CRITICAL CARE EXAM STUDY GUIDE 2026
QUESTIONS WITH ANSWERS GRADED A+
◉ phlebitis . Answer: is an inflammation of the vein that can occur from
mechanical or chemical (medication) trauma or from a local infection.
Phlebitis can cause the development of a clot (thrombophlebitis).
◉ Infiltration . Answer: is seepage of the intravenous fluid out of the
vein and into the surrounding interstitial spaces. It is a form of tissue
injury, but the injury is not to the extent that occurs with extravasation.
◉ Signs and symptoms of an air embolus . Answer: confusion, pallor,
lightheadedness, tachycardia, tachypnea, hypotension, anxiety, and
unresponsiveness.
◉ manifestations of hyperglycemia . Answer: unresponsiveness.
Polyuria, polydipsia, and polyphagia
◉ A client who is receiving total parenteral nutrition (TPN) complains of
a headache. The nurse notes that the client has an increased blood
pressure and a bounding pulse. The nurse reports the findings, knowing
that these signs/symptoms are indicative of which complication of this
therapy? . Answer: 1. Sepsis
,2.Air embolism
3.Fluid overload
4.Hyperglycemia
Answer 3
Due to: The client's signs and symptoms are consistent with fluid
overload. The increased intravascular volume increases the blood
pressure, whereas the pulse rate increases as the heart tries to pump the
extra fluid volume.
◉ Formula:Total volume × gtt factor
------------------------- = gtt/min
Time in minutes . Answer:
◉ The primary health care provider prescribes one unit of packed red
blood cells to infuse over 4 hours. One unit of blood contains 250 mL,
and the drop factor is 10 gtt/1 mL. Although an infusion pump will be
used, the registered nurse asks the licensed practical nurse (LPN) to
assist with monitoring the flow rate during the infusion. The LPN
monitors the flow rate, knowing that how many gtt/min should infuse?
Fill in the blank and round answer to the nearest whole number. .
Answer: Answer: 10gtt/min
Rationale: The prescribed 250 mL is to be infused over 4 hours. Follow
the formula, and multiply 250 mL by 10 (gtt factor). Then divide the
,result by 240 minutes (4 hours × 60 minutes). The infusion is to run at
10.4 or 10 gtt/min.
◉ A client presents to the emergency department with upper
gastrointestinal (GI) bleeding and is in moderate distress. Which nursing
action should be the priority for this client? . Answer: 1.Determine vital
signs.
2.Complete abdominal physical examination. 3.Thoroughly investigate
the precipitating events. 4.Insert a nasogastric tube and conduct a
Hematest of the emesis.
Answer: 1
Rationale:The determination of vital signs indicates whether the client is
in shock from blood loss and provides a baseline blood pressure and
pulse by which to monitor the progress of treatment.
◉ Signs and symptoms of shock . Answer: low blood pressure; rapid,
weak pulse; increased thirst; cold, clammy skin; and restlessness.
◉ The nurse is assisting in monitoring the condition of a client after
pericardiocentesis for cardiac tamponade. Which observation indicates
that the procedure was unsuccessful? . Answer: 1. Clear breath sounds
2.Client expressions of relief
3.Clearly audible heart sounds
, 4.Distant and muffled heart sounds
Answer: 4.
Rationale:Following pericardiocentesis, the client usually expresses
immediate relief. Heart sounds are no longer muffled or distant. Clear
breath sounds and clearly audible heart sounds are positive signs.
◉ pericardiocentesis . Answer: surgical puncture to aspirate fluid from
the sac surrounding the heart
◉ A client is receiving thrombolytic therapy by continuous infusion. The
client suddenly becomes extremely anxious and complains of itching.
The nurse hears stridor, and on examination of the client, notes
generalized urticaria and hypotension. Which should be the priority
action of the nurse? . Answer: 1. Administer oxygen and protamine
sulfate.
2.Stop the infusion, and notify the registered nurse.
3.Cut the infusion rate in half, and sit the client up in bed.
4.Administer diphenhydramine and continue the infusion.
Answer: 2
Rationale:The client is experiencing an anaphylactic reaction to
thrombolytic therapy. The infusion should be stopped; the registered
nurse notified; and the client treated with epinephrine, antihistamines,
and corticosteroids as prescribed.
