Critical Care-Exam Questions and Correct
Answers
Question 1
Oxygen saturation (SaO2) represents
a. alveolar oxygen tension.
b. oxygen that is chemically combined with hemoglobin.
c. oxygen that is physically dissolved in plasma.
d. total oxygen consumption.
Correct Answer
b. oxygen that is chemically combined with hemoglobin.
Question 2
The nurse is caring for a patient whose ventilator settings include 15 cm H2O of
positive end-expiratory pressure (PEEP). What complication does the nurse assess the
patient for?
a. Fluid overload secondary to decreased venous return
b. High cardiac index secondary to more efficient ventricular function
c. Hypoxemia secondary to prolonged positive pressure at expiration
d. Low cardiac output secondary to increased intrathoracic pressure
Correct Answer
d. Low cardiac output secondary to increased intrathoracic pressure
Question 3
A patient presents to the emergency department in acute respiratory failure
secondary to community-acquired pneumonia. The patient has a history of chronic
obstructive pulmonary disease. The nurse anticipates which treatment to facilitate
ventilation?
a. Emergency tracheostomy and mechanical ventilation
b. Mechanical ventilation via an endotracheal tube
c. Noninvasive positive-pressure ventilation (NPPV)
d. Oxygen at 100% via bag-valve-mask device
Correct Answer
c. Noninvasive positive-pressure ventilation (NPPV)
Page 1 of 125
,Question 4
Patients often have recollections of the critical care experience. Which is likely to be
the most common recollection of patients who required endotracheal intubation and
mechanical ventilation?
a. Difficulty in communicating
b. Inability to get comfortable
c. Pain
d. Sleep disruption
Correct Answer
a. Difficulty in communicating
Question 5
A patient is being mechanically ventilated in the synchronized intermittent mandatory
ventilation mode at a rate of 4 breaths/min. His spontaneous respirations are 12
breaths/min. He receives a dose of morphine sulfate, and his spontaneous
respirations decrease to 4 breaths/min. Which acid-base disturbance will likely occur?
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis
Correct Answer
c. Respiratory acidosis
Question 6
The nurse is caring for a mechanically ventilated patient being monitored with a left
radial arterial line. During the inspiratory phase of ventilation, the nurse assesses a 20
mm Hg decrease in arterial blood pressure. What is the best interpretation of this
finding by the nurse?
a. The mechanical ventilator is malfunctioning.
b. The patient may require fluid resuscitation.
c. The arterial line may need to be replaced.
d. The left limb may have reduced perfusion.
Correct Answer
b. The patient may require fluid resuscitation.
Page 2 of 125
,Question 7
Which nursing actions are most important for a patient with a right radial arterial line?
(Select all that apply.)
a. Checking the circulation to the right hand every 2 hours
b. Maintaining a pressurized flush solution to the arterial line setup
c. Monitoring the waveform on the monitor for dampening
d. Restraining all four extremities with soft limb restraints
e. Ensuring all junctions remain tightly connected
Correct Answer
a. Checking the circulation to the right hand every 2 hours
b. Maintaining a pressurized flush solution to the arterial line setup
c. Monitoring the waveform on the monitor for dampening
e. Ensuring all junctions remain tightly connected
Question 8
A patient is admitted to the hospital with multiple trauma and extensive blood loss.
The nurse assesses vital signs to be BP 80/50 mm Hg, heart rate 135 beats/min,
respirations 36 breaths/min, cardiac output (CO) of 2 L/min, systemic vascular
resistance of 3000 dynes/sec/cm-5, and a hematocrit of 20%. The nurse anticipates
administration of which the following therapies or medications?
a. Blood transfusion
b. Furosemide
c. Dobutamine infusion
d. Dopamine hydrochloride infusion
Correct Answer
a. Blood transfusion
Question 9
When assessing the patient for hypoxemia, the nurse recognizes that an early sign of
the effect of hypoxemia on the cardiovascular system is
a. heart block.
b. restlessness.
c. tachycardia.
d. tachypnea.
Correct Answer
c. tachycardia.
Page 3 of 125
, Question 10
A patient is admitted to the cardiac surgical intensive care unit after cardiac surgery.
Four hours after admission to the surgical intensive care unit at 4 PM, the patient has
stable vital signs and normal arterial blood gases (ABGs), and is placed on a T-piece
for ventilatory weaning. The following information pertains to the 1900 assessment.
Assessments and Vital Signs Nursing Action
Restless Performs complete assessment
Increased to 110 beats/min Suctions patient for pink, frothy secretions
Respirations 36 breaths/min Obtains prescriptions from provider for ABGs, electrolyte
levels, and portable chest x-ray
Blood pressure 156/98 mm Hg
Sinus tachycardia
10 PVCs/min
Elevated pulmonary artery pressure
Loud crackles throughout
New ABGs:
pH: 7.28
PaCO2: 46 mm Hg
Bicarbonate: 22 mEq/L
PaO2: 58 mm Hg
O2 saturation: 88%
What action by the nurse is best?
a. Prepare for rapid intubation.
b. Increase the patient's oxygen.
c. Prepare to administer a diuretic.
d. Change the ventilator settings.
Correct Answer
c. Prepare to administer a diuretic.
