Question 1

A patient demonstrates signs of elevated pulmonary vascular resistance (PVR) . For which health problem should the nurse assess this patient? Select all that apply.

Accepted Answer

A)   Hypoxia
B)   Aortic stenosis
C)   Pulmonary stenosis
D)   Pulmonary embolism
E)   Pulmonary hypertensionF) B) and E)
G) B) and D)

Question 2

After assessing a patient's hemodynamic parameters, the nurse determines that preload and afterload are both elevated. These findings are consistent with which health problems? Select all that apply.

Accepted Answer

A)   Pericardial tamponade
B)   Constrictive pericarditis
C)   Hypovolemia
D)   Neurogenic shock
E)   Mitral stenosisF) B) and D)
G) A) and D)

Question 3

A patient asks the nurse, "What is blood pressure?" What should the nurse respond?

Accepted Answer

A)   "A measurement that should always be 120/80 unless complications are present."
B)   "The amount of pressure exerted on your veins by the blood."
C)   "A measurement that takes into consideration the amount of blood that your heart is pumping and the size of the vessel diameter the heart must pump against."
D)   "A complex measurement that should only be discussed with your health care provider."E) A) and B)
F) B) and C)

Question 4

A patient has mixed venous oxygen saturation (SVO2)  of 52% with the following hemodynamic findings: CO of 4.8 L/min, SaO2 of 95%, and an unchanged hemoglobin level. For what should the nurse assess the patient?

Accepted Answer

A)   Excessive sedation
B)   Position of the PA catheter
C)   Hypothermia
D)   PainE) None of the above
F) A) and B)

Question 5

A patient with an arterial line has an elevated partial thromboplastin time (PTT)  and is not on anticoagulation therapy. What should the nurse do?

Accepted Answer

A)   Take the patient for an immediate V/Q scan.
B)   Assess for the presence of a deep vein thrombosis.
C)   Change the heparinized saline solution in the pressure bag for the arterial line to a normal saline solution.
D)   Ask for an order to begin Lovenox therapy.E) A) and D)
F) B) and C)

Question 6

The health care provider is preparing to insert a PA catheter. What action is a priority for the nurse?

Accepted Answer

A)   The patient is in the Trendelenburg position to prevent air embolism.
B)   The patient has received a dose of IV lidocaine.
C)   The site has been cleaned with soap and water.
D)   A tourniquet has been applied to the neck.E) A) and B)
F) B) and C)

Question 7

While caring for a patient in the intensive care unit, when should the nurse plan to conduct the square wave test on the patient's arterial pressure monitoring system? Select all that apply.

Accepted Answer

A)   At the beginning of the shift
B)   After drawing blood
C)   When the arterial tracing is not consistent with an auscultated blood pressure
D)   When the monitoring cable is disconnected from the flush system
E)   Any time the patient's position is changedF) A) and E)
G) A) and D)

Question 8

A patient has a blood pressure of 134/70 per blood pressure cuff and a blood pressure of 90/50 per arterial line. What action should the nurse take?

Accepted Answer

A)   Discontinue the arterial line immediately.
B)   Check the level of the transducer and relevel and rezero the system.
C)   Do nothing because this is a normal variation between the two methods of measurement.
D)   Begin the infusion of a dopamine drip.E) C) and D)
F) B) and D) B

Question 9

A patient has a lactate level of 8 mmol/L. What should this finding indicate to the nurse?

Accepted Answer

A)   Carbon dioxide exchange
B)   Underuse of oxygen
C)   Glucose metabolism
D)   Tissue hypoxiaE) All of the above
F) A) and B)

Question 10

Which nursing intervention ensures an accurate cardiac output reading for a patient?

Accepted Answer

A)   Administer the injectate within 4 seconds.
B)   Use 5 cc of iced saline as the injectate.
C)   Ensure that there is a difference of 10°C between the injectate temperature and the patient's body temperature.
D)   Inject the fluid into the pulmonary artery distal port.E) A) and B)
F) A) and C)

Question 11

The nurse is monitoring a patient's pulmonary vascular resistance. Which value is the normal value?

Accepted Answer

A)   100-250 mm Hg
B)   10-250 dynes/sec/cm2
C)   400-800 mm Hg
D)   900-1,400 dynes/sec/cm2E) All of the above
F) A) and B)

Question 12

The nurse is planning to assess the blood pressure of a patient with a BMI of 40. Which approaches should the nurse use to correctly obtain this patient's blood pressure? Select all that apply.

Accepted Answer

A)   Use a cuff with a bladder that is 80% of the patient's arm circumference.
B)   Use a thigh cuff.
C)   Use an adult cuff on the patient's forearm.
D)   Assess the blood pressure using the same approach each time.
E)   Use an adult cuff on the patient's thigh.F) All of the above
G) B) and C)

Question 13

A patient has a central line for fluid management and antibiotic therapy. What interventions should the nurse use to reduce the risk of infection in the access site? Select all that apply.

Accepted Answer

A)   Practice thorough hand hygiene.
B)   Use chlorhexidine skin asepsis.
C)   Review the continued need for the line daily.
D)   Cover the insertion site with an opaque gauze dressing.
E)   Change the dressing over the insertion site using clean technique.F) C) and E)
G) None of the above

Question 14

What should the nurse do to correctly calculate cardiac output?

Accepted Answer

A)   Only take two measurements and then average the two readings.
B)   Take one measurement to prevent fluid volume overload.
C)   Obtain five measurements and record the highest reading.
D)   Take three to five measurements and take the average of the three readings that are within 10% of one another.E) B) and C)
F) A) and B) D

Question 15

Prior to the insertion of an arterial line in the radial artery, which assessment should the nurse perform?

