Critical Care nursing NCLEX Questions

The critical care nursing program is designed to train nurses who will provide specialized care to patients who are critically ill or are suffering from life-threatening injuries that require advanced care in ICUs, emergency rooms, neonatal ICUs, pediatrics ICUs, cardiac care units, cardiac catheter labs, telemetry units, progressive units, and recovery rooms.

But before you can become a critical care nurse, you must pass through various stages, the first stage is obtaining a BSN degree certificate from an accredited nursing school and then proceeding to registering and writing the NCLEX exam.

To successfully pass the critical care nursing NCLEX exam you need to prepare adequately for it by studying extensively and reviewing past questions.

Studying the past critical care nursing NCLEX questions provides hints and guidelines on everything you need to know about the nature and pattern of the NCLEX exam.

Passing the critical care nursing NCLEX exam should be your utmost priority as this is the only medium that qualifies you to become a registered nurse and also provides you with an opportunity to acquire your nursing license to start practicing your nursing profession and obtain a nursing job.

If you are planning on writing the NCLEX exam, then this content is for you. I have provided a list of past critical care nursing questions that you can start practicing with before the exam date, make sure you read this content till the end.

Critical care Nursing NCLEX questions 

The following are some of the critical care nursing NCLEX questions that you can use as study  guide

1 .A patient who has been in the intensive care unit for 4 days has disturbed sensory perception from sleep deprivation. Which action should the nurse include in the plan of care?

1. Administer prescribed sedatives or opioids at bedtime to promote sleep.
2.  Cluster nursing activities so that the patient has uninterrupted rest periods.
3. Silence the alarms on the cardiac monitors to allow 30- to 40-minute naps.
4. Eliminate assessments between 2200 and 0600 to allow uninterrupted sleep.

Correct Answer (B)

2. Which hemodynamic parameter best reflects the effectiveness of drugs that the nurse gives to reduce a patient’s left ventricular afterload?

1. Mean arterial pressure (MAP)
2. Systemic vascular resistance (SVR)
3. Pulmonary vascular resistance (PVR)
4. Pulmonary artery wedge pressure (PAWP)

Correct Answer (B)

3.While close family members are visiting, a patient has a respiratory arrest, and resuscitation is started. Which action by the nurse is best?

1. Tell the family members that watching the resuscitation will be very stressful.
2.  Ask family members if they wish to remain in the room during the resuscitation.
3. Take the family members quickly out of the patient room and remain with them.
4. Assign a staff member to wait with family members just outside the patient room.

Correct Answer (B)

4. After surgery for an abdominal aortic aneurysm, a patient’s central venous pressure (CVP) monitor indicates low pressures. Which action should the nurse take?

1. Administer IV diuretic medications.
2. Increase the IV fluid infusion per protocol.
3. Increase the infusion rate of IV vasodilators.
4. Elevate the head of the patient’s bed to 45 degrees.

Correct Answer (B)

5. When caring for a patient with pulmonary hypertension, which parameter will the nurse use to directly evaluate the effectiveness of the treatment?

1. Central venous pressure (CVP)
2. Systemic vascular resistance (SVR)
3. Pulmonary vascular resistance (PVR)
4. Pulmonary artery wedge pressure (PAWP)

Correct Answer ( C)

6. What action by a new intensive care unit staff nurse would indicate that the nurse educator’s teaching about arterial pressure monitoring has been effective?

1. Balances and calibrates the monitoring equipment every 2 hours.
2. Positions the zero-reference stopcock line level with the phlebostatic axis.
3. Ensures that the patient is supine with the head of the bed flat for all readings.
4. Rechecks the location of the phlebostatic axis with changes in the patient’s position.

Correct Answer (B)

7. When monitoring the effectiveness of treatment for a patient with a large anterior wall myocardial infarction, what is the most pertinent measurement for the nurse to obtain?

1. Central venous pressure (CVP)
2. Systemic vascular resistance (SVR)
3.  Pulmonary vascular resistance (PVR)
4. Pulmonary artery wedge pressure (PAWP)

Correct Answer (D)

8.Which action should the nurse take first when the low pressure alarm sounds for a patient who has an arterial line in the left radial artery?

1. Assess for dysrhythmias.
2. Fast flush the arterial line.
3. Check the left hand for pallor.
4.  Re-zero the monitoring equipment.

Correct Answer (A)

9.Which nursing action is needed when preparing to assist with the insertion of a pulmonary artery catheter?

