Critical Care exam 2
CRITICAL CARE EXAM 2 NEWEST 2025/2026 COMPLETE ALL
QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+||BRAND NEW VERSION!
A diabetic patient who has had vomiting and diarrhea for the past 3 days is
admitted to the hospital with a blood glucose of 748 mg/ml (41.5 mmol/L) and a
urinary output of 120 ml in the first hour. The vital signs are blood pressure (BP)
72/62; pulse 128, irregular and thready; respirations 38; and temperature 97° F
(36.1° C). The patient is disoriented and lethargic with cold, clammy skin and
cyanosis in the hands and feet. The nurse recognizes that the patient is
experiencing the
a. progressive stage of septic shock.
b. compensatory stage of diabetic shock.
c. refractory stage of cardiogenic shock.
d. progressive stage of hypovolemic shock.
Correct Answer: D
Rationale: The patient's history of hyperglycemia (and the associated polyuria),
vomiting, and diarrhea is consistent with hypovolemia, and the symptoms are
most consistent with the progressive stage of shock. The patient's temperature of
97° F is inconsistent with septic shock. The history is inconsistent with a diagnosis
of cardiogenic shock, and the patient's neurologic status is not consistent with
refractory shock.
A patient who has been involved in a motor-vehicle crash is admitted to the ED
with cool, clammy skin, tachycardia, and hypotension. All of these orders are
written. Which one will the nurse act on first?
a. Insert two 14-gauge IV catheters.
b. Administer oxygen at 100% per non-rebreather mask.
c. Place the patient on continuous cardiac monitor.
d. Draw blood to type and crossmatch for transfusions.
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, Critical Care exam 2
Correct Answer: B
Rationale: The first priority in the initial management of shock is maintenance of
the airway and ventilation. Cardiac monitoring, insertion of IV catheters, and
obtaining blood for transfusions should also be rapidly accomplished, but only
after actions to maximize oxygen delivery have been implemented.
A patient with massive trauma and possible spinal cord injury is admitted to the
ED. The nurse suspects that the patient may be experiencing neurogenic shock in
addition to hypovolemic shock, based on the finding of
a. cool, clammy skin.
b. shortness of breath.
c. heart rate of 48 beats/min
d. BP of 82/40 mm Hg.
Correct Answer: C
Rationale: The normal sympathetic response to shock/hypotension is an increase
in heart rate. The presence of bradycardia suggests unopposed parasympathetic
function, as occurs in neurogenic shock. The other symptoms are consistent with
hypovolemic shock.
A patient in septic shock has not responded to fluid resuscitation, as evidenced by
a decreasing BP and cardiac output. The nurse anticipates the administration of
a. nitroglycerine (Tridil).
b. dobutamine (Dobutrex).
c. norepinephrine (Levophed).
d. sodium nitroprusside (Nipride).
Correct Answer: C
Rationale: When fluid resuscitation is unsuccessful, administration of vasopressor
drugs is used to increase the systemic vascular resistance (SVR) and improve tissue
perfusion. Nitroglycerin would decrease the preload and further drop cardiac
output and BP. Dobutamine will increase stroke volume, but it would also further
decrease SVR. Nitroprusside is an arterial vasodilator and would further decrease
SVR.
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, Critical Care exam 2
All of these collaborative interventions are ordered by the health care provider for
a patient stung by a bee who develops severe respiratory distress and faintness.
Which one will the nurse administer first?
a. Epinephrine (Adrenalin)
b. Normal saline infusion
c. Dexamethasone (Decadron)
d. Diphenhydramine (Benadryl)
Correct Answer: A
Rationale: Epinephrine rapidly causes peripheral vasoconstriction, dilates the
bronchi, and blocks the effects of histamine and reverses the vasodilation,
bronchoconstriction, and histamine release that cause the symptoms of
anaphylaxis. The other interventions are also appropriate but would not be the
first ones administered.
