care, Ventilator Alarms & Rapid Response Scenarios
Testable Area Emergency & Critical Care
Part 5 of 5
Question Range 201-250
Format Multiple choice with rationales and key terms
Primary Focus Advanced emergency prioritization, airway, shock, trauma,
sepsis, codes, and rapid response
This final part completes the Emergency & Critical Care exam pack. It emphasizes advanced
prioritization, rapid recognition of clinical deterioration, shock states, ventilator and airway
emergencies, trauma care, and code response principles.
Part 5 | Emergency & Critical Care | Page 1
,Table of Contents
Section Questions
Septic, Cardiogenic, Hypovolemic, and Obstructive Shock 201-205
Airway, Oxygenation, and Ventilator Emergencies 206-215
Trauma, Burns, and Neurologic Critical Care 216-225
Sepsis, Codes, and Rapid Response Communication 226-235
Final Comprehensive Emergency Prioritization 236-250
Part 5 | Emergency & Critical Care | Page 2
,Question 201
The nurse is caring for a client admitted with septic shock. The client remains hypotensive after
prescribed fluid resuscitation and is started on a vasopressor infusion through a central line. Which
assessment finding best indicates that perfusion is improving?
[X] A. Urine output increases from 10 mL/hr to 40 mL/hr
[ ] B. Skin becomes more mottled over both knees
[ ] C. The client becomes more difficult to arouse
[ ] D. Systolic blood pressure decreases by another 20 mm Hg
Answer: A. Urine output increases from 10 mL/hr to 40 mL/hr
RATIONALE
The correct answer is A. Improved urine output suggests improved renal perfusion and more effective
circulation. In shock, the nurse monitors blood pressure, mental status, skin signs, capillary refill, lactate
trends, and urine output to evaluate tissue perfusion. Worsening mottling, decreased alertness, and
falling blood pressure indicate deterioration.
KEY TERMS EXPLAINED
Term Meaning
Perfusion Delivery of oxygenated blood to body tissues.
Vasopressor Medication used to increase vascular tone and support blood
pressure.
Renal perfusion Blood flow to the kidneys.
Mottling Patchy skin discoloration often associated with poor circulation.
Part 5 | Emergency & Critical Care | Page 3
, Question 202
A client arrives after a high-speed motor vehicle collision. The nurse notes gurgling respirations, facial
trauma, and blood pooling in the mouth. Which priority action should guide initial care?
[X] A. Maintain airway patency while protecting the cervical spine
[ ] B. Complete the full health history before touching the client
[ ] C. Offer oral fluids to clear the blood from the mouth
[ ] D. Ask the client to sit upright and walk to radiology
Answer: A. Maintain airway patency while protecting the cervical spine
RATIONALE
The correct answer is A. Airway obstruction is the immediate concern, and cervical spine protection is
required because the mechanism of injury suggests possible spinal trauma. Trauma care follows a
primary survey approach focused on airway, breathing, circulation, disability, and exposure. Oral fluids
and ambulation are unsafe in this situation.
KEY TERMS EXPLAINED
Term Meaning
Airway patency An open airway that allows effective airflow.
Cervical spine protection Maintaining alignment to reduce risk of spinal cord injury.
Primary survey Rapid assessment of life-threatening trauma problems.
Gurgling respirations Breathing sounds suggesting fluid or blood in the airway.
Part 5 | Emergency & Critical Care | Page 4
