HESI Critical Care Exam V3 | 2026 Q&A
with Rationale (HESI Critical Care Exam
2026)
1. A nurse is caring for a client with a Central Venous Pressure (CVP) of 1 mmHg. Which
intervention should the nurse anticipate first?
A. Administering a potent loop diuretic
B. Administering a bolus of intravenous fluids
C. Increasing the rate of a norepinephrine drip
D. Placing the client in a high-Fowler position
Correct Answer: B
Rationale: Normal CVP ranges from 2 to 8 mmHg. A CVP of 1 mmHg indicates fluid volume
deficit or dehydration, requiring fluid resuscitation to improve cardiac output. Diuretics
and high-Fowler positioning would further decrease venous return and worsen the client’s
condition.
2. The high-pressure alarm on a client’s mechanical ventilator is sounding. What is the
priority nursing action?
A. Disconnect the ventilator and use a manual resuscitation bag
B. Increase the oxygen concentration to 100 percent
C. Suction the client’s endotracheal tube
,D. Auscultate the client’s breath sounds
Correct Answer: D
Rationale: The first step is always to assess the patient to determine the cause of the
alarm. High-pressure alarms are often caused by secretions, biting the tube, or
pneumothorax, and auscultation helps identify these issues. If the patient is in immediate
distress and the cause cannot be found, then manual ventilation would be indicated.
3. A client with a head injury has an intracranial pressure (ICP) of 22 mmHg. Which position is
most appropriate for this client?
A. Supine with the head of the bed flat
B. Trendelenburg position
C. Side-lying with knees flexed toward the chest
D. Head of the bed elevated to 30 to 45 degrees
Correct Answer: D
Rationale: Normal ICP is 5 to 15 mmHg; 22 mmHg is elevated. Elevating the head of the
bed to 30-45 degrees promotes venous drainage from the brain and helps lower ICP.
Flexion of the hips or neck should be avoided as it increases intrathoracic pressure and
hinders drainage.
4. A nurse is monitoring a client’s Pulmonary Artery Wedge Pressure (PAWP). The reading is
20 mmHg. Which clinical manifestation is consistent with this finding?
A. Crackles in the lungs and dyspnea
, B. Clear breath sounds and flat neck veins
C. Dry mucous membranes and poor skin turgor
D. A heart rate of 50 beats per minute
Correct Answer: A
Rationale: The normal PAWP range is 6 to 12 mmHg. An elevation to 20 mmHg indicates
left ventricular end-diastolic pressure elevation and fluid backup into the lungs. This leads
to pulmonary congestion, manifesting as crackles and shortness of breath.
5. Which assessment finding should the nurse report immediately for a client receiving a
nitroprusside infusion?
A. Nausea and muscle twitching
B. Blood pressure of 110/70 mmHg
C. A slight decrease in heart rate
D. Warm and dry skin
Correct Answer: A
Rationale: Nitroprusside is a potent vasodilator that can lead to thiocyanate toxicity if
used for prolonged periods or at high doses. Nausea, muscle twitching, and confusion are
early signs of this toxicity. The nurse must monitor levels and notify the provider if these
symptoms occur to prevent seizures or coma.
with Rationale (HESI Critical Care Exam
2026)
1. A nurse is caring for a client with a Central Venous Pressure (CVP) of 1 mmHg. Which
intervention should the nurse anticipate first?
A. Administering a potent loop diuretic
B. Administering a bolus of intravenous fluids
C. Increasing the rate of a norepinephrine drip
D. Placing the client in a high-Fowler position
Correct Answer: B
Rationale: Normal CVP ranges from 2 to 8 mmHg. A CVP of 1 mmHg indicates fluid volume
deficit or dehydration, requiring fluid resuscitation to improve cardiac output. Diuretics
and high-Fowler positioning would further decrease venous return and worsen the client’s
condition.
2. The high-pressure alarm on a client’s mechanical ventilator is sounding. What is the
priority nursing action?
A. Disconnect the ventilator and use a manual resuscitation bag
B. Increase the oxygen concentration to 100 percent
C. Suction the client’s endotracheal tube
,D. Auscultate the client’s breath sounds
Correct Answer: D
Rationale: The first step is always to assess the patient to determine the cause of the
alarm. High-pressure alarms are often caused by secretions, biting the tube, or
pneumothorax, and auscultation helps identify these issues. If the patient is in immediate
distress and the cause cannot be found, then manual ventilation would be indicated.
3. A client with a head injury has an intracranial pressure (ICP) of 22 mmHg. Which position is
most appropriate for this client?
A. Supine with the head of the bed flat
B. Trendelenburg position
C. Side-lying with knees flexed toward the chest
D. Head of the bed elevated to 30 to 45 degrees
Correct Answer: D
Rationale: Normal ICP is 5 to 15 mmHg; 22 mmHg is elevated. Elevating the head of the
bed to 30-45 degrees promotes venous drainage from the brain and helps lower ICP.
Flexion of the hips or neck should be avoided as it increases intrathoracic pressure and
hinders drainage.
4. A nurse is monitoring a client’s Pulmonary Artery Wedge Pressure (PAWP). The reading is
20 mmHg. Which clinical manifestation is consistent with this finding?
A. Crackles in the lungs and dyspnea
, B. Clear breath sounds and flat neck veins
C. Dry mucous membranes and poor skin turgor
D. A heart rate of 50 beats per minute
Correct Answer: A
Rationale: The normal PAWP range is 6 to 12 mmHg. An elevation to 20 mmHg indicates
left ventricular end-diastolic pressure elevation and fluid backup into the lungs. This leads
to pulmonary congestion, manifesting as crackles and shortness of breath.
5. Which assessment finding should the nurse report immediately for a client receiving a
nitroprusside infusion?
A. Nausea and muscle twitching
B. Blood pressure of 110/70 mmHg
C. A slight decrease in heart rate
D. Warm and dry skin
Correct Answer: A
Rationale: Nitroprusside is a potent vasodilator that can lead to thiocyanate toxicity if
used for prolonged periods or at high doses. Nausea, muscle twitching, and confusion are
early signs of this toxicity. The nurse must monitor levels and notify the provider if these
symptoms occur to prevent seizures or coma.
