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NUR 445 / NURS 445 EXAM 1: CRITICAL CARE
NURSING MASTERY BANK – HEMODYNAMICS,
SHOCK, RESPIRATORY FAILURE &
MULTISYSTEM EMERGENCIES (2026 EDITION)
TABLE OF CONTENTS
| Section | Topic | Question Numbers |
|---------|-------|------------------|
| 1 | Hemodynamics & Hemodynamic Monitoring | 1 – 25 |
| 2 | Shock States (Distributive, Cardiogenic, Hypovolemic, Obstructive) | 26 – 55 |
| 3 | Cardiac Emergencies: ACS, STEMI, NSTEMI | 56 – 75 |
| 4 | Heart Failure & Pulmonary Edema | 76 – 90 |
| 5 | Dysrhythmias & ECG Interpretation | 91 – 110 |
| 6 | Vasoactive & Cardiac Medications | 111 – 125 |
| 7 | Respiratory Failure & Mechanical Ventilation | 126 – 150 |
| 8 | ARDS & Prone Positioning | 151 – 165 |
| 9 | COPD & Asthma Exacerbation | 166 – 180 |
| 10 | Endocrine Emergencies: DKA, HHS, SIADH, DI | 181 – 200 |
| 11 | Electrolyte Imbalances (K+, Na+, Ca++) | 201 – 215 |
| 12 | Neurocritical Care: ICP, Stroke, Seizures | 216 – 235 |
| 13 | Renal Failure & AKI | 236 – 245 |
| 14 | Burns & Multisystem Trauma | 246 – 255 |
| 15 | Coagulopathies: DIC, HIT, Transfusions | 256 – 265 |
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# SECTION 1: HEMODYNAMICS & MONITORING (1–25)
**1.** A patient has a cardiac output (CO) of 3.2 L/min and a body
surface area (BSA) of 1.6 m². What is the cardiac index (CI)?
A. 1.5 L/min/m²
B. 2.0 L/min/m²
C. 3.2 L/min/m²
D. 5.1 L/min/m²
**Answer: B. 2.0 L/min/m²**
*Rationale:* CI = CO ÷ BSA = 3.2 ÷ 1.6 = 2.0. Normal CI = 2.5–4.0.
Below 2.2 indicates cardiogenic shock.
**2.** Which hemodynamic parameter directly reflects left ventricular
preload?
A. Central venous pressure (CVP)
B. Pulmonary artery wedge pressure (PAWP)
C. Systemic vascular resistance (SVR)
D. Mean arterial pressure (MAP)
**Answer: B. PAWP**
*Rationale:* PAWP estimates left atrial pressure and LV end-diastolic
volume (preload). CVP reflects right-sided preload.
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**3.** A patient has a CVP of 2 mm Hg (normal 2–8). This suggests:
A. Fluid overload
B. Hypovolemia
C. Left heart failure
D. Increased afterload
**Answer: B. Hypovolemia**
*Rationale:* Low CVP indicates decreased right ventricular preload,
commonly from dehydration or hemorrhage.
**4.** The nurse calculates SVR = 2,200 dynes·sec·cm⁻⁵ (normal 800–
1,200). This indicates:
A. Vasodilation
B. Vasoconstriction
C. Normal afterload
D. Low cardiac output only
**Answer: B. Vasoconstriction**
*Rationale:* Elevated SVR means increased afterload, forcing the LV to
work harder. Seen in cardiogenic/hypovolemic shock.
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**5.** A pulmonary artery catheter shows PAWP = 25 mm Hg, CO =
2.1 L/min. The nurse suspects:
A. Hypovolemic shock
B. Distributive shock
C. Cardiogenic shock
D. Obstructive shock
**Answer: C. Cardiogenic shock**
*Rationale:* High PAWP (>18) + low CO = left ventricular failure
(cardiogenic shock).
**6.** Mixed venous oxygen saturation (SvO₂) is 50% (normal 60–
80%). This indicates:
A. Increased oxygen extraction
B. Decreased oxygen demand
C. Adequate tissue perfusion
D. Left shift of oxyhemoglobin curve
**Answer: A. Increased oxygen extraction**
*Rationale:* Low SvO₂ means tissues are extracting more O₂ due to low
CO or hypoxia.
