Q.1 Which of the following is the most critical initial assessment in a patient admitted to the ICU?
Pain level assessment
Airway, Breathing, Circulation assessment
Nutritional status assessment
Psychosocial assessment
Explanation - In critical care, the ABCs (Airway, Breathing, Circulation) are assessed first because they are essential for immediate survival.
Correct answer is: Airway, Breathing, Circulation assessment
Q.2 A patient in septic shock is likely to show which of the following signs?
Bradycardia and hypertension
Tachycardia and hypotension
Normal vital signs
Hypothermia and bradycardia
Explanation - Septic shock typically causes systemic vasodilation, resulting in hypotension and compensatory tachycardia.
Correct answer is: Tachycardia and hypotension
Q.3 Which intervention is priority when a patient develops acute respiratory distress in the ICU?
Administer IV fluids
Initiate supplemental oxygen or mechanical ventilation
Obtain blood cultures
Perform a skin assessment
Explanation - Maintaining oxygenation is the first priority in acute respiratory distress to prevent hypoxia and organ failure.
Correct answer is: Initiate supplemental oxygen or mechanical ventilation
Q.4 The primary purpose of a central venous catheter in critical care is:
Administer oral medications
Monitor central venous pressure and deliver IV therapies
Measure blood pressure non-invasively
Assist in physical therapy
Explanation - Central lines are used to deliver medications and fluids that require central access and to monitor CVP for hemodynamic status.
Correct answer is: Monitor central venous pressure and deliver IV therapies
Q.5 Which of the following is a common complication of mechanical ventilation?
Hypertension
Ventilator-associated pneumonia
Hypoglycemia
Renal calculi
Explanation - Mechanical ventilation increases the risk of infections like VAP due to impaired natural airway defenses.
Correct answer is: Ventilator-associated pneumonia
Q.6 A patient receiving vasopressor therapy should be monitored primarily for:
Hyperglycemia
Arrhythmias and blood pressure changes
Skin rash
Gastrointestinal upset
Explanation - Vasopressors can cause cardiac arrhythmias and significant blood pressure fluctuations; monitoring is essential.
Correct answer is: Arrhythmias and blood pressure changes
Q.7 Which lab value is most important to monitor in a patient receiving continuous renal replacement therapy (CRRT)?
Serum electrolytes
Hemoglobin A1c
Serum albumin
Prothrombin time
Explanation - CRRT affects fluid and electrolyte balance, so regular monitoring of electrolytes is critical to prevent complications.
Correct answer is: Serum electrolytes
Q.8 In critical care, the Glasgow Coma Scale is used to assess:
Lung function
Cardiac output
Level of consciousness
Renal function
Explanation - The GCS provides a standardized assessment of consciousness in critically ill patients, especially after neurological injuries.
Correct answer is: Level of consciousness
Q.9 Which of the following is an early sign of shock?
Hypotension
Tachycardia
Cyanosis
Coma
Explanation - Tachycardia is an early compensatory response to shock before hypotension and other late signs develop.
Correct answer is: Tachycardia
Q.10 The primary goal of sedation in mechanically ventilated patients is to:
Induce coma
Reduce anxiety and prevent self-harm while maintaining hemodynamic stability
Enhance muscle strength
Increase renal perfusion
Explanation - Sedation helps the patient tolerate mechanical ventilation safely and reduces stress without excessive sedation risks.
Correct answer is: Reduce anxiety and prevent self-harm while maintaining hemodynamic stability
Q.11 Which electrolyte imbalance is most dangerous in a critically ill patient?
Hyponatremia
Hyperkalemia
Hypocalcemia
Hypophosphatemia
Explanation - Hyperkalemia can precipitate life-threatening cardiac arrhythmias, making it particularly dangerous in critical care.
Correct answer is: Hyperkalemia
Q.12 Prone positioning is often used in patients with:
Acute respiratory distress syndrome (ARDS)
Congestive heart failure
Renal failure
Sepsis without lung involvement
Explanation - Prone positioning improves oxygenation in ARDS by enhancing ventilation-perfusion matching and alveolar recruitment.
Correct answer is: Acute respiratory distress syndrome (ARDS)
Q.13 Which of the following is a priority nursing action for a patient with elevated intracranial pressure (ICP)?
