12,241 verified 4-option questions Double-checked by independent solution

NCLEX-RN Hemodynamics practice questions

4 questions · answers open · no sign-up

These are original practice items written to the NCLEX-RN blueprint (4 options, no penalty for wrong answers), not actual exam questions. Try each one before you open the answer.

What this topic covers

Hemodynamics sits inside the Physiological Adaptation category of the NCLEX-RN. Our bank holds 33 verified items tagged to it, and the 4 below are a fixed sample so the page stays the same every time you open it. Each one shows the reasoning, not just the letter.

The topic tag comes from our own items rather than from a published syllabus, so treat it as a map of what we cover. For the official category breakdown see the NCLEX-RN page.

Hemodynamics sample questions

Question 1

A 66-year-old client in the cardiac step-down unit has a pulmonary artery catheter. The nurse notes a pulmonary artery wedge pressure (PAWP) of 22 mm Hg, cardiac output of 3.2 L/min, and mean arterial pressure of 62 mm Hg. The client has crackles in the lung bases and jugular venous distention. Which hemodynamic pattern is most consistent with these findings?

  1. A Obstructive shock with increased afterload and decreased preload.
  2. B Hypovolemia with decreased preload and normal afterload.
  3. C Cardiogenic shock with increased preload and decreased contractility.
  4. D Distributive shock with decreased afterload and normal preload.
Show the answer and explanation

Correct answer: C

An elevated PAWP of 22 mm Hg shows high left-sided filling pressure, while the low cardiac output and MAP show pump failure. With crackles and jugular venous distention, this pattern fits cardiogenic shock.

Why the other options are wrong:
A: Obstructive shock such as massive pulmonary embolism usually lowers left-sided preload, and pulmonary crackles are not expected.
B: Hypovolemia causes a low PAWP, not 22 mm Hg.
D: Distributive shock lowers afterload and has a normal or high cardiac output early on.

Question 2

A 66-year-old client in the intensive care unit has a pulmonary artery catheter in place. The nurse measures the pulmonary artery wedge pressure (PAWP) and obtains a value of 4 mm Hg. The client's heart rate is 112 beats per minute, blood pressure is 82/50 mm Hg, and urine output has been 15 mL over the past hour. Which condition should the nurse suspect?

  1. A Cardiac tamponade with equalization of pressures.
  2. B Left ventricular failure with fluid volume overload.
  3. C Hypovolemia with decreased preload.
  4. D Pulmonary hypertension with right ventricular failure.
Show the answer and explanation

Correct answer: C

A PAWP of 4 mm Hg indicates low left ventricular filling pressure (preload). Combined with tachycardia, hypotension, and urine output of 15 mL/hr, the findings point to hypovolemia.

Why the other options are wrong:
A: Cardiac tamponade causes equalization of elevated diastolic pressures, not a low PAWP.
B: Left ventricular failure with volume overload raises PAWP, often above 18 mm Hg.
D: Pulmonary hypertension with right ventricular failure raises pulmonary artery and right-sided pressures and does not explain a low PAWP.

Question 3

A 45-year-old client in the intensive care unit has a pulmonary artery catheter in place. The nurse observes that the pulmonary artery wedge pressure (PAWP) has increased from 8 mm Hg to 18 mm Hg over the past 2 hours. The client's urine output is 15 mL/hr, and crackles are heard in the lung bases. Which condition does the nurse suspect?

  1. A Pulmonary embolism.
  2. B Acute hypovolemia.
  3. C Right ventricular failure.
  4. D Left ventricular failure.
Show the answer and explanation

Correct answer: D

PAWP reflects left atrial and left ventricular filling pressure, and a rise from 8 to 18 mm Hg (normal about 4 to 12) means the left ventricle is not pumping effectively. Crackles from pulmonary congestion and low urine output from reduced cardiac output confirm left ventricular failure.

Why the other options are wrong:
A: Pulmonary embolism raises pulmonary artery pressure, but PAWP stays normal or low and crackles are not typical.
B: Hypovolemia lowers PAWP and would not cause pulmonary crackles.
C: Right ventricular failure raises central venous pressure and causes systemic congestion such as jugular venous distention, not a high PAWP with crackles.

Question 4

A 60-year-old client in the cardiac step-down unit has a pulmonary artery catheter in place. The nurse notes a pulmonary artery wedge pressure (PAWP) of 22 mm Hg, cardiac output of 3.5 L/min, and mean arterial pressure (MAP) of 65 mm Hg. The client has crackles in the lung bases and peripheral edema. Which condition do these findings suggest?

  1. A Neurogenic shock
  2. B Hypovolemic shock
  3. C Septic shock
  4. D Cardiogenic shock
Show the answer and explanation

Correct answer: D

A PAWP of 22 mm Hg is elevated (normal 4-12 mm Hg), indicating increased left ventricular filling pressure consistent with fluid overload. The low cardiac output (3.5 L/min, normal 4-8 L/min) and low MAP (65 mm Hg, normal 70-100 mm Hg) along with crackles and edema point to pump failure, which is cardiogenic shock. Hypovolemic shock would show a low PAWP (less than 4 mm Hg) and low cardiac output. Septic shock typically presents with a high cardiac output and low systemic vascular resistance, not an elevated PAWP. Neurogenic shock involves vasodilation with low blood pressure but usually normal or low PAWP and no pulmonary congestion.

The whole NCLEX-RN bank

2,666 verified questions with explanations, timed category tests and an 85-item full-length practice test, a review pool that brings back what you missed until you get it right, and an AI tutor that explains why. One payment per exam, or one bundle for all of them.

NCLEX-RN practice opens soon: 2,666 questions verified so far. Purchase opens automatically when the bank is complete. About the NCLEX-RN

Related pages

All NCLEX-RN sample questions 8 categorys All Physiological Adaptation questions 3 topics Unexpected response to therapies with explanations Alterations in body systems with explanations TEAS 7 sample questions with explanations HESI A2 sample questions with explanations

TEAS is a registered trademark of Assessment Technologies Institute, LLC; HESI is a registered trademark of Elsevier Inc. NCLEX and NCLEX-RN are registered trademarks of the National Council of State Boards of Nursing, Inc. (NCSBN). AdmitNurse is an independent practice service, not affiliated with or endorsed by any of these organizations.