NSG 4100 Exam 3 Actual Updated 2026 With Detailed Answers
,
,SECTION 1: CENTRAL VENOUS PRESSURE (CVP) & HEMODYNAMIC
MONITORING (Questions 1-25)
Question 1:
The nurse is attending to a client who has orders for central venous pressure
monitoring. The nurse understands the catheter attached to a pressure
monitoring system will be placed in the:
A) Left to right ventricle
B) Vena cava or Left atrium
C) Vena cava or Right atrium
D) Pulmonary artery or vein
Answer: C) Vena cava or Right atrium
Rationale: Central venous pressure (CVP) monitoring measures pressure in
the vena cava or right atrium, reflecting right ventricular preload and
circulating blood volume. The catheter tip must be positioned in the superior
vena cava or right atrium for accurate measurement. Placement in the
ventricle would measure intraventricular pressure, not CVP. The pulmonary
artery is used for pulmonary artery pressure (PAP) monitoring with a Swan-
Ganz catheter.
Question 2:
The nurse preceptor is observing a newly hired nurse care for a client who has
a hemodynamic monitoring catheter in place. Which of the following actions by
the newly hired nurse requires immediate intervention by the nurse preceptor?
A) Refusing to use topical antibiotic ointment and creams on the insertion sites
, B) Using alcohol-based hand rub before and after each contact with the
catheter
C) Replacing transducer tubing, continuous flush devices and solution every 96
hours
D) Informing the client that this type of catheter allows for total freedom in the
bath and shower
Answer: D) Informing the client that this type of catheter allows for total
freedom in the bath and shower
Rationale: Hemodynamic monitoring catheters are invasive lines that must be
protected from water sources to prevent infection and dislodgement. Clients
should never immerse the insertion site in water. Sponge baths are
recommended. The other actions are correct: avoiding unnecessary topical
antibiotics (can promote resistance), proper hand hygiene, and changing
transducer tubing every 96 hours per CDC guidelines are all appropriate.
Question 3:
A client has a pulmonary artery catheter (Swan-Ganz) in place. Which pressure
reading reflects left ventricular preload?
A) Central venous pressure (CVP)
B) Pulmonary artery systolic pressure (PASP)
C) Pulmonary artery wedge pressure (PAWP)
D) Right atrial pressure (RAP)
Answer: C) Pulmonary artery wedge pressure (PAWP)
Rationale: Pulmonary artery wedge pressure (PAWP), also called pulmonary
capillary wedge pressure (PCWP), reflects left atrial pressure and left
ventricular end-diastolic pressure (LVEDP), which is a measure of left
ventricular preload. CVP and RAP reflect right ventricular preload. PASP
reflects right ventricular systolic pressure and pulmonary artery resistance.
,
,SECTION 1: CENTRAL VENOUS PRESSURE (CVP) & HEMODYNAMIC
MONITORING (Questions 1-25)
Question 1:
The nurse is attending to a client who has orders for central venous pressure
monitoring. The nurse understands the catheter attached to a pressure
monitoring system will be placed in the:
A) Left to right ventricle
B) Vena cava or Left atrium
C) Vena cava or Right atrium
D) Pulmonary artery or vein
Answer: C) Vena cava or Right atrium
Rationale: Central venous pressure (CVP) monitoring measures pressure in
the vena cava or right atrium, reflecting right ventricular preload and
circulating blood volume. The catheter tip must be positioned in the superior
vena cava or right atrium for accurate measurement. Placement in the
ventricle would measure intraventricular pressure, not CVP. The pulmonary
artery is used for pulmonary artery pressure (PAP) monitoring with a Swan-
Ganz catheter.
Question 2:
The nurse preceptor is observing a newly hired nurse care for a client who has
a hemodynamic monitoring catheter in place. Which of the following actions by
the newly hired nurse requires immediate intervention by the nurse preceptor?
A) Refusing to use topical antibiotic ointment and creams on the insertion sites
, B) Using alcohol-based hand rub before and after each contact with the
catheter
C) Replacing transducer tubing, continuous flush devices and solution every 96
hours
D) Informing the client that this type of catheter allows for total freedom in the
bath and shower
Answer: D) Informing the client that this type of catheter allows for total
freedom in the bath and shower
Rationale: Hemodynamic monitoring catheters are invasive lines that must be
protected from water sources to prevent infection and dislodgement. Clients
should never immerse the insertion site in water. Sponge baths are
recommended. The other actions are correct: avoiding unnecessary topical
antibiotics (can promote resistance), proper hand hygiene, and changing
transducer tubing every 96 hours per CDC guidelines are all appropriate.
Question 3:
A client has a pulmonary artery catheter (Swan-Ganz) in place. Which pressure
reading reflects left ventricular preload?
A) Central venous pressure (CVP)
B) Pulmonary artery systolic pressure (PASP)
C) Pulmonary artery wedge pressure (PAWP)
D) Right atrial pressure (RAP)
Answer: C) Pulmonary artery wedge pressure (PAWP)
Rationale: Pulmonary artery wedge pressure (PAWP), also called pulmonary
capillary wedge pressure (PCWP), reflects left atrial pressure and left
ventricular end-diastolic pressure (LVEDP), which is a measure of left
ventricular preload. CVP and RAP reflect right ventricular preload. PASP
reflects right ventricular systolic pressure and pulmonary artery resistance.
