NUR 445 / NURS 445 Exam 2: High-Yield Critical Care – Oxygenation, Hemodynamics, Shock, Sepsis, ARDS, Acid-Base, Pharmacology & Monitoring (240+ Q&A with Rationales) 2026 Update

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NUR 445 / NURS 445 EXAM 2 – 240+ COMPLETE
QUESTIONS & RATIONALES – HIGH-YIELD
CRITICAL CARE: OXYGENATION,
HEMODYNAMICS, SHOCK, SEPSIS, ARDS, ACID-
BASE, PHARMACOLOGY, MONITORING – 2026
UPDATE – FIRST TIME PASS GUARANTEE


TABLE OF CONTENTS


| Section | Topic | Questions |
|---------|-------|-----------|
| I | Oxyhemoglobin Dissociation Curve & Gas Exchange | 1–35 |
| II | Hemodynamics: Preload, Afterload, Contractility, CO | 36–70 |
| III | Shock States: Hypovolemic, Cardiogenic, Distributive, Obstructive
| 71–120 |
| IV | Sepsis & Septic Shock (SSC 2026 Guidelines) | 121–150 |
| V | ARDS & Mechanical Ventilation (PEEP, P/F Ratio) | 151–180 |
| VI | Acid-Base Disorders (ABG Interpretation) | 181–210 |
| VII | High-Yield Pharmacology for Critical Care | 211–230 |
| VIII | Advanced Monitoring (PAC, CVP, ScvO2, FloTrac) | 231–240 |


**Total Questions: 240**

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SECTION I: OXYHEMOGLOBIN DISSOCIATION CURVE & GAS
EXCHANGE (1–35)


**1. A nurse reviews the oxyhemoglobin dissociation curve. What does
a "right shift" indicate?**
A. Increased affinity of hemoglobin for oxygen
B. Decreased affinity of hemoglobin for oxygen, allowing easier release
to tissues
C. An increase in the partial pressure of oxygen in the alveoli
D. A decrease in body temperature


<details><summary><b>Answer & Rationale</b></summary>
<b>Correct Answer: B</b><br/>
<b>Rationale:</b> A right shift occurs during acidosis (low pH),
hyperthermia, or hypercapnia. It decreases hemoglobin's affinity for
oxygen, facilitating oxygen release to hypoxic tissues.
</details>


**2. A patient has a PaO2 of 60 mmHg. According to the
oxyhemoglobin dissociation curve, what is the approximate SaO2?**
A. 100%
B. 90%
C. 75%
D. 50%

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<details><summary><b>Answer & Rationale</b></summary>
<b>Correct Answer: B</b><br/>
<b>Rationale:</b> On the standard curve, a PaO2 of 60 mmHg
correlates with an SaO2 of approximately 90%. This is the "steep"
portion of the curve where oxygen unloading occurs.
</details>


**3. Which condition causes a "left shift" in the oxyhemoglobin
dissociation curve?**
A. Hyperthermia
B. Increased 2,3-DPG
C. Alkalosis
D. Hypercapnia


<details><summary><b>Answer & Rationale</b></summary>
<b>Correct Answer: C</b><br/>
<b>Rationale:</b> Alkalosis (high pH), hypothermia, and decreased
2,3-DPG cause a left shift, meaning hemoglobin holds oxygen too
tightly and does not release it well to the tissues.
</details>


**4. A patient has a fever of 102°F (38.9°C). How does this affect
oxygen consumption (VO2)?**

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A. VO2 decreases significantly
B. VO2 increases
C. VO2 remains unchanged
D. VO2 stops


<details><summary><b>Answer & Rationale</b></summary>
<b>Correct Answer: B</b><br/>
<b>Rationale:</b> Fever increases the metabolic rate, which directly
increases cellular oxygen consumption (VO2). For every 1°C rise in
temperature, VO2 can increase by 10-13%.
</details>


**5. A patient's mixed venous oxygen saturation (SvO2) drops to 50%.
This indicates:**
A. Increased oxygen supply
B. Decreased oxygen extraction by the tissues
C. Increased oxygen extraction or decreased supply
D. The patient is sleeping


<details><summary><b>Answer & Rationale</b></summary>
<b>Correct Answer: C</b><br/>