Accepted Answer

A)   Homan's test
B)   Kernig's test
C)   Allen's test
D)   Leopold's maneuverE) None of the above
F) All of the above C

Question 16

The nurse is concerned that a patient's pulmonary artery catheter has slipped into the right ventricle. What are the hallmarks of the waveform that the nurse observes on the monitor? Select all that apply.

Accepted Answer

A)   Low diastolic pressure
B)   No dicrotic notch
C)   Continuous wedge waveform
D)   Sharp upstroke, a plateau, and a rapid downstroke extending below the baseline
E)   Smooth upstroke followed by a gradual downslope to the baselineF) A) and C)
G) B) and E)

Question 17

A patient with a right subclavian triple lumen catheter has a CVP reading of 18 mm Hg. For what symptoms should the nurse assess this patient?

Accepted Answer

A)   Peripheral edema and jugular vein distention
B)   Decreased peripheral pulses and cool extremities
C)   Hypovolemia and hypotension
D)   Orbital edema and disorientationE) A) and C)
F) C) and D)

Question 18

Which action has the highest priority for maintaining safety when caring for a patient with a PA catheter?

Accepted Answer

A)   Obtain pressures per protocol.
B)   Administer fluids and medications via pump.
C)   Maintain asepsis when providing line care.
D)   Obtain lab values as ordered.E) None of the above
F) A) and B)

Question 19

A patient with a PA catheter needs PCWP readings every 4 hours. What technique should the nurse follow when obtaining these pressures?

Accepted Answer

A)   Cap the port after the balloon is inflated.
B)   Keep the balloon inflated for 30 seconds.
C)   Inflate the balloon until the PA waveform changes.
D)   Open the balloon inflation valve after each measurement.E) A) and C)
F) A) and B)

Question 20

What should the nurse monitor in response to a change in SVO2 readings?

Accepted Answer

A)   Potassium level
B)   Glucose level
C)   Sodium level
D)   Hemoglobin levelE) A) and D)
F) A) and B)

Exam 5: Cardiodynamics and Hemodynamic Regulation

A patient demonstrates signs of elevated pulmonary vascular resistance (PVR) . For which health problem should the nurse assess this patient? Select all that apply.

Correct AnswerverifiedShow Answer

After assessing a patient's hemodynamic parameters, the nurse determines that preload and afterload are both elevated. These findings are consistent with which health problems? Select all that apply.

Correct AnswerverifiedShow Answer

A patient asks the nurse, "What is blood pressure?" What should the nurse respond?

Correct AnswerverifiedShow Answer

A patient has mixed venous oxygen saturation (SVO2) of 52% with the following hemodynamic findings: CO of 4.8 L/min, SaO2 of 95%, and an unchanged hemoglobin level. For what should the nurse assess the patient?

Correct AnswerverifiedShow Answer

A patient with an arterial line has an elevated partial thromboplastin time (PTT) and is not on anticoagulation therapy. What should the nurse do?

Correct AnswerverifiedShow Answer

The health care provider is preparing to insert a PA catheter. What action is a priority for the nurse?

Correct AnswerverifiedShow Answer

While caring for a patient in the intensive care unit, when should the nurse plan to conduct the square wave test on the patient's arterial pressure monitoring system? Select all that apply.

Correct AnswerverifiedShow Answer

A patient has a blood pressure of 134/70 per blood pressure cuff and a blood pressure of 90/50 per arterial line. What action should the nurse take?

Correct AnswerverifiedB

A patient has a lactate level of 8 mmol/L. What should this finding indicate to the nurse?

Correct AnswerverifiedShow Answer

Which nursing intervention ensures an accurate cardiac output reading for a patient?

Correct AnswerverifiedShow Answer

The nurse is monitoring a patient's pulmonary vascular resistance. Which value is the normal value?

Correct AnswerverifiedShow Answer

The nurse is planning to assess the blood pressure of a patient with a BMI of 40. Which approaches should the nurse use to correctly obtain this patient's blood pressure? Select all that apply.

Correct AnswerverifiedShow Answer

A patient has a central line for fluid management and antibiotic therapy. What interventions should the nurse use to reduce the risk of infection in the access site? Select all that apply.

Correct AnswerverifiedShow Answer

What should the nurse do to correctly calculate cardiac output?

Correct AnswerverifiedD

Prior to the insertion of an arterial line in the radial artery, which assessment should the nurse perform?

Correct AnswerverifiedC

The nurse is concerned that a patient's pulmonary artery catheter has slipped into the right ventricle. What are the hallmarks of the waveform that the nurse observes on the monitor? Select all that apply.

Correct AnswerverifiedShow Answer

A patient with a right subclavian triple lumen catheter has a CVP reading of 18 mm Hg. For what symptoms should the nurse assess this patient?

Correct AnswerverifiedShow Answer

Which action has the highest priority for maintaining safety when caring for a patient with a PA catheter?

Correct AnswerverifiedShow Answer

A patient with a PA catheter needs PCWP readings every 4 hours. What technique should the nurse follow when obtaining these pressures?

Correct AnswerverifiedShow Answer

What should the nurse monitor in response to a change in SVO2 readings?

Correct AnswerverifiedShow Answer

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A patient has mixed venous oxygen saturation (SVO₂) of 52% with the following hemodynamic findings: CO of 4.8 L/min, SaO₂ of 95%, and an unchanged hemoglobin level. For what should the nurse assess the patient?

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B

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D

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C

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What should the nurse monitor in response to a change in SVO₂ readings?

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