A patient with a myocardial infarction (MI) and cardiogenic shock has the
following vital signs: BP 86/50, pulse 126, respirations 30. Hemodynamic
monitoring reveals an elevated PAWP and decreased cardiac output. The nurse
will anticipate
a. administration of furosemide (Lasix) IV.
b. titration of an epinephrine (Adrenalin) drip.
c. administration of a normal saline bolus.
d. assisting with endotracheal intubation.
Correct Answer: A
Rationale: The PAWP indicates that the patient's preload is elevated and
furosemide is indicated to reduce the preload and improve cardiac output.
Epinephrine would further increase myocardial oxygen demand and might extend
the MI. The PAWP is already elevated, so normal saline boluses would be
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, Critical Care exam 2
contraindicated. There is no indication that the patient requires endotracheal
intubation.
The triage nurse receives a call from a community member who is driving an
unconscious friend with multiple injuries after a motorcycle accident to the
hospital. The caller states that they will be arriving in 1 minute. In preparation for
the patient's arrival, the nurse will obtain
a. a liter of lactated Ringer's solution.
b. 500 ml of 5% albumin.
c. two 14-gauge IV catheters.
d. a retention catheter.
Correct Answer: C
Rationale: A patient with multiple trauma may require fluid resuscitation to
prevent or treat hypovolemic shock, so the nurse will anticipate the need for 2
large bore IV lines to administer normal saline. Lactated Ringer's solution should
be used cautiously and will not be ordered until the patient had been assessed for
possible liver abnormalities. Although colloids may sometimes be used for volume
expansion, it is generally accepted that crystalloids should be used as the initial
therapy for fluid resuscitation. A catheter would likely be ordered, but in the 1
minute that the nurse has to obtain supplies, the IV catheters would take priority.
The nurse is caring for a patient admitted with a urinary tract infection and sepsis.
Which information obtained in the assessment indicates a need for a change in
therapy?
a. The patient is restless and anxious.
b. The patient has a heart rate of 134.
c. The patient has hypotonic bowel sounds.
d. The patient has a temperature of 94.1° F.
Correct Answer: D
Rationale: Hypothermia is an indication that the patient is in the progressive stage
of shock. The other data are consistent with compensated shock.
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CRITICAL CARE EXAM 2 NEWEST 2025/2026 COMPLETE ALL
QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+||BRAND NEW VERSION!
A diabetic patient who has had vomiting and diarrhea for the past 3 days is
admitted to the hospital with a blood glucose of 748 mg/ml (41.5 mmol/L) and a
urinary output of 120 ml in the first hour. The vital signs are blood pressure (BP)
72/62; pulse 128, irregular and thready; respirations 38; and temperature 97° F
(36.1° C). The patient is disoriented and lethargic with cold, clammy skin and
cyanosis in the hands and feet. The nurse recognizes that the patient is
experiencing the
a. progressive stage of septic shock.
b. compensatory stage of diabetic shock.
c. refractory stage of cardiogenic shock.
d. progressive stage of hypovolemic shock.
Correct Answer: D
Rationale: The patient's history of hyperglycemia (and the associated polyuria),
vomiting, and diarrhea is consistent with hypovolemia, and the symptoms are
most consistent with the progressive stage of shock. The patient's temperature of
97° F is inconsistent with septic shock. The history is inconsistent with a diagnosis
of cardiogenic shock, and the patient's neurologic status is not consistent with
refractory shock.
A patient who has been involved in a motor-vehicle crash is admitted to the ED
with cool, clammy skin, tachycardia, and hypotension. All of these orders are
written. Which one will the nurse act on first?
a. Insert two 14-gauge IV catheters.
b. Administer oxygen at 100% per non-rebreather mask.
c. Place the patient on continuous cardiac monitor.
d. Draw blood to type and crossmatch for transfusions.
1|Page
, Critical Care exam 2
Correct Answer: B
Rationale: The first priority in the initial management of shock is maintenance of
the airway and ventilation. Cardiac monitoring, insertion of IV catheters, and
obtaining blood for transfusions should also be rapidly accomplished, but only
after actions to maximize oxygen delivery have been implemented.
