Prophecy General ICU RN A v2 Updated Exam Questions & Answers
This comprehensive study guide contains verified questions and answers for the Prophecy General ICU RN A v2 exam. The content covers critical care nursing topics including hemodynamics, arterial blood gases, shock management, mechanical ventilation, medications, and ICU procedures. Use this guide to prepare for your Prophecy certification exam.
Arterial Blood Gases (ABGs)
Q1. ABG: pH 7.56, paCO2 24 mmHg, HCO3 23 mEq/L. What type of imbalance?
ANSWER: Respiratory Alkalosis
Q2. ABG: pH 7.25, pCO2 40, pO2 90, HCO3 20 mEq/L. What type of imbalance?
ANSWER: Metabolic Acidosis
Q3. ABG: pH 7.35, paCO2 60 mmHg, HCO3 38 mEq/L. What type of imbalance?
ANSWER: Compensated Respiratory Acidosis
Shock & Hemodynamics
Q4. A patient exhibits hypotension without an increase in HR. This is indicative of what type of shock?
ANSWER: Neurogenic Shock
Q5. A patient was admitted with hemoglobin of 6, hematocrit of 25, has clammy skin, confusion, agitation, BP 80/40, HR 145. What type of shock?
ANSWER: Hypovolemic Shock
Q6. Which of the following is a response of the cardiovascular system to early sepsis?
ANSWER: Increased cardiac output and reduced systemic vascular resistance
Q7. 90% of thrombi develop in which area of the body?
ANSWER: Legs
Cardiac Conditions & Procedures
Q8. What is cardiac tamponade?
ANSWER: Fluid in the pericardial sac causing decreased preload, which decreases stroke volume and ultimately cardiac output
Q9. Muffled heart sounds would indicate what condition?
ANSWER: Cardiac tamponade
Q10. IABP (Intra-Aortic Balloon Pump) optimal timing?
ANSWER: Inflation during diastole (AV closure) and deflation during systole (QRS)
Q11. IABP function?
ANSWER: Decrease afterload and increase coronary artery perfusion
Q12. What is endocarditis?
ANSWER: Inflammation of the inner lining of the heart
Medications – Cardiac & Vasoactive Drugs
Q13. Which medication improves contractility, increases stroke volume, and increases cardiac output?
ANSWER: Dobutamine
Q14. Dobutamine classification and action?
ANSWER: Inotrope & Dilator (Beta 1/2 agonist)
Q15. Dopamine classification and dosing?
ANSWER: Vasopressor (catecholamine). Dopamine agonist at low doses, beta agonist
at 5-10 mcg/kg/min, alpha agonist at higher doses
Q16. How is dopamine usually administered in the ICU?
ANSWER: Titratable continuous infusion
Q17. Epinephrine classification?
ANSWER: Vasopressor/catecholamine (Beta agonist, alpha agonist at large doses)
Q18. Amiodarone classification?
ANSWER: Antiarrhythmic
Q19. Nicardipine/Cardene classification?
ANSWER: Calcium Channel Blocker works on periphery – used for hypertensive crisis
Q20. Cardizem/Diltiazem classification?
ANSWER: Calcium channel blocker works on periphery and heart
Q21. Which of the following classes of drugs are used to therapeutically decrease venous return and reduce peripheral vascular resistance?
ANSWER: Nitrates
Respiratory & Airway Management
Q22. When assessing a chest tube, which of the following indicates a possible air leak?
ANSWER: Excessive bubbling in the water chamber
Q23. Your patient is in bed eating lunch when they begin to cough and gag.
Suddenly they become dyspneic and bradycardic with excessive salivation.
What do you suspect?
ANSWER: Aspiration
Q24. What respiratory support would an alert patient with an acute COPD exacerbation likely receive FIRST?
ANSWER: BiPAP
Q25. Which patient would you expect to be extubated?
ANSWER: Patient is awake, follows commands with RR of 14, FiO2 40%, and PEEP 5
Q26. What is a potential complication of high PEEP?
ANSWER: Pneumothorax
Q27. The physician is unable to clear the airway during choking. You would expect to prepare for which emergency procedure?
ANSWER: Tracheostomy
Neurological & Sedation
Q28. CAM-ICU is a measure for which condition?
ANSWER: Delirium
Q29. Which of the following IV sedatives would most likely be ordered for a non-intubated patient?
ANSWER: Precedex (Dexmedetomidine)
Q30. Pain assessment in an unconscious patient?
ANSWER: Requires astute assessment skills using multiple approaches
Renal & Metabolic
Q31. Your patient sustained a crushed pelvis in an MVC. You notice pinkish sediment in the urinary catheter tubing and decreased urinary output. What condition do you suspect?