A)Determine if the cardiac troponin level is elevated.

b. Auscultate heart sounds before and during insertion.
c. Place the patient on NPO status before the procedure.
d. Attach cardiac monitoring leads before the procedure.

Correct Answer (D)

10. The nurse is assisting with the placement of a pulmonary artery (PA) catheter. What would the nurse expect to see on the monitor as an indication that the catheter with an inflated balloon is placed correctly?

1. Typical PA pressure waveform
2. Tracing of the systemic arterial pressure
3. Tracing of the systemic vascular resistance
4. Typical PA wedge pressure (PAWP) tracing

Correct Answer (D)

11. Which finding by the nurse caring for a patient with a right radial arterial line indicates a need for the nurse to take immediate action?

1. The right hand feels cooler than the left hand.
2.  The mean arterial pressure (MAP) is 77 mm Hg.
3. The system is delivering 3 mL of flush solution per hour.
4. The flush bag and tubing were changed 2 days previously.

Correct Answer (A)

12. The central venous oxygen saturation (ScvO2) is decreasing in a patient who has severe pancreatitis. What would the nurse assess to determine the possible cause of the decreased ScvO2?

1. Lipase level
2. Temperature
3. Urinary output
4. Body mass index

Correct Answer ( B)

13. An intra aortic balloon pump (IABP) is being used for a patient who is in cardiogenic shock. Which data indicate to the nurse that the goals of treatment with the IABP are being met?

1. Urine output of 25 mL/hr
2. Heart rate of 110 beats/min
3. Cardiac output (CO) of 5 L/min
4. Stroke volume (SV) of 40 mL/beat

Correct Answer ( C)

14. The nurse is caring for a patient who has an intra aortic balloon pump in place. Which action should be included in the plan of care?

1. Avoid the use of anticoagulant medications.
2. Measure the patient’s urinary output every hour.
3. Provide passive range of motion for all extremities.
4. Position the patient supine with head flat at all times.

Correct Answer (B)

15. While waiting for heart transplantation, a patient with severe cardiomyopathy has a ventricular assist device (VAD) implanted. What should the nurse anticipate when planning care for this patient?

1. Preparing the patient for a permanent VAD
2. Teaching the patient the reason for bed rest
3. Monitoring the incision for signs of infection
4. Administering immunosuppressants medications

Correct Answer ( C)

16. What is the best initial action by the nurse to verify the correct placement of an oral endotracheal tube (ET) after insertion?

1. Obtain a portable chest x-ray.
2. Use an end-tidal CO2 monitor.
3. Auscultate for bilateral breath sounds.
4. Observe for symmetrical chest movement.

Correct Answer (B)

17. How should the nurse maintain proper cuff pressure of an endotracheal tube (ET) when the patient is on mechanical ventilation?

1. Inflate the cuff with a minimum of 10 mL of air.
2. Inflate the cuff until the pilot balloon is firm on palpation.
3. Inject air into the cuff until a manometer shows 15 mm Hg pressure.
4. Inject air into the cuff until a slight leak is heard only at peak inflation.

Correct Answer ( C)

18. The nurse notes premature ventricular contractions (PVCs) while suctioning a patient’s endotracheal tube. Which next action by the nurse is indicated?

1. Plan to suction the patient more frequently.
2. Decrease the suction pressure to 80 mm Hg.
3. Give antidysrhythmic medications per protocol.
4. Stop and ventilate the patient with 100% oxygen

Correct Answer (D)

19. Which assessment finding by the nurse caring for a patient receiving mechanical ventilation indicates the need for suctioning?

1. The patient was last suctioned 6 hours ago.
2. The patient’s oxygen saturation drops to 93%.
3. The patient’s respiratory rate is 32 breaths/min.
4. The patient has occasional audible expiratory wheezes

Correct Answer ( B)

20. The nurse notes thick, white secretions in the endotracheal tube (ET) of a patient who is receiving mechanical ventilation. Which intervention will most directly treat this finding?

1. Reposition the patient every 1 to 2 hours.
2. Increase suction frequency to every hour.
3. Add additional water to the patient’s internal feedings.
4. Instil 5 mL of sterile saline into the ET before suctioning

Correct Answer (B)

21. Four hours after mechanical ventilation is initiated, a patient’s arterial blood gas (ABG) results include a pH of 7.51, PaO2 of 82 mm Hg, PaCO2 of 26 mm Hg, and HCO3?2- of 23 mEq/L (23 mmol/L). What change should the nurse anticipate to the ventilator settings?

