1|Page
NUR 445/NURS 445 EXAM 3: CRITICAL CARE &
COMPLEX DISORDERS LATEST 2026 UPDATE |
260 QUESTIONS WITH RATIONALES |
FIRST‑TIME PASS GUARANTEE
## Table of Contents
| Section | Title | Question Numbers |
|---------|-------|------------------|
| 1 | Neurological Critical Care (ICP, TBI, Stroke, Seizures, Neurogenic
Shock) | 1–45 |
| 2 | Endocrine & Metabolic Emergencies (DKA, HHS, SIADH, DI,
Thyroid Storm, Adrenal Crisis) | 46–90 |
| 3 | Shock States & Hemodynamic Monitoring | 91–125 |
| 4 | Respiratory Critical Care (ARDS, Mechanical Ventilation, PE,
Pneumothorax) | 126–160 |
| 5 | Cardiac Emergencies (Tamponade, Arrhythmias, ACS, Hypertensive
Crises) | 161–185 |
| 6 | Multisystem & Hematologic Disorders (MODS, DIC, Burns,
Transfusions) | 186–210 |
| 7 | Renal, GI & Infectious Critical Care (AKI, Pancreatitis, Sepsis,
VAP) | 211–235 |
| 8 | Pharmacology & Rapid Fire Review for Exam Success | 236–260 |
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# SECTION 1: NEUROLOGICAL CRITICAL CARE (Questions 1–45)
**1.** A nurse is assessing a patient with a traumatic brain injury. Vital
signs: BP 192/98, HR 48, respirations irregular and shallow. The nurse
correctly identifies this as:
A) Neurogenic shock
B) Cushing's triad
C) Malignant hypertension
D) Autonomic dysreflexia
**Answer: B**
**Rationale:** Cushing's triad (hypertension, bradycardia, irregular
respirations) indicates increased ICP with brainstem compression.
Neurogenic shock causes hypotension/bradycardia.
**2.** A patient's Glasgow Coma Scale (GCS) is E2, V2, M4. The nurse
interprets this as:
A) Mild TBI (13–15)
B) Moderate TBI (9–12)
C) Severe TBI (≤8)
D) No brain injury
**Answer: C** (Total score = 8)
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**Rationale:** GCS ≤8 = severe injury; patient likely requires
intubation for airway protection.
**3.** The earliest sign of increased intracranial pressure (ICP) is:
A) Pupil dilation
B) Change in level of consciousness (LOC)
C) Projectile vomiting
D) Seizures
**Answer: B**
**Rationale:** Restlessness, confusion, and drowsiness occur before
pupillary or motor changes.
**4.** A patient with an epidural hematoma is most likely to
experience:
A) Slow, progressive confusion over 24 hours
B) A lucid interval followed by sudden deterioration
C) Isolated motor deficits without mental status change
D) Symptoms resolving with head elevation
**Answer: B**
**Rationale:** Epidural bleeds (arterial, middle meningeal artery) →
brief lucid period → rapid herniation.
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**5.** Which finding is the priority to report in a patient
post‑craniotomy?
A) ICP 16 mm Hg
B) CPP 70 mm Hg
C) Clear drainage from the nose
D) Pain score 4/10
**Answer: C**
**Rationale:** Clear rhinorrhea suggests CSF leak → meningitis risk.
Normal ICP <20, CPP >60.
**6.** A patient with a left‑hemispheric stroke is expected to have:
A) Left‑sided neglect and impulsivity
B) Aphasia and right‑sided weakness
C) Inability to recognize faces
D) Ataxia and vertigo
**Answer: B**
**Rationale:** Left hemisphere → language (aphasia) and right
motor/sensory deficits.
NUR 445/NURS 445 EXAM 3: CRITICAL CARE &
COMPLEX DISORDERS LATEST 2026 UPDATE |
260 QUESTIONS WITH RATIONALES |
FIRST‑TIME PASS GUARANTEE
## Table of Contents
| Section | Title | Question Numbers |
|---------|-------|------------------|
| 1 | Neurological Critical Care (ICP, TBI, Stroke, Seizures, Neurogenic
Shock) | 1–45 |
| 2 | Endocrine & Metabolic Emergencies (DKA, HHS, SIADH, DI,
Thyroid Storm, Adrenal Crisis) | 46–90 |
| 3 | Shock States & Hemodynamic Monitoring | 91–125 |
| 4 | Respiratory Critical Care (ARDS, Mechanical Ventilation, PE,
Pneumothorax) | 126–160 |
| 5 | Cardiac Emergencies (Tamponade, Arrhythmias, ACS, Hypertensive
Crises) | 161–185 |
| 6 | Multisystem & Hematologic Disorders (MODS, DIC, Burns,
Transfusions) | 186–210 |
| 7 | Renal, GI & Infectious Critical Care (AKI, Pancreatitis, Sepsis,
VAP) | 211–235 |
| 8 | Pharmacology & Rapid Fire Review for Exam Success | 236–260 |
,2|Page
# SECTION 1: NEUROLOGICAL CRITICAL CARE (Questions 1–45)
**1.** A nurse is assessing a patient with a traumatic brain injury. Vital
signs: BP 192/98, HR 48, respirations irregular and shallow. The nurse
correctly identifies this as:
A) Neurogenic shock
B) Cushing's triad
C) Malignant hypertension
D) Autonomic dysreflexia
**Answer: B**
**Rationale:** Cushing's triad (hypertension, bradycardia, irregular
respirations) indicates increased ICP with brainstem compression.
Neurogenic shock causes hypotension/bradycardia.
**2.** A patient's Glasgow Coma Scale (GCS) is E2, V2, M4. The nurse
interprets this as:
A) Mild TBI (13–15)
B) Moderate TBI (9–12)
C) Severe TBI (≤8)
D) No brain injury
**Answer: C** (Total score = 8)
,3|Page
**Rationale:** GCS ≤8 = severe injury; patient likely requires
intubation for airway protection.
**3.** The earliest sign of increased intracranial pressure (ICP) is:
A) Pupil dilation
B) Change in level of consciousness (LOC)
C) Projectile vomiting
D) Seizures
**Answer: B**
**Rationale:** Restlessness, confusion, and drowsiness occur before
pupillary or motor changes.
**4.** A patient with an epidural hematoma is most likely to
experience:
A) Slow, progressive confusion over 24 hours
B) A lucid interval followed by sudden deterioration
C) Isolated motor deficits without mental status change
D) Symptoms resolving with head elevation
**Answer: B**
**Rationale:** Epidural bleeds (arterial, middle meningeal artery) →
brief lucid period → rapid herniation.
, 4|Page
**5.** Which finding is the priority to report in a patient
post‑craniotomy?
A) ICP 16 mm Hg
B) CPP 70 mm Hg
C) Clear drainage from the nose
D) Pain score 4/10
**Answer: C**
**Rationale:** Clear rhinorrhea suggests CSF leak → meningitis risk.
Normal ICP <20, CPP >60.
**6.** A patient with a left‑hemispheric stroke is expected to have:
A) Left‑sided neglect and impulsivity
B) Aphasia and right‑sided weakness
C) Inability to recognize faces
D) Ataxia and vertigo
**Answer: B**
**Rationale:** Left hemisphere → language (aphasia) and right
motor/sensory deficits.