ANSWER: Rhabdomyolysis
Q32. What is a significant complication of imaging studies performed with IV contrast?
ANSWER: Acute kidney injury
Q33. Long term use of TPN may lead to: ANSWER: Liver Failure
Endocrine
Q34. Which of the following drugs would you expect to administer in a patient diagnosed with myasthenia gravis?
ANSWER: Mestinon (Pyridostigmine)
Q35. An adrenocorticotropic hormone (ACTH) stimulation test would be ordered for which hormone?
ANSWER: Cortisol
Q36. Which of the following hormones is secreted by the hypothalamus to regulate water balance?
ANSWER: ADH (Antidiuretic Hormone)
Q37. The initial insulin therapy for a patient with acute DKA is usually administered by which route?
ANSWER: Intravenous bolus followed by continuous infusion
Procedures & Tests
Q38. Which of the following tests should be performed prior to administering tPA?
ANSWER: CT Scan
Q39. Common complications of massive transfusions are: ANSWER: Dilutional coagulopathy, DIC, hypothermia, and fibrinolysis
GI/Surgical
Q40. What is a common assessment finding for a patient returning from a small bowel resection?
ANSWER: Hypoactive bowel sounds
Q41. Which of the following can be given through an enteral feeding tube?
ANSWER: Crushed medications (if not extended-release)
Pharmacology – General
Q42. Which class of drugs should be avoided in patients with asthma?
ANSWER: Beta Blockers
Q43. When administering a titratable infusion, what information must you check on the medication IV bag to confirm the correct dose?
ANSWER: Concentration
Patient Assessment & Safety
Q44. Your patient suddenly becomes diaphoretic, anxious, tachycardic, and has clammy skin. Which would you suspect?
ANSWER: Hypoglycemia (also consider hypoxemia and acute MI based on additional assessment)
Q45. Your patient has a known baseline heart rate of around 45. The ECG monitor keeps alarming when the heart rate decreases below 50. Vital signs are stable. What would you do?
ANSWER: Adjust the alarm parameters
Legal & Ethical
Q46. Your intubated and unresponsive patient is scheduled for surgery in the morning. Who is the most appropriate person to make decisions?
ANSWER: The healthcare POA (Power of Attorney)
Q47. The staff nurse asks the nursing assistant to check on a patient. The assistant reports the patient is experiencing chest pain and is diaphoretic.
What should the nurse do?
ANSWER: Assess the patient immediately
MI Leads & EKG
Q48. MI Leads – Septal: ANSWER: V1, V2
Q49. MI Leads – Anterior: ANSWER: V3, V4
Q50. MI Leads – Lateral: ANSWER: I, aVL, V5, V6
Q51. MI Leads – Inferior: ANSWER: II, III, aVF
Normal Values & Reference Ranges
• Normal BP: 90-120/60-80 mmHg
• Normal HR: 60-100 bpm
• Normal CO (Cardiac Output): 4-8 L/min
• Normal SVR (Systemic Vascular Resistance): 800-1,200 dynes/seconds
• Normal PVR (Pulmonary Vascular Resistance): 37-250 dynes/sec/cm5
• Normal SvO2 (Mixed Venous Oxygen Saturation): 60-80%
• Normal PAP (Pulmonary Artery Pressure): Systolic 15-30 mmHg, Diastolic 4-12 mmHg
• Normal CVP (Central Venous Pressure): 2-8 mmHg
Study Tips for ICU Nursing Success
• Master ABGs: Practice interpreting arterial blood gases until you can quickly identify acidosis vs alkalosis and respiratory vs metabolic
• Know Your Hemodynamics: Understand normal values for CO, SVR, CVP, and PAP – these are critical for ICU nursing
• Medication Knowledge: Focus on vasoactive medications (dopamine, dobutamine, epinephrine) including dosing and effects
• Recognize Shock Types: Understand the differences between hypovolemic, cardiogenic, neurogenic, and septic shock
• Safety First: Always prioritize patient safety in assessment questions – think ABCs (Airway, Breathing, Circulation)
• Clinical Reasoning: Practice applying knowledge to real scenarios rather than just memorizing facts
IMPORTANT DISCLAIMER: This study guide is compiled from publicly available practice materials and educational resources for the Prophecy General ICU RN A v2 exam. It should be used as a supplemental study tool only. Always refer to official Prophecy testing materials, current evidence-based practice guidelines, and your facility’s policies and procedures. This guide is for educational purposes and may not reflect the most current updates to critical care nursing standards.