NUR 445 / NURS 445 EXAM 1: CRITICAL CARE
NURSING MASTERY BANK – HEMODYNAMICS,
SHOCK, RESPIRATORY FAILURE &
MULTISYSTEM EMERGENCIES (2026 EDITION)
TABLE OF CONTENTS
| Section | Topic | Question Numbers |
|---------|-------|------------------|
| 1 | Hemodynamics & Hemodynamic Monitoring | 1 – 25 |
| 2 | Shock States (Distributive, Cardiogenic, Hypovolemic, Obstructive) | 26 – 55 |
| 3 | Cardiac Emergencies: ACS, STEMI, NSTEMI | 56 – 75 |
| 4 | Heart Failure & Pulmonary Edema | 76 – 90 |
| 5 | Dysrhythmias & ECG Interpretation | 91 – 110 |
| 6 | Vasoactive & Cardiac Medications | 111 – 125 |
| 7 | Respiratory Failure & Mechanical Ventilation | 126 – 150 |
| 8 | ARDS & Prone Positioning | 151 – 165 |
| 9 | COPD & Asthma Exacerbation | 166 – 180 |
| 10 | Endocrine Emergencies: DKA, HHS, SIADH, DI | 181 – 200 |
| 11 | Electrolyte Imbalances (K+, Na+, Ca++) | 201 – 215 |
| 12 | Neurocritical Care: ICP, Stroke, Seizures | 216 – 235 |
| 13 | Renal Failure & AKI | 236 – 245 |
| 14 | Burns & Multisystem Trauma | 246 – 255 |
| 15 | Coagulopathies: DIC, HIT, Transfusions | 256 – 265 |
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# SECTION 1: HEMODYNAMICS & MONITORING (1–25)
**1.** A patient has a cardiac output (CO) of 3.2 L/min and a body
surface area (BSA) of 1.6 m². What is the cardiac index (CI)?
A. 1.5 L/min/m²
B. 2.0 L/min/m²
C. 3.2 L/min/m²
D. 5.1 L/min/m²
**Answer: B. 2.0 L/min/m²**
*Rationale:* CI = CO ÷ BSA = 3.2 ÷ 1.6 = 2.0. Normal CI = 2.5–4.0.
Below 2.2 indicates cardiogenic shock.
**2.** Which hemodynamic parameter directly reflects left ventricular
preload?
A. Central venous pressure (CVP)
B. Pulmonary artery wedge pressure (PAWP)
C. Systemic vascular resistance (SVR)
D. Mean arterial pressure (MAP)
**Answer: B. PAWP**
*Rationale:* PAWP estimates left atrial pressure and LV end-diastolic
volume (preload). CVP reflects right-sided preload.
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**3.** A patient has a CVP of 2 mm Hg (normal 2–8). This suggests:
A. Fluid overload
B. Hypovolemia
C. Left heart failure
D. Increased afterload
**Answer: B. Hypovolemia**
*Rationale:* Low CVP indicates decreased right ventricular preload,
commonly from dehydration or hemorrhage.
**4.** The nurse calculates SVR = 2,200 dynes·sec·cm⁻⁵ (normal 800–
1,200). This indicates:
A. Vasodilation
B. Vasoconstriction
C. Normal afterload
D. Low cardiac output only
**Answer: B. Vasoconstriction**
*Rationale:* Elevated SVR means increased afterload, forcing the LV to
work harder. Seen in cardiogenic/hypovolemic shock.
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**5.** A pulmonary artery catheter shows PAWP = 25 mm Hg, CO =
2.1 L/min. The nurse suspects:
A. Hypovolemic shock
B. Distributive shock
C. Cardiogenic shock
D. Obstructive shock
**Answer: C. Cardiogenic shock**
*Rationale:* High PAWP (>18) + low CO = left ventricular failure
(cardiogenic shock).
**6.** Mixed venous oxygen saturation (SvO₂) is 50% (normal 60–
80%). This indicates:
A. Increased oxygen extraction
B. Decreased oxygen demand
C. Adequate tissue perfusion
D. Left shift of oxyhemoglobin curve
**Answer: A. Increased oxygen extraction**
*Rationale:* Low SvO₂ means tissues are extracting more O₂ due to low
CO or hypoxia.