Encourage coughing and deep breathing
Maintain head of bed at 30 degrees and avoid neck flexion
Increase fluid intake aggressively
Administer high-dose sedatives routinely
Explanation - Proper positioning helps reduce ICP and promotes venous drainage from the brain.
Correct answer is: Maintain head of bed at 30 degrees and avoid neck flexion
Q.14 Which medication is commonly used to reduce gastric stress ulcers in critically ill patients?
Omeprazole
Furosemide
Lisinopril
Acetaminophen
Explanation - Proton pump inhibitors like omeprazole are used to prevent stress-related mucosal damage in ICU patients.
Correct answer is: Omeprazole
Q.15 Early goal-directed therapy in sepsis primarily aims to:
Maintain normal oxygen saturation, blood pressure, and urine output
Administer sedatives
Limit caloric intake
Reduce white blood cell count
Explanation - Early goal-directed therapy improves tissue perfusion and outcomes in septic patients by optimizing hemodynamics.
Correct answer is: Maintain normal oxygen saturation, blood pressure, and urine output
Q.16 The primary reason for continuous cardiac monitoring in ICU patients is to detect:
Sleep disturbances
Cardiac arrhythmias
Nutritional deficiencies
Seizure activity
Explanation - ICU patients are at high risk of arrhythmias due to medications, electrolyte imbalances, and underlying cardiac conditions.
Correct answer is: Cardiac arrhythmias
Q.17 Which of the following is a key feature of multi-organ dysfunction syndrome (MODS)?
Isolated organ failure
Progressive dysfunction of two or more organ systems
Rapid healing of organs
Stable vital signs
Explanation - MODS is characterized by the progressive failure of multiple organ systems, often secondary to severe sepsis or trauma.
Correct answer is: Progressive dysfunction of two or more organ systems
Q.18 Which action is essential when a patient has a sudden drop in oxygen saturation on the ventilator?
Increase IV fluids
Assess for airway obstruction, tube displacement, or pneumothorax
Administer oral medications
Encourage ambulation
Explanation - Rapid assessment of the airway and ventilator circuit is critical to identify life-threatening causes of hypoxia.
Correct answer is: Assess for airway obstruction, tube displacement, or pneumothorax
Q.19 Which of the following is a primary complication of immobility in critically ill patients?
Pressure ulcers
Hypertension
Hyperthermia
Hyperactive reflexes
Explanation - Immobility increases the risk of skin breakdown and pressure ulcers due to prolonged pressure on bony prominences.
Correct answer is: Pressure ulcers
Q.20 In the ICU, a sudden spike in body temperature may indicate:
Improved patient outcome
Infection or sepsis
Renal failure
Electrolyte imbalance
Explanation - Fever in critically ill patients is often an early sign of infection or sepsis and requires immediate evaluation.
Correct answer is: Infection or sepsis
Q.21 Which hemodynamic parameter reflects the amount of blood ejected by the left ventricle per minute?
Central venous pressure (CVP)
Cardiac output (CO)
Mean arterial pressure (MAP)
Pulmonary artery pressure (PAP)
Explanation - Cardiac output measures the volume of blood pumped by the heart per minute and is critical in assessing circulatory function.
Correct answer is: Cardiac output (CO)
Q.22 The main goal of nutritional support in critical care is to:
Promote rapid weight gain
Prevent malnutrition and support healing
Induce ketosis
Eliminate fluid overload
Explanation - Adequate nutrition in ICU patients prevents catabolism, supports immune function, and promotes tissue repair.
Correct answer is: Prevent malnutrition and support healing
Q.23 Which of the following is an indicator of inadequate perfusion in critically ill patients?
Warm extremities
Hypotension, decreased urine output, and altered mental status
Normal blood pressure
Bradycardia only
Explanation - These signs indicate poor tissue perfusion and organ dysfunction, often seen in shock states.
Correct answer is: Hypotension, decreased urine output, and altered mental status
Q.24 Which nursing intervention is essential for preventing deep vein thrombosis (DVT) in immobilized ICU patients?
Frequent repositioning and use of compression devices
Fluid restriction
Administering sedatives
Restricting protein intake
Explanation - Mobility and mechanical prophylaxis help prevent venous stasis and DVT in immobilized patients.
Correct answer is: Frequent repositioning and use of compression devices