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Section 1: Cardiovascular – Monitoring, Dysrhythmias &
Hemodynamics (Questions 1–20)
Q1: A patient with a pulmonary artery catheter has a measured pulmonary artery
occlusion pressure (PAOP) of 10 mmHg. This value falls within which range?
A. Elevated, suggesting fluid overload
B. Low, indicating hypovolemia
C. Normal [CORRECT]
D. Critically high, requiring immediate diuresis
Correct Answer: C
Rationale: The best answer is C because a PAOP of 10 mmHg sits comfortably within
the normal range of 6 to 12 mmHg, indicating adequate left ventricular preload without
fluid overload.
Q2: On a cardiac monitor, you observe a rhythm with no discernible P waves, an
irregularly irregular ventricular response, and a rate of 110 beats per minute. Which
dysrhythmia is this?
A. Sinus tachycardia
B. Atrial flutter
C. Atrial fibrillation [CORRECT]
D. Third-degree AV block
Correct Answer: C
,Rationale: The best answer is C because the absence of P waves combined with an
irregularly irregular rhythm is the classic signature of atrial fibrillation.
Q3: The normal range for systemic vascular resistance (SVR) in a resting adult is
approximately:
A. 200–400 dynes·sec/cm⁵
B. 400–600 dynes·sec/cm⁵
C. 800–1200 dynes·sec/cm⁵ [CORRECT]
D. 1500–2000 dynes·sec/cm⁵
Correct Answer: C
Rationale: The best answer is C because SVR normally runs between 800 and 1200
dynes·sec/cm⁵ in healthy adults at rest.
Q4: A patient in sinus rhythm has a PR interval measuring 0.24 seconds on the ECG.
How would you classify this finding?
A. Normal PR interval
B. First-degree AV block [CORRECT]
C. Second-degree AV block Type I
D. Third-degree AV block
Correct Answer: B
Rationale: The best answer is B because a PR interval greater than 0.20 seconds
defines first-degree AV block, and every P wave is still conducted to the ventricles.
Q5: Which vasoactive medication is classified as an inodilator, meaning it increases
contractility while simultaneously causing vasodilation?
A. Norepinephrine
B. Phenylephrine
C. Milrinone [CORRECT]
D. Vasopressin
Correct Answer: C
Rationale: The best answer is C because milrinone is a phosphodiesterase inhibitor that
boosts cardiac contractility and opens up both arterial and venous vessels, making it a
true inodilator.
, Q6: A 68-year-old man is admitted to progressive care following an NSTEMI. His
telemetry shows occasional unifocal PVCs at a rate of 4 per minute. He is
asymptomatic, and his vital signs are stable. What is your priority nursing action?
A. Administer amiodarone 150 mg IV push immediately
B. Prepare for synchronized cardioversion
C. Continue monitoring and document the rhythm [CORRECT]
D. Call a rapid response for frequent ectopy
Correct Answer: C
Rationale: The best answer is C because occasional unifocal PVCs in a stable post-MI
patient require monitoring rather than aggressive intervention; treatment is reserved for
symptomatic or dangerous rhythms.
Q7: A patient on a dobutamine infusion at 5 mcg/kg/min has a blood pressure of 98/52
mmHg and complains of palpitations. The monitor shows sinus tachycardia at 128
bpm. Which parameter should you monitor most closely while notifying the provider?
A. Central venous pressure waveform morphology
B. Urine output every 4 hours
C. Heart rate and rhythm for increasing tachycardia or ectopy [CORRECT]
D. Pulmonary artery wedge pressure every hour
Correct Answer: C
Rationale: The best answer is C because dobutamine is a beta-agonist that can trigger
tachycardia and ventricular ectopy; the nurse must watch for escalating arrhythmias as
the primary safety concern.
Q8: A 72-year-old woman post-CABG has an arterial line in her right radial artery. The
waveform suddenly shows a dampened, flattened appearance with a systolic pressure
reading of 72 mmHg. Her other vital signs are unchanged. What is your first action?
A. Administer a fluid bolus for hypotension
B. Check the pressure bag, tubing, and transducer for air bubbles or kinks [CORRECT]
C. Increase the vasopressor infusion
D. Obtain a stat 12-lead ECG
Correct Answer: B
Rationale: The best answer is B because a sudden dampened waveform with an
unexpectedly low reading usually signals a technical problem with the line—air, clot, or
kink—rather than true hemodynamic collapse.