QUESTIONS WITH ANSWERS GRADED A+
◉ phlebitis . Answer: is an inflammation of the vein that can occur from
mechanical or chemical (medication) trauma or from a local infection.
Phlebitis can cause the development of a clot (thrombophlebitis).
◉ Infiltration . Answer: is seepage of the intravenous fluid out of the
vein and into the surrounding interstitial spaces. It is a form of tissue
injury, but the injury is not to the extent that occurs with extravasation.
◉ Signs and symptoms of an air embolus . Answer: confusion, pallor,
lightheadedness, tachycardia, tachypnea, hypotension, anxiety, and
unresponsiveness.
◉ manifestations of hyperglycemia . Answer: unresponsiveness.
Polyuria, polydipsia, and polyphagia
◉ A client who is receiving total parenteral nutrition (TPN) complains of
a headache. The nurse notes that the client has an increased blood
pressure and a bounding pulse. The nurse reports the findings, knowing
that these signs/symptoms are indicative of which complication of this
therapy? . Answer: 1. Sepsis
,2.Air embolism
3.Fluid overload
4.Hyperglycemia
Answer 3
Due to: The client's signs and symptoms are consistent with fluid
overload. The increased intravascular volume increases the blood
pressure, whereas the pulse rate increases as the heart tries to pump the
extra fluid volume.
◉ Formula:Total volume × gtt factor
------------------------- = gtt/min
Time in minutes . Answer:
◉ The primary health care provider prescribes one unit of packed red
blood cells to infuse over 4 hours. One unit of blood contains 250 mL,
and the drop factor is 10 gtt/1 mL. Although an infusion pump will be
used, the registered nurse asks the licensed practical nurse (LPN) to
assist with monitoring the flow rate during the infusion. The LPN
monitors the flow rate, knowing that how many gtt/min should infuse?
Fill in the blank and round answer to the nearest whole number. .
Answer: Answer: 10gtt/min
Rationale: The prescribed 250 mL is to be infused over 4 hours. Follow
the formula, and multiply 250 mL by 10 (gtt factor). Then divide the
,result by 240 minutes (4 hours × 60 minutes). The infusion is to run at
10.4 or 10 gtt/min.
◉ A client presents to the emergency department with upper
gastrointestinal (GI) bleeding and is in moderate distress. Which nursing
action should be the priority for this client? . Answer: 1.Determine vital
signs.
2.Complete abdominal physical examination. 3.Thoroughly investigate
the precipitating events. 4.Insert a nasogastric tube and conduct a
Hematest of the emesis.
Answer: 1
Rationale:The determination of vital signs indicates whether the client is
in shock from blood loss and provides a baseline blood pressure and
pulse by which to monitor the progress of treatment.
◉ Signs and symptoms of shock . Answer: low blood pressure; rapid,
weak pulse; increased thirst; cold, clammy skin; and restlessness.
◉ The nurse is assisting in monitoring the condition of a client after
pericardiocentesis for cardiac tamponade. Which observation indicates
that the procedure was unsuccessful? . Answer: 1. Clear breath sounds
2.Client expressions of relief
3.Clearly audible heart sounds
, 4.Distant and muffled heart sounds
Answer: 4.
Rationale:Following pericardiocentesis, the client usually expresses
immediate relief. Heart sounds are no longer muffled or distant. Clear
breath sounds and clearly audible heart sounds are positive signs.
◉ pericardiocentesis . Answer: surgical puncture to aspirate fluid from
the sac surrounding the heart
◉ A client is receiving thrombolytic therapy by continuous infusion. The
client suddenly becomes extremely anxious and complains of itching.
The nurse hears stridor, and on examination of the client, notes
generalized urticaria and hypotension. Which should be the priority
action of the nurse? . Answer: 1. Administer oxygen and protamine
sulfate.
2.Stop the infusion, and notify the registered nurse.
3.Cut the infusion rate in half, and sit the client up in bed.
4.Administer diphenhydramine and continue the infusion.
Answer: 2
Rationale:The client is experiencing an anaphylactic reaction to
thrombolytic therapy. The infusion should be stopped; the registered
nurse notified; and the client treated with epinephrine, antihistamines,
and corticosteroids as prescribed.
