TEST BANK PRIORITIES IN CRITICAL CARE
NURSING, 9TH EDITION BY URDEN, STACY
WITH QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONELS LATEST UPDATE
2026/2027
SECTION A: MULTIPLE CHOICE (Chapters 1–6: Foundations & Ethics)
1. A critically ill patient has a do-not-resuscitate (DNR) order but develops severe respiratory distress.
The nurse should:
a) Initiate bag-valve-mask ventilation immediately
b) Call a code blue and begin chest compressions
c) Provide comfort measures and oxygen per DNR parameters
d) Ask family if they want to change the code status
Answer: c) Provide comfort measures and oxygen per DNR parameters
Rationale: DNR means no CPR, but comfort care including oxygen, suctioning, and pain management is
appropriate unless specified otherwise.
2. The nurse is caring for a patient with septic shock. Which hemodynamic parameter indicates
improvement?
a) Decreased central venous pressure (CVP)
b) Increased systemic vascular resistance (SVR)
c) Decreased cardiac output (CO)
d) Increased pulmonary artery wedge pressure (PAWP)
Answer: b) Increased SVR
Rationale: Septic shock causes vasodilation (low SVR). Improving SVR indicates response to
vasopressors/fluids.
,3. A patient with acute respiratory distress syndrome (ARDS) has PaO₂ 55 mm Hg on FiO₂ 0.8. The
nurse anticipates:
a) Increasing PEEP
b) Decreasing tidal volume
c) Administering IV epinephrine
d) Performing chest physiotherapy
Answer: a) Increasing PEEP
Rationale: In ARDS, high PEEP recruits alveoli, improves oxygenation, and allows lower FiO₂.
4. Which finding is most concerning in a patient with a traumatic brain injury (TBI)?
a) Glasgow Coma Scale (GCS) from 14 to 15
b) Pupils equal and reactive
c) Blood pressure 90/50 mm Hg
d) Serum sodium 135 mEq/L
Answer: c) BP 90/50 mm Hg
Rationale: Hypotension in TBI causes secondary brain injury due to decreased cerebral perfusion
pressure (CPP).
5. The patient in cardiogenic shock has an intra-aortic balloon pump (IABP). Which assessment
indicates proper timing?
a) Balloon inflates at the peak of the T wave
b) Balloon inflates at the dicrotic notch
c) Balloon deflates during systole
d) Balloon inflates just before the QRS complex
Answer: b) Balloon inflates at the dicrotic notch
Rationale: IABP inflates at the dicrotic notch (aortic valve closure, start of diastole) to augment coronary
perfusion.
6. Which lab finding best indicates adequate tissue perfusion in a patient with shock?
a) Serum lactate 6.0 mmol/L
b) Base deficit –8
c) Mixed venous oxygen saturation (SvO₂) 70%
d) Central venous pressure 22 mm Hg
Answer: c) SvO₂ 70%
Rationale: Normal SvO₂ is 60–80%. Low values indicate increased oxygen extraction (low flow).
7. A patient on a ventilator has a sudden drop in SpO₂ to 80% and absent breath sounds on the right.
First action:
a) Stat portable chest x-ray
, b) Reposition the patient
c) Manually ventilate with 100% O₂ and call for help
d) Suction the endotracheal tube
Answer: c) Manually ventilate with 100% O₂ and call for help
Rationale: Suspected tension pneumothorax – immediate decompression needed; manual ventilation
buys time.
8. Which sedation scale is best for a paralyzed patient?
a) Richmond Agitation-Sedation Scale (RASS)
b) Ramsay Sedation Scale
c) Bispectral index (BIS) monitor
d) Sedation-Agitation Scale
Answer: c) BIS monitor
Rationale: BIS uses EEG to assess sedation level even with neuromuscular blockade.
9. The patient has a pulmonary artery catheter. CVP 2 mm Hg, PAWP 4 mm Hg, BP 80/50. Priority
intervention:
a) Administer dobutamine
b) Give 500 mL normal saline bolus
c) Start norepinephrine infusion
d) Increase PEEP
Answer: b) Give 500 mL normal saline bolus
Rationale: Low CVP and PAWP suggest hypovolemia as cause of hypotension.
10. After cardiac arrest, the patient has return of spontaneous circulation (ROSC). Target temperature
management (TTM) is ordered. Goal temperature range:
a) 35–36°C
b) 32–36°C
c) 37–38°C
d) 30–32°C
Answer: b) 32–36°C
Rationale: Current guidelines recommend maintaining 32–36°C for at least 24 hours post-arrest.
SECTION B: MULTIPLE CHOICE (Chapters 7–12 – Cardiovascular & Respiratory)
11. Which finding in a patient with acute coronary syndrome (ACS) is most indicative of left
ventricular failure?