A patient with massive trauma and possible spinal cord injury is admitted to the
ED. The nurse suspects that the patient may be experiencing neurogenic shock in
addition to hypovolemic shock, based on the finding of
a. cool, clammy skin.
b. shortness of breath.
c. heart rate of 48 beats/min
d. BP of 82/40 mm Hg.
Correct Answer: C
Rationale: The normal sympathetic response to shock/hypotension is an increase
in heart rate. The presence of bradycardia suggests unopposed parasympathetic
function, as occurs in neurogenic shock. The other symptoms are consistent with
hypovolemic shock.
A patient in septic shock has not responded to fluid resuscitation, as evidenced by
a decreasing BP and cardiac output. The nurse anticipates the administration of
a. nitroglycerine (Tridil).
b. dobutamine (Dobutrex).
c. norepinephrine (Levophed).
d. sodium nitroprusside (Nipride).
Correct Answer: C
Rationale: When fluid resuscitation is unsuccessful, administration of vasopressor
drugs is used to increase the systemic vascular resistance (SVR) and improve tissue
perfusion. Nitroglycerin would decrease the preload and further drop cardiac
output and BP. Dobutamine will increase stroke volume, but it would also further
decrease SVR. Nitroprusside is an arterial vasodilator and would further decrease
SVR.
2|Page
, Critical Care exam 2
All of these collaborative interventions are ordered by the health care provider for
a patient stung by a bee who develops severe respiratory distress and faintness.
Which one will the nurse administer first?
a. Epinephrine (Adrenalin)
b. Normal saline infusion
c. Dexamethasone (Decadron)
d. Diphenhydramine (Benadryl)
Correct Answer: A
Rationale: Epinephrine rapidly causes peripheral vasoconstriction, dilates the
bronchi, and blocks the effects of histamine and reverses the vasodilation,
bronchoconstriction, and histamine release that cause the symptoms of
anaphylaxis. The other interventions are also appropriate but would not be the
first ones administered.
A patient with a myocardial infarction (MI) and cardiogenic shock has the
following vital signs: BP 86/50, pulse 126, respirations 30. Hemodynamic
monitoring reveals an elevated PAWP and decreased cardiac output. The nurse
will anticipate
a. administration of furosemide (Lasix) IV.
b. titration of an epinephrine (Adrenalin) drip.
c. administration of a normal saline bolus.
d. assisting with endotracheal intubation.
Correct Answer: A
Rationale: The PAWP indicates that the patient's preload is elevated and
furosemide is indicated to reduce the preload and improve cardiac output.
Epinephrine would further increase myocardial oxygen demand and might extend
the MI. The PAWP is already elevated, so normal saline boluses would be
3|Page
, Critical Care exam 2
contraindicated. There is no indication that the patient requires endotracheal
intubation.
The triage nurse receives a call from a community member who is driving an
unconscious friend with multiple injuries after a motorcycle accident to the
hospital. The caller states that they will be arriving in 1 minute. In preparation for
the patient's arrival, the nurse will obtain
a. a liter of lactated Ringer's solution.
b. 500 ml of 5% albumin.
c. two 14-gauge IV catheters.
d. a retention catheter.
Correct Answer: C
Rationale: A patient with multiple trauma may require fluid resuscitation to
prevent or treat hypovolemic shock, so the nurse will anticipate the need for 2
large bore IV lines to administer normal saline. Lactated Ringer's solution should
be used cautiously and will not be ordered until the patient had been assessed for
possible liver abnormalities. Although colloids may sometimes be used for volume
expansion, it is generally accepted that crystalloids should be used as the initial
therapy for fluid resuscitation. A catheter would likely be ordered, but in the 1
minute that the nurse has to obtain supplies, the IV catheters would take priority.
The nurse is caring for a patient admitted with a urinary tract infection and sepsis.
Which information obtained in the assessment indicates a need for a change in
therapy?
a. The patient is restless and anxious.
b. The patient has a heart rate of 134.
c. The patient has hypotonic bowel sounds.
d. The patient has a temperature of 94.1° F.
Correct Answer: D
Rationale: Hypothermia is an indication that the patient is in the progressive stage
of shock. The other data are consistent with compensated shock.
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