Question 1

A patient with a PA catheter has an SVO2 of 90%. For what should the nurse assess this patient?

Accepted Answer

A)  Fever 
B)  Pain 
C)  Hypothermia 
D)  Anemia

Question 2

A patient's hemodynamic parameters include the following: right atrial pressure (RAP) of 13 mm Hg, pulmonary artery wedge pressure (PAWP) of 8 mm Hg, systemic vascular resistance (SVR) of 1,000 dynes/sec/cm2, cardiac output (CO) of 4.9 L/min, cardiac index (CI) of 3.5 L/min, and pulmonary vascular resistance (PVR) of 280 dynes/sec/cm2. Which heart function should cause the nurse concern?

Accepted Answer

A)  Afterload 
B)  Left heart contractility 
C)  Right heart contractility 
D)  Heart rate

Question 3

A patient is experiencing reduced afterload. What should the nurse identify as causes for this finding? Select all that apply.

Accepted Answer

A)  Sepsis 
B)  Mitral stenosis 
C)  Reduced circulating blood volume 
D)  Vasodilator medications 
E)  Myocarditis

Question 4

The health care provider is planning to insert a pulmonary artery catheter into a patient. What should the nurse explain to the patient as being the purpose of this device? Select all that apply.

Accepted Answer

A)  Determine hemodynamic stability in heart failure. 
B)  Monitor the effects of vasodilator administration. 
C)  Monitor cardiac function during vascular surgical procedures. 
D)  Assess cardiac output. 
E)  Continuously monitor blood pressure.

Question 5

A patient has a pressure-monitoring device inserted after an acute myocardial infarction. Which action should the nurse take to minimize the risk of overdampened measurements? Select all that apply.

Accepted Answer

A)  Ensure tubing is without kinks. 
B)  Add tubing to the flush system. 
C)  Remove all air from the flush system. 
D)  Inflate the pressure bag to 300 mm Hg. 
E)  Maintain adequate normal saline in the flush bag.

Question 6

What should the nurse use to measure the contractility of the left side of a patient's heart?

Accepted Answer

A)  Left atrial pressure 
B)  Pulmonary artery wedge pressure 
C)  Systemic vascular resistance 
D)  Left ventricular stroke work index

Question 7

The nurse wants to assess the oxygenation status of a patient who has been experiencing a gastrointestinal bleed. How should the nurse complete this assessment? Select all that apply.

Accepted Answer

A)  Use pulse oximetry. 
B)  Send a blood sample for arterial blood gas analysis. 
C)  Auscultate lung sounds. 
D)  Evaluate cardiac rhythm strip. 
E)  Calculate mean arterial pressure.

Question 8

A patient's systemic vascular resistance (SVR) has dangerously decreased. The nurse would expect to administer which medications?

Accepted Answer

A)  Furosemide (Lasix) and dopamine 
B)  Nitroprusside and furosemide (Lasix) 
C)  Dopamine and norepinephrine (Levophed) 
D)  Nitroglycerin and digoxin (Lanoxin)

Question 9

Which observation indicates pulsus paradoxus on a patient's arterial pressure waveform?

Accepted Answer

A)  The waveform has tall, tented waves. 
B)  The pulse pressure is above 20 mm Hg on exhalation. 
C)  There is a decrease of more than 10 mm Hg in the arterial waveform before inhalation. 
D)  There is a single, nonperfused beat.

Question 10

When observing the waveform of an arterial line, the nurse notes the presence of a dicrotic notch. How should the nurse interpret this finding?

Accepted Answer

A)  Pulmonic valve opening 
B)  Mitral valve closure 
C)  Aortic valve closure 
D)  Tricuspid valve closure

Question 11

The nurse is monitoring the PA pressure of a mechanically ventilated patient. When should the nurse obtain the measurement to accurately assess this pressure?

Accepted Answer

A)  Whenever, because the timing does not matter 
B)  At the last clear waveform before the baseline drops 
C)  At the last clear waveform before the baseline rises 
D)  With the patient off of the ventilator

Question 12

The nurse suspects that a patient is experiencing cardiogenic shock. Which parameter indicates that the nurse's suspicion is correct?

Accepted Answer

A)  Cardiac output of 8.9 L/min 
B)  Pulmonary artery wedge pressure (PAWP) of 8 mm Hg 
C)  Central venous pressure (CVP) of 5 mm Hg 
D)  Cardiac index (CI) of 1.8 L/min/m2

Question 13

How should the nurse calculate a patient's mean arterial pressure (MAP)?

Accepted Answer

A)  Divide the systolic pressure by the diastolic pressure. 
B)  Average three of the patient's blood pressures over a 6-hour period. 
C)  Divide the diastolic pressure by the pulse pressure. 
D)  Add the systolic pressure and two diastolic pressures and then divide by 3.

Question 14

Which value should the nurse recognize is normal for a patient's cardiac output?

Accepted Answer

A)  6-9 L/min 
B)  4-8 L/min 
C)  8-10 L/min 
D)  2-4 L/min

Question 15

A patient is admitted with atrial fibrillation. Why should the nurse identify interventions to address low cardiac output for this patient?

Accepted Answer

A)  Loss of atrial kick 
B)  Pressure in the ventricles 
C)  Irregular ventricular rhythm 
D)  Systemic blood from the left ventricle

Question 16

The nurse is concerned that the hand with an arterial line in the wrist is becoming ischemic. What did the nurse assess in this patient? Select all that apply.

Accepted Answer

A)  Delayed capillary refill 
B)  Pale skin color of the wrist and hand 
C)  Reduced pulses in the brachial artery 
D)  Hand cold to touch 
E)  Blood pressure discrepancy of 15 mm Hg

Exam 5: Cardiodynamics and Hemodynamic Regulation

A patient with a PA catheter has an SVO₂ of 90%. For what should the nurse assess this patient?