Critical Care HESI Exam 2026| Actual
Exam Questions and Rationales for
Guaranteed Pass
1. ID: 20123067301
Question: The nurse is assessing a client who is 12 hours postoperative for the removal of a
benign pituitary brain tumor and has been placed in a drug-induced coma with normal saline
0.9% infusing at 125 mL/hr. The client's heart rate is 90 beats/minute, blood pressure 100/60
mmHg, and the indwelling urinary catheter has drained 250 mL of pale yellow urine in the last
30 minutes into the collection bag. After reporting these findings to the healthcare provider,
which action should the nurse implement?
A. Identify the underlying cause of this condition.
B. Prepare to administer desmopressin (DDAVP).
C. Decrease the intravenous fluids to a maintenance rate.
D. Replace fluid losses with D5W every shift.
Correct Answer: B
Explanation: This client is showing signs of neurogenic diabetes insipidus (DI), which
commonly occurs after pituitary surgery due to deficient antidiuretic hormone (ADH). DI causes
massive polyuria (here, 500 mL/hour), leading to hypovolemia. Desmopressin (DDAVP) is the
treatment of choice to replace the missing ADH and control urine output.
2. ID: 20123066699
Question: An intubated client is in the process of being weaned off ventilator support. The
client's baseline parameters are temperature 98.2 F (36.8 C), heart rate 88 beats/minute,
respirations 14 breaths/minute, blood pressure 112/78 mmHg, and oxygen saturation 94%.
Which assessment findings would indicate to the nurse that the client is tolerating the weaning
procedure? (Select all that apply.)
A. Oxygen saturation is 91%.
B. Slight nasal flaring is present.
C. Heart rate is 97 beats/minute.
,D. Work of breathing is done by client.
E. Respiratory rate is 36 breaths/minute.
Correct Answers: A, C, D
Explanation: Tolerance of weaning includes oxygen saturation ≥90%, heart rate increase <20%
from baseline, and most work of breathing performed by the client. A respiratory rate of 36
breaths/minute is too high, and nasal flaring indicates increased work of breathing and
intolerance.
3. ID: 20123066697
Question: The nurse is assessing a burn victim who suffered destruction of the epidermis and
some of the dermis of the entire right arm and half the length of the right leg. How should the
nurse document the burn assessment findings?
A. Superficial, 18% TBSA.
B. Superficial partial-thickness, 18% TBSA.
C. Deep-partial thickness, 27% TBSA.
D. Full-thickness, 27% TBSA.
Correct Answer: B
Explanation: Destruction of the epidermis and some dermis describes a superficial partial-
thickness burn. Using the Rule of Nines, one arm = 9% and half a leg = 9%, for a total of 18%
TBSA.
4. ID: 20123066695
Question: The critical care nurse is providing care for a client diagnosed clinically brain dead and
identified as an organ donor. Which are the nurse's priorities in providing care? (Select all that
apply.)
A. Sustaining a state of hypothermia.
B. Maintaining a normal blood pressure.
C. Ensuring adequate oxygenation and ventilation.
D. Treating any coagulopathy, thrombocytopenia and anemia.
E. Monitoring arterial blood gases and serum electrolytes levels.
Correct Answers: B, C, D, E
, Explanation: After brain death is declared, care shifts to preserving organ function for donation.
Priorities include maintaining normal blood pressure, adequate oxygenation/ventilation, treating
coagulopathy/anemia/thrombocytopenia, and monitoring ABGs and electrolytes. Hypothermia is
avoided (normothermia is the goal).
5. ID: 20123066691
Question: A client is admitted to the intensive care unit with hematemesis related to esophageal
varices. Which assessment finding should the nurse identify that is the result of an estimated
blood loss at 35% of total blood volume?
A. Absent bowel sounds.
B. Coma.
C. Anuria.
D. Abdominal pain.
Correct Answer: A
Explanation: Blood loss of 30–40% causes decreased perfusion to non-vital organs, resulting in
absent bowel sounds, lethargy, and elevated serum potassium. Anuria and coma occur with >40%
loss.
6. ID: 20123066689
Question: The nurse is planning care for a client admitted to the intensive care unit with acute
infected necrotizing pancreatitis. Which diagnostic procedure should the nurse prepare the client
to expect the healthcare provider to prescribe?
A. Contrast-enhanced computed tomography (CT).
B. Endoscopic retrograde cholangiopancreatography (ERCP).
C. Abdominal radiography.
D. Abdominal ultrasound.
Correct Answer: A
Explanation: Contrast-enhanced CT is the gold standard imaging test to evaluate the extent of
pancreatic necrosis in necrotizing pancreatitis.
7. ID: 20123066686
Question: The nurse is caring for a client admitted to the surgical intensive care unit (ICU) after
undergoing gastrointestinal surgery. Which intervention should the nurse include in the plan of
care to minimize the risk for vomiting?