NURSING, 9TH EDITION BY URDEN, STACY
WITH QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONELS LATEST UPDATE
2026/2027
SECTION A: MULTIPLE CHOICE (Chapters 1–6: Foundations & Ethics)
1. A critically ill patient has a do-not-resuscitate (DNR) order but develops severe respiratory distress.
The nurse should:
a) Initiate bag-valve-mask ventilation immediately
b) Call a code blue and begin chest compressions
c) Provide comfort measures and oxygen per DNR parameters
d) Ask family if they want to change the code status
Answer: c) Provide comfort measures and oxygen per DNR parameters
Rationale: DNR means no CPR, but comfort care including oxygen, suctioning, and pain management is
appropriate unless specified otherwise.
2. The nurse is caring for a patient with septic shock. Which hemodynamic parameter indicates
improvement?
a) Decreased central venous pressure (CVP)
b) Increased systemic vascular resistance (SVR)
c) Decreased cardiac output (CO)
d) Increased pulmonary artery wedge pressure (PAWP)
Answer: b) Increased SVR
Rationale: Septic shock causes vasodilation (low SVR). Improving SVR indicates response to
vasopressors/fluids.
,3. A patient with acute respiratory distress syndrome (ARDS) has PaO₂ 55 mm Hg on FiO₂ 0.8. The
nurse anticipates:
a) Increasing PEEP
b) Decreasing tidal volume
c) Administering IV epinephrine
d) Performing chest physiotherapy
Answer: a) Increasing PEEP
Rationale: In ARDS, high PEEP recruits alveoli, improves oxygenation, and allows lower FiO₂.
4. Which finding is most concerning in a patient with a traumatic brain injury (TBI)?
a) Glasgow Coma Scale (GCS) from 14 to 15
b) Pupils equal and reactive
c) Blood pressure 90/50 mm Hg
d) Serum sodium 135 mEq/L
Answer: c) BP 90/50 mm Hg
Rationale: Hypotension in TBI causes secondary brain injury due to decreased cerebral perfusion
pressure (CPP).
5. The patient in cardiogenic shock has an intra-aortic balloon pump (IABP). Which assessment
indicates proper timing?
a) Balloon inflates at the peak of the T wave
b) Balloon inflates at the dicrotic notch
c) Balloon deflates during systole
d) Balloon inflates just before the QRS complex
Answer: b) Balloon inflates at the dicrotic notch
Rationale: IABP inflates at the dicrotic notch (aortic valve closure, start of diastole) to augment coronary
perfusion.
6. Which lab finding best indicates adequate tissue perfusion in a patient with shock?
a) Serum lactate 6.0 mmol/L
b) Base deficit –8
c) Mixed venous oxygen saturation (SvO₂) 70%
d) Central venous pressure 22 mm Hg
Answer: c) SvO₂ 70%
Rationale: Normal SvO₂ is 60–80%. Low values indicate increased oxygen extraction (low flow).
7. A patient on a ventilator has a sudden drop in SpO₂ to 80% and absent breath sounds on the right.
First action:
a) Stat portable chest x-ray
, b) Reposition the patient
c) Manually ventilate with 100% O₂ and call for help
d) Suction the endotracheal tube
Answer: c) Manually ventilate with 100% O₂ and call for help
Rationale: Suspected tension pneumothorax – immediate decompression needed; manual ventilation
buys time.
8. Which sedation scale is best for a paralyzed patient?
a) Richmond Agitation-Sedation Scale (RASS)
b) Ramsay Sedation Scale
c) Bispectral index (BIS) monitor
d) Sedation-Agitation Scale
Answer: c) BIS monitor
Rationale: BIS uses EEG to assess sedation level even with neuromuscular blockade.
9. The patient has a pulmonary artery catheter. CVP 2 mm Hg, PAWP 4 mm Hg, BP 80/50. Priority
intervention:
a) Administer dobutamine
b) Give 500 mL normal saline bolus
c) Start norepinephrine infusion
d) Increase PEEP
Answer: b) Give 500 mL normal saline bolus
Rationale: Low CVP and PAWP suggest hypovolemia as cause of hypotension.
10. After cardiac arrest, the patient has return of spontaneous circulation (ROSC). Target temperature
management (TTM) is ordered. Goal temperature range:
a) 35–36°C
b) 32–36°C
c) 37–38°C
d) 30–32°C
Answer: b) 32–36°C
Rationale: Current guidelines recommend maintaining 32–36°C for at least 24 hours post-arrest.
SECTION B: MULTIPLE CHOICE (Chapters 7–12 – Cardiovascular & Respiratory)
11. Which finding in a patient with acute coronary syndrome (ACS) is most indicative of left
ventricular failure?