Page 4 of 125
Answers
Question 1
Oxygen saturation (SaO2) represents
a. alveolar oxygen tension.
b. oxygen that is chemically combined with hemoglobin.
c. oxygen that is physically dissolved in plasma.
d. total oxygen consumption.
Correct Answer
b. oxygen that is chemically combined with hemoglobin.
Question 2
The nurse is caring for a patient whose ventilator settings include 15 cm H2O of
positive end-expiratory pressure (PEEP). What complication does the nurse assess the
patient for?
a. Fluid overload secondary to decreased venous return
b. High cardiac index secondary to more efficient ventricular function
c. Hypoxemia secondary to prolonged positive pressure at expiration
d. Low cardiac output secondary to increased intrathoracic pressure
Correct Answer
d. Low cardiac output secondary to increased intrathoracic pressure
Question 3
A patient presents to the emergency department in acute respiratory failure
secondary to community-acquired pneumonia. The patient has a history of chronic
obstructive pulmonary disease. The nurse anticipates which treatment to facilitate
ventilation?
a. Emergency tracheostomy and mechanical ventilation
b. Mechanical ventilation via an endotracheal tube
c. Noninvasive positive-pressure ventilation (NPPV)
d. Oxygen at 100% via bag-valve-mask device
Correct Answer
c. Noninvasive positive-pressure ventilation (NPPV)
Page 1 of 125
,Question 4
Patients often have recollections of the critical care experience. Which is likely to be
the most common recollection of patients who required endotracheal intubation and
mechanical ventilation?
a. Difficulty in communicating
b. Inability to get comfortable
c. Pain
d. Sleep disruption
Correct Answer
a. Difficulty in communicating
Question 5
A patient is being mechanically ventilated in the synchronized intermittent mandatory
ventilation mode at a rate of 4 breaths/min. His spontaneous respirations are 12
breaths/min. He receives a dose of morphine sulfate, and his spontaneous
respirations decrease to 4 breaths/min. Which acid-base disturbance will likely occur?
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis
Correct Answer
c. Respiratory acidosis
Question 6
The nurse is caring for a mechanically ventilated patient being monitored with a left
radial arterial line. During the inspiratory phase of ventilation, the nurse assesses a 20
mm Hg decrease in arterial blood pressure. What is the best interpretation of this
finding by the nurse?
a. The mechanical ventilator is malfunctioning.
b. The patient may require fluid resuscitation.
c. The arterial line may need to be replaced.
d. The left limb may have reduced perfusion.
Correct Answer
b. The patient may require fluid resuscitation.
Page 2 of 125
,Question 7
Which nursing actions are most important for a patient with a right radial arterial line?
(Select all that apply.)
a. Checking the circulation to the right hand every 2 hours
b. Maintaining a pressurized flush solution to the arterial line setup
c. Monitoring the waveform on the monitor for dampening
d. Restraining all four extremities with soft limb restraints
e. Ensuring all junctions remain tightly connected
Correct Answer
a. Checking the circulation to the right hand every 2 hours
b. Maintaining a pressurized flush solution to the arterial line setup
c. Monitoring the waveform on the monitor for dampening
e. Ensuring all junctions remain tightly connected
Question 8
A patient is admitted to the hospital with multiple trauma and extensive blood loss.
The nurse assesses vital signs to be BP 80/50 mm Hg, heart rate 135 beats/min,
respirations 36 breaths/min, cardiac output (CO) of 2 L/min, systemic vascular
resistance of 3000 dynes/sec/cm-5, and a hematocrit of 20%. The nurse anticipates
administration of which the following therapies or medications?
a. Blood transfusion
b. Furosemide
c. Dobutamine infusion
d. Dopamine hydrochloride infusion
Correct Answer
a. Blood transfusion
Question 9
When assessing the patient for hypoxemia, the nurse recognizes that an early sign of
the effect of hypoxemia on the cardiovascular system is
a. heart block.
b. restlessness.
c. tachycardia.
d. tachypnea.
Correct Answer
c. tachycardia.
Page 3 of 125
, Question 10
A patient is admitted to the cardiac surgical intensive care unit after cardiac surgery.
Four hours after admission to the surgical intensive care unit at 4 PM, the patient has
stable vital signs and normal arterial blood gases (ABGs), and is placed on a T-piece
for ventilatory weaning. The following information pertains to the 1900 assessment.
Assessments and Vital Signs Nursing Action
Restless Performs complete assessment
Increased to 110 beats/min Suctions patient for pink, frothy secretions
Respirations 36 breaths/min Obtains prescriptions from provider for ABGs, electrolyte
levels, and portable chest x-ray
Blood pressure 156/98 mm Hg
Sinus tachycardia
10 PVCs/min
Elevated pulmonary artery pressure
Loud crackles throughout
New ABGs:
pH: 7.28
PaCO2: 46 mm Hg
Bicarbonate: 22 mEq/L
PaO2: 58 mm Hg
O2 saturation: 88%
What action by the nurse is best?
a. Prepare for rapid intubation.
b. Increase the patient's oxygen.
c. Prepare to administer a diuretic.
d. Change the ventilator settings.
Correct Answer
c. Prepare to administer a diuretic.
Page 4 of 125
