HESI Critical Care V1 V2 V3 Exams
(PDF) | (2026) Exam Questions |
Nursing, Exams of Nursing
1. A client with septic shock has a BP of 78/45 mmHg after a 2 L fluid bolus. Which
vasopressor is first-line?
A) Norepinephrine
B) Dopamine
C) Phenylephrine
D) Epinephrine
Answer: A
Rationale: Surviving Sepsis Campaign: norepinephrine is first-line vasopressor in
septic shock.
2. A client with cardiogenic shock has a PAOP of 24 mmHg, CI 1.6 L/min/m², and
SVR 1400. Which medication is most appropriate?
A) Dobutamine
B) Norepinephrine
C) Furosemide
D) Nitroprusside
Answer: A
Rationale: Dobutamine increases contractility (low CI) and reduces afterload.
3. A client with a pulmonary artery catheter has a CVP of 2 mmHg. The nurse
should assess for?
A) Hypovolemia
B) Right ventricular failure
C) Cardiac tamponade
,D) Pulmonary hypertension
Answer: A
Rationale: Low CVP (<4-6 mmHg) indicates decreased preload (hypovolemia).
4. A client with a tension pneumothorax has tracheal deviation, absent breath
sounds, and hypotension. Which action is priority?
A) Needle decompression (2nd ICS, MCL)
B) Chest x-ray
C) Place a chest tube
D) Administer IV fluids
Answer: A
Rationale: Tension pneumothorax is a clinical diagnosis; needle decompression
before imaging.
5. A client on mechanical ventilation has a plateau pressure of 38 cm H₂O. Which
complication is most concerning?
A) Barotrauma
B) Hypovolemia
C) Hypercapnia
D) Pneumothorax
Answer: A
Rationale: Plateau pressure >30 cm H₂O increases risk of ventilator-induced lung
injury.
6. A client with ARDS has a PaO₂/FiO₂ ratio of 140. Which intervention improves
mortality?
A) Prone positioning
B) High tidal volume
C) Decreased PEEP
D) Sedation alone
Answer: A
Rationale: Prone positioning reduces mortality in moderate-severe ARDS (P/F
<150).
,7. A client with an arterial line has a dampened waveform. Which action should the
nurse take first?
A) Check for air bubbles or kinks; perform fast flush test
B) Zero the transducer
C) Replace the transducer
D) Document as normal
Answer: A
Rationale: Dampened waveform: troubleshoot system (air, clots, kinks) before
rezeroing.
8. A client in neurogenic shock (C5 spinal injury) has BP 70/40, HR 48, and warm
skin. Which intervention is priority?
A) Atropine and norepinephrine
B) IV fluids only
C) Dobutamine
D) Place in Trendelenburg
Answer: A
Rationale: Neurogenic shock: vasopressor + atropine/pacing for bradycardia.
9. A client with acute respiratory distress syndrome (ARDS) is on PEEP of 15 cm
H₂O. Which finding indicates a complication?
A) Blood pressure 85/50 mmHg
B) PaO₂ 85 mmHg
C) Urine output 50 mL/hour
D) Heart rate 80 bpm
Answer: A
Rationale: High PEEP decreases venous return → hypotension.
10. A client with a pulmonary embolism and hypotension receives thrombolytics.
Which complication is most serious?
A) Intracranial hemorrhage
B) Hemoptysis
C) Bruising
, D) Tachycardia
Answer: A
Rationale: Thrombolytics increase bleeding risk; intracranial hemorrhage is
life-threatening.
11. A client in hypovolemic shock has a CVP of 2 mmHg and BP 80/50. Which
intervention should the nurse implement first?
A) Administer IV fluid bolus
B) Start norepinephrine
C) Administer packed RBCs
D) Place in Trendelenburg
Answer: A
Rationale: Hypovolemic shock → fluid resuscitation first (crystalloid).
12. A client with an intra-aortic balloon pump (IABP) has a timing trigger set on
ECG. The balloon inflates at the T wave. Which adjustment is correct?
A) Inflate at dicrotic notch (end of systole)
B) Inflate at R wave
C) Deflate at T wave
D) No change
Answer: A
Rationale: IABP inflation at dicrotic notch increases coronary perfusion.
13. A client on mechanical ventilation has a high-pressure alarm. Which action
should the nurse take first?
A) Suction the patient
B) Sedate the patient
C) Disconnect the circuit
D) Notify respiratory therapy
Answer: A
Rationale: High pressure → likely mucus plug, biting, kink, or coughing; suction
first.
14. A client with a chest tube to water seal has continuous bubbling in the water
seal chamber. Which action is priority?
