HESI Critical Care Exit Practice Exam
2025-2026: 100 Highly-Tested Questions
and Rationales– Pass on Your First
Attempt and Avoid Resits
Question 1
A client with a pulmonary artery (Swan-Ganz) catheter has a
pulmonary artery wedge pressure (PAWP) of 22 mm Hg (normal
6-12 mm Hg). How does the nurse interpret this finding?
A. Hypovolemia
B. Left ventricular failure
C. Right ventricular failure
D. Pulmonary embolism
Answer: B. Left ventricular failure. Rationale: PAWP reflects left
atrial pressure. An elevated PAWP (>18 mm Hg) indicates left
ventricular failure or fluid overload, while hypovolemia would
show a low PAWP (<6 mm Hg).
Question 2
A client's mixed venous oxygen saturation (SvO₂) is 55% (normal
60-80%). How does the nurse interpret this value?
A. Increased tissue oxygen extraction
B. Decreased tissue oxygen extraction
C. Normal tissue oxygenation
D. Oxygen toxicity
,Answer: A. Increased tissue oxygen extraction. Rationale: Low
SvO₂ (desaturation) indicates increased tissue oxygen extraction,
often due to decreased cardiac output, hypoxemia, or increased
metabolic demand.
Question 3
A client’s CVP is 2 mm Hg (normal 2-8 mm Hg) and the client is
hypotensive. What should the nurse do first?
A. Administer a fluid bolus
B. Start a dopamine infusion
C. Administer a vasodilator
D. Place the client in Trendelenburg position
Answer: A. Administer a fluid bolus. Rationale: A low CVP
combined with hypotension indicates hypovolemia. The first
action is to administer a fluid bolus to increase preload and
improve blood pressure.
2. Shock States & Sepsis
Question 4
A client exhibits symptoms of alcohol intoxication. The blood
alcohol level is 200 mg (0.2%). Which measurement tool is best for
the nurse to use during the initial assessment?
A. CAGE questionnaire
B. Addiction Severity Index
C. Glasgow Coma Scale
D. DSM multiaxial evaluation
, Answer: C. Glasgow Coma Scale. Rationale: Evaluation of level of
consciousness, which is the purpose of the Glasgow Coma Scale,
is the priority for a client with a high blood alcohol level.
Question 5
A client is first-day postoperative after a mastectomy and
becomes increasingly restless and agitated. Vital signs:
temperature, 100° F; pulse, 98 beats/min; respirations, 24
breaths/min; blood pressure, 120/80 mm Hg. What is the first
intervention?
A. Administer a PRN analgesic.
B. Assess the incision for drainage or redness.
C. Instruct the UAP to take vital signs hourly.
D. Assist the client to a more comfortable position.
Answer: B. Assess the incision for drainage or
redness. Rationale: The priority is to observe for possible
hemorrhage, as the client is at high risk for hypovolemic shock.
Question 6
A client admitted to the ICU after a colon resection has a heart
rate of 130, temperature of 100°F (37.8°C), blood pressure of
88/65, and urine output of 10 mL/hr. What intervention should
the nurse implement?
A. Give a 500 mL IV fluid bolus challenge
B. Administer a PRN dose of an antipyretic
C. Notify the healthcare provider immediately
D. Obtain a stat order for a vasopressor
2025-2026: 100 Highly-Tested Questions
and Rationales– Pass on Your First
Attempt and Avoid Resits
Question 1
A client with a pulmonary artery (Swan-Ganz) catheter has a
pulmonary artery wedge pressure (PAWP) of 22 mm Hg (normal
6-12 mm Hg). How does the nurse interpret this finding?
A. Hypovolemia
B. Left ventricular failure
C. Right ventricular failure
D. Pulmonary embolism
Answer: B. Left ventricular failure. Rationale: PAWP reflects left
atrial pressure. An elevated PAWP (>18 mm Hg) indicates left
ventricular failure or fluid overload, while hypovolemia would
show a low PAWP (<6 mm Hg).
Question 2
A client's mixed venous oxygen saturation (SvO₂) is 55% (normal
60-80%). How does the nurse interpret this value?
A. Increased tissue oxygen extraction
B. Decreased tissue oxygen extraction
C. Normal tissue oxygenation
D. Oxygen toxicity
,Answer: A. Increased tissue oxygen extraction. Rationale: Low
SvO₂ (desaturation) indicates increased tissue oxygen extraction,
often due to decreased cardiac output, hypoxemia, or increased
metabolic demand.
Question 3
A client’s CVP is 2 mm Hg (normal 2-8 mm Hg) and the client is
hypotensive. What should the nurse do first?
A. Administer a fluid bolus
B. Start a dopamine infusion
C. Administer a vasodilator
D. Place the client in Trendelenburg position
Answer: A. Administer a fluid bolus. Rationale: A low CVP
combined with hypotension indicates hypovolemia. The first
action is to administer a fluid bolus to increase preload and
improve blood pressure.
2. Shock States & Sepsis
Question 4
A client exhibits symptoms of alcohol intoxication. The blood
alcohol level is 200 mg (0.2%). Which measurement tool is best for
the nurse to use during the initial assessment?
A. CAGE questionnaire
B. Addiction Severity Index
C. Glasgow Coma Scale
D. DSM multiaxial evaluation
, Answer: C. Glasgow Coma Scale. Rationale: Evaluation of level of
consciousness, which is the purpose of the Glasgow Coma Scale,
is the priority for a client with a high blood alcohol level.
Question 5
A client is first-day postoperative after a mastectomy and
becomes increasingly restless and agitated. Vital signs:
temperature, 100° F; pulse, 98 beats/min; respirations, 24
breaths/min; blood pressure, 120/80 mm Hg. What is the first
intervention?
A. Administer a PRN analgesic.
B. Assess the incision for drainage or redness.
C. Instruct the UAP to take vital signs hourly.
D. Assist the client to a more comfortable position.
Answer: B. Assess the incision for drainage or
redness. Rationale: The priority is to observe for possible
hemorrhage, as the client is at high risk for hypovolemic shock.
Question 6
A client admitted to the ICU after a colon resection has a heart
rate of 130, temperature of 100°F (37.8°C), blood pressure of
88/65, and urine output of 10 mL/hr. What intervention should
the nurse implement?
A. Give a 500 mL IV fluid bolus challenge
B. Administer a PRN dose of an antipyretic
C. Notify the healthcare provider immediately
D. Obtain a stat order for a vasopressor