Exam Questions and Rationales for
Guaranteed Pass
1. ID: 20123067301
Question: The nurse is assessing a client who is 12 hours postoperative for the removal of a
benign pituitary brain tumor and has been placed in a drug-induced coma with normal saline
0.9% infusing at 125 mL/hr. The client's heart rate is 90 beats/minute, blood pressure 100/60
mmHg, and the indwelling urinary catheter has drained 250 mL of pale yellow urine in the last
30 minutes into the collection bag. After reporting these findings to the healthcare provider,
which action should the nurse implement?
A. Identify the underlying cause of this condition.
B. Prepare to administer desmopressin (DDAVP).
C. Decrease the intravenous fluids to a maintenance rate.
D. Replace fluid losses with D5W every shift.
Correct Answer: B
Explanation: This client is showing signs of neurogenic diabetes insipidus (DI), which
commonly occurs after pituitary surgery due to deficient antidiuretic hormone (ADH). DI causes
massive polyuria (here, 500 mL/hour), leading to hypovolemia. Desmopressin (DDAVP) is the
treatment of choice to replace the missing ADH and control urine output.
2. ID: 20123066699
Question: An intubated client is in the process of being weaned off ventilator support. The
client's baseline parameters are temperature 98.2 F (36.8 C), heart rate 88 beats/minute,
respirations 14 breaths/minute, blood pressure 112/78 mmHg, and oxygen saturation 94%.
Which assessment findings would indicate to the nurse that the client is tolerating the weaning
procedure? (Select all that apply.)
A. Oxygen saturation is 91%.
B. Slight nasal flaring is present.
C. Heart rate is 97 beats/minute.
,D. Work of breathing is done by client.
E. Respiratory rate is 36 breaths/minute.
Correct Answers: A, C, D
Explanation: Tolerance of weaning includes oxygen saturation ≥90%, heart rate increase <20%
from baseline, and most work of breathing performed by the client. A respiratory rate of 36
breaths/minute is too high, and nasal flaring indicates increased work of breathing and
intolerance.
3. ID: 20123066697
Question: The nurse is assessing a burn victim who suffered destruction of the epidermis and
some of the dermis of the entire right arm and half the length of the right leg. How should the
nurse document the burn assessment findings?
A. Superficial, 18% TBSA.
B. Superficial partial-thickness, 18% TBSA.
C. Deep-partial thickness, 27% TBSA.
D. Full-thickness, 27% TBSA.
Correct Answer: B
Explanation: Destruction of the epidermis and some dermis describes a superficial partial-
thickness burn. Using the Rule of Nines, one arm = 9% and half a leg = 9%, for a total of 18%
TBSA.
4. ID: 20123066695
Question: The critical care nurse is providing care for a client diagnosed clinically brain dead and
identified as an organ donor. Which are the nurse's priorities in providing care? (Select all that
apply.)
A. Sustaining a state of hypothermia.
B. Maintaining a normal blood pressure.
C. Ensuring adequate oxygenation and ventilation.
D. Treating any coagulopathy, thrombocytopenia and anemia.
E. Monitoring arterial blood gases and serum electrolytes levels.
Correct Answers: B, C, D, E
, Explanation: After brain death is declared, care shifts to preserving organ function for donation.
Priorities include maintaining normal blood pressure, adequate oxygenation/ventilation, treating
coagulopathy/anemia/thrombocytopenia, and monitoring ABGs and electrolytes. Hypothermia is
avoided (normothermia is the goal).
5. ID: 20123066691
Question: A client is admitted to the intensive care unit with hematemesis related to esophageal
varices. Which assessment finding should the nurse identify that is the result of an estimated
blood loss at 35% of total blood volume?
A. Absent bowel sounds.
B. Coma.
C. Anuria.
D. Abdominal pain.
Correct Answer: A
Explanation: Blood loss of 30–40% causes decreased perfusion to non-vital organs, resulting in
absent bowel sounds, lethargy, and elevated serum potassium. Anuria and coma occur with >40%
loss.
6. ID: 20123066689
Question: The nurse is planning care for a client admitted to the intensive care unit with acute
infected necrotizing pancreatitis. Which diagnostic procedure should the nurse prepare the client
to expect the healthcare provider to prescribe?
A. Contrast-enhanced computed tomography (CT).
B. Endoscopic retrograde cholangiopancreatography (ERCP).
C. Abdominal radiography.
D. Abdominal ultrasound.
Correct Answer: A
Explanation: Contrast-enhanced CT is the gold standard imaging test to evaluate the extent of
pancreatic necrosis in necrotizing pancreatitis.
7. ID: 20123066686
Question: The nurse is caring for a client admitted to the surgical intensive care unit (ICU) after
undergoing gastrointestinal surgery. Which intervention should the nurse include in the plan of
care to minimize the risk for vomiting?