(PDF) | (2026) Exam Questions |
Nursing, Exams of Nursing
1. A client with septic shock has a BP of 78/45 mmHg after a 2 L fluid bolus. Which
vasopressor is first-line?
A) Norepinephrine
B) Dopamine
C) Phenylephrine
D) Epinephrine
Answer: A
Rationale: Surviving Sepsis Campaign: norepinephrine is first-line vasopressor in
septic shock.
2. A client with cardiogenic shock has a PAOP of 24 mmHg, CI 1.6 L/min/m², and
SVR 1400. Which medication is most appropriate?
A) Dobutamine
B) Norepinephrine
C) Furosemide
D) Nitroprusside
Answer: A
Rationale: Dobutamine increases contractility (low CI) and reduces afterload.
3. A client with a pulmonary artery catheter has a CVP of 2 mmHg. The nurse
should assess for?
A) Hypovolemia
B) Right ventricular failure
C) Cardiac tamponade
,D) Pulmonary hypertension
Answer: A
Rationale: Low CVP (<4-6 mmHg) indicates decreased preload (hypovolemia).
4. A client with a tension pneumothorax has tracheal deviation, absent breath
sounds, and hypotension. Which action is priority?
A) Needle decompression (2nd ICS, MCL)
B) Chest x-ray
C) Place a chest tube
D) Administer IV fluids
Answer: A
Rationale: Tension pneumothorax is a clinical diagnosis; needle decompression
before imaging.
5. A client on mechanical ventilation has a plateau pressure of 38 cm H₂O. Which
complication is most concerning?
A) Barotrauma
B) Hypovolemia
C) Hypercapnia
D) Pneumothorax
Answer: A
Rationale: Plateau pressure >30 cm H₂O increases risk of ventilator-induced lung
injury.
6. A client with ARDS has a PaO₂/FiO₂ ratio of 140. Which intervention improves
mortality?
A) Prone positioning
B) High tidal volume
C) Decreased PEEP
D) Sedation alone
Answer: A
Rationale: Prone positioning reduces mortality in moderate-severe ARDS (P/F
<150).
,7. A client with an arterial line has a dampened waveform. Which action should the
nurse take first?
A) Check for air bubbles or kinks; perform fast flush test
B) Zero the transducer
C) Replace the transducer
D) Document as normal
Answer: A
Rationale: Dampened waveform: troubleshoot system (air, clots, kinks) before
rezeroing.
8. A client in neurogenic shock (C5 spinal injury) has BP 70/40, HR 48, and warm
skin. Which intervention is priority?
A) Atropine and norepinephrine
B) IV fluids only
C) Dobutamine
D) Place in Trendelenburg
Answer: A
Rationale: Neurogenic shock: vasopressor + atropine/pacing for bradycardia.
9. A client with acute respiratory distress syndrome (ARDS) is on PEEP of 15 cm
H₂O. Which finding indicates a complication?
A) Blood pressure 85/50 mmHg
B) PaO₂ 85 mmHg
C) Urine output 50 mL/hour
D) Heart rate 80 bpm
Answer: A
Rationale: High PEEP decreases venous return → hypotension.
10. A client with a pulmonary embolism and hypotension receives thrombolytics.
Which complication is most serious?
A) Intracranial hemorrhage
B) Hemoptysis
C) Bruising
, D) Tachycardia
Answer: A
Rationale: Thrombolytics increase bleeding risk; intracranial hemorrhage is
life-threatening.
11. A client in hypovolemic shock has a CVP of 2 mmHg and BP 80/50. Which
intervention should the nurse implement first?
A) Administer IV fluid bolus
B) Start norepinephrine
C) Administer packed RBCs
D) Place in Trendelenburg
Answer: A
Rationale: Hypovolemic shock → fluid resuscitation first (crystalloid).
12. A client with an intra-aortic balloon pump (IABP) has a timing trigger set on
ECG. The balloon inflates at the T wave. Which adjustment is correct?
A) Inflate at dicrotic notch (end of systole)
B) Inflate at R wave
C) Deflate at T wave
D) No change
Answer: A
Rationale: IABP inflation at dicrotic notch increases coronary perfusion.
13. A client on mechanical ventilation has a high-pressure alarm. Which action
should the nurse take first?
A) Suction the patient
B) Sedate the patient
C) Disconnect the circuit
D) Notify respiratory therapy
Answer: A
Rationale: High pressure → likely mucus plug, biting, kink, or coughing; suction
first.
14. A client with a chest tube to water seal has continuous bubbling in the water
seal chamber. Which action is priority?
