Exam (elaborations)
Sole - Chapter 8_ Hemodynamic Monitoring.
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- Gpstc Criminal Law.
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- Gpstc Criminal Law.
Sole - Chapter 8_ Hemodynamic Monitoring.
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Sole - Chapter 8: HemodynamicMonitoring
The nurse is caring for a 100-kg patient being monitored with a pulmonary artery catheter.
The nurse assesses a blood pressure of 90/60 mm Hg, heart rate 110 beats/min,
respirations 36/min, oxygen saturation of 89% on 3 L of oxygen via nasal cannula. Bilateral
crackles are audible upon auscultation. Which hemodynamic value requires immediate
action by the nurse?
A. Cardiac index (CI) of 1.2 L/min/m3
B. Cardiac output (CO) of 4 L/min
C. Pulmonary vascular resistance (PVR) of 80 dynes/sec/cm-5
D. Systemic vascular resistance (SVR) of 1400 dynes/sec/cm-5 - correct answer-A
While caring for a patient with a small bowel obstruction, the nurse assesses a pulmonary
artery occlusion pressure (PAOP) of 1 mm Hg and hourly urine output of 5 mL. The nurse
anticipates which therapeutic intervention?
A. Diuretics
B. Intravenous fluids
C. Negative inotropic agents
D. Vasopressors - correct answer-B
The nurse is caring for a patient who has had an arterial line inserted. To reduce the risk of
complications, what is the priority nursing intervention?
A. Apply a pressure dressing to the insertion site.
B. Ensure that all tubing connections are tightened.
C. Obtain a portable x-ray to confirm placement.
D. Restrain the affected extremity for 24 hours. - correct answer-B
While caring for a patient with a pulmonary artery catheter, the nurse notes the pulmonary
artery occlusion pressure (PAOP) to be significantly higher than previously recorded values.
The nurse assesses respirations to be unlabored at 16 breaths/min, oxygen saturation of
98% on 3 L of oxygen via nasal cannula, and lungs clear to auscultation bilaterally. What is
the priority nursing action?
A. Increase supplemental oxygen and notify respiratory therapy.
B. Notify the provider immediately of the assessment findings.
C. Obtain a stat chest x-ray film to verify proper catheter placement.
D. Zero reference and level the catheter at the phlebostatic axis. - correct answer-D
A patient is admitted to the hospital with multiple trauma and extensive blood loss. The nurse
assesses vital signs to be BP 80/50 mm Hg, heart rate 135 beats/min, respirations 36
breaths/min, cardiac output (CO) of 2 L/min, systemic vascular resistance of 3000
dynes/sec/cm-5, and a hematocrit of 20%. The nurse anticipates administration of which the
following therapies or medications?
A. Blood transfusion
B. Furosemide
, C. Dobutamine infusion
D. Dopamine hydrochloride infusion - correct answer-A
After pulmonary artery catheter insertion, the nurse assesses a pulmonary artery pressure of
45/25 mm Hg, a pulmonary artery occlusion pressure (PAOP) of 20 mm Hg, a cardiac output
of 2.6 L/min and a cardiac index of 1.9 L/min/m2. Which provider order is of the highest
priority?
A. Apply 50% oxygen via Venturi mask.
B. Insert an indwelling urinary catheter.
C. Begin a dobutamine infusion.
D. Obtain stat cardiac enzymes and troponin. - correct answer-C
The nurse is caring for a patient with a left subclavian central venous catheter (CVC) and a
left radial arterial line. Which assessment finding by the nurse requires immediate action?
A. A dampened arterial line waveform
B. Numbness and tingling in the left hand
C. Slight bloody drainage at subclavian insertion site
D. Slight redness at subclavian insertion site - correct answer-B
The provider writes an order to discontinue a patient's left radial arterial line. When
discontinuing the patient's invasive line, what is the priority nursing action?
A. Apply an air occlusion dressing to insertion site.
B. Apply pressure to the insertion site for 5 minutes.
C. Elevate the affected limb on pillows for 24 hours.
D. Keep the patient's wrist in a neutral position. - correct answer-B
Following insertion of a central venous catheter, the nurse obtains a stat chest x-ray film to
verify proper catheter placement. The radiologist reports to the nurse: "The tip of the catheter
is located in the superior vena cava." What is the best interpretation of these results by the
nurse?
A. The catheter is not positioned correctly and should be removed.
B. The catheter position increases the risk of ventricular dysrhythmias.
C. The distal tip of the catheter is in the appropriate position.
D. The physician should be called to advance the catheter into the pulmonary artery. -
correct answer-C
While inflating the balloon of a pulmonary artery catheter (PAC) with 1.0 mL of air to obtain a
pulmonary artery occlusion pressure (PAOP), the nurse encounters resistance. What is the
best nursing action?
A. Add an additional 0.5 mL of air to the balloon and repeat the procedure.
B. Advance the catheter with the balloon deflated and repeat the procedure.
C. Deflate the balloon and obtain a chest x-ray study to determine line placement.
D. Lock the balloon in the inflated position, and flush the distal port of the PAC with normal
saline. - correct answer-C
The nurse is caring for a patient following insertion of a left subclavian central venous
catheter (CVC). Which assessment finding 2 hours after insertion by the nurse warrants
immediate action?
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