1.  Increase the FIO2.
2. Increase the tidal volume.
3.  Increase the respiratory rate.
4. Decrease the respiratory rate

Correct Answer (D)

22. A patient with respiratory failure has arterial pressure–based cardiac output (APCO) monitoring and is receiving mechanical ventilation with peak end-expiratory pressure (PEEP) of 12 cm H2O. Which information indicates that a change in the ventilator settings may be required?

1. The arterial pressure is 90/46.
2. The heart rate is 58 beats/min.
3. The stroke volume is increased.
4. The stroke volume variation is 12%.

Correct Answer (B)

23. The nurse is weaning a 68-kg patient who has chronic obstructive pulmonary disease (COPD) from mechanical ventilation. Which finding indicates that the weaning protocol should be stopped?

1. The patient’s heart rate is 97 beats/min.
2. The patient’s oxygen saturation is 93%.
3. The patient respiratory rate is 32 breaths/min.
4. The patient’s spontaneous tidal volume is 450 mL

Correct Answer ( C)

24. The nurse is caring for a patient receiving a continuous norepinephrine IV infusion. Which finding indicates that the infusion rate may need to be adjusted?

1. Heart rate is slow at 58 beats/min.
2. Mean arterial pressure (MAP) is 56 mm Hg.
3. Systemic vascular resistance (SVR) is elevated.
4. Pulmonary artery wedge pressure (PAWP) is low

Correct Answer (A)

25. The nurse observes that the patient’s central venous catheter insertion site is red and tender to touch. The patient’s temperature is 101.8° F. What should the nurse plan to do?

1. Discontinue the catheter and culture the tip.
2. Use the catheter only for fluid administration.
3. Change the flush system and monitor the site.
4. Check the site more frequently for any swelling.

Correct Answer (A)

26. An 81-yr-old patient who has been in the intensive care unit (ICU) for a week is now stable and transfer to the progressive care unit is planned. On rounds, the nurse notices that the patient has new onset confusion. What should the nurse plan to do?

1. Give PRN lorazepam (Ativan) and cancel the transfer.
2. Inform the receiving nurse and then transfer the patient.
3. Notify the health care provider and postpone the transfer.
4. Obtain an order for restraints as needed and transfer the patient.

Correct Answer ( C)

27. The family members of a patient who has been admitted to the intensive care unit (ICU) with multiple traumatic injuries have just arrived in the ICU waiting room. Which action should the nurse take first?

1. Explain ICU visitation policies and encourage family visits.
2. Escort the family from the waiting room to the patient’s bedside.
3. Describe the patient’s injuries and the care that is being provided.
4. Invite the family to participate in an interprofessional care conference.

Correct Answer (B)

28. The nurse is caring for a patient who has an arterial catheter in the left radial artery for arterial pressure–based cardiac output (APCO) monitoring. Which information obtained by the nurse requires a report to the health care provider?

1. The patient has a positive Allen test result.
2. There is redness at the catheter insertion site.
3. The mean arterial pressure (MAP) is 86 mm Hg.
4. The dicrotic notch is visible in the arterial waveform.

Correct Answer (B)

29. The nurse responding to a ventilator alarm finds the patient lying in bed gasping and the endotracheal tube on the floor. Which action should the nurse take next?

1. Activate the rapid response team.
2. Provide reassurance to the patient.
3. Call the health care provider to reinsert the tube.
4. Manually ventilate the patient with 100% oxygen.

Correct Answer (D)

30. The nurse notes that a patient’s endotracheal tube (ET), which was at the 22-cm mark, is now at the 25-cm mark, and the patient is anxious and restless. Which action should the nurse take next?

1. Check the O2 saturation.
2. Offer reassurance to the patient.
3. Listen to the patient’s breath sounds.
4. Notify the patient’s health care provider.

Correct Answer (A)

Final Thought

Critical care nursing NCLEX exam questions are computer-based and come along with multiple-choice questions and answer options.

For you to pass the NCLEX exam, you need to score a minimum of 50% and above. There are higher chances that these questions will be repeated in the next  exam.

You are to study these questions carefully as they are likely to appear again at the NCLEX exam for critical care nursing. Also, ensure you take note of the correct answers for each question.