NUR 417 Exam 1 Questions With Correct
Answers
An older adult patient who has just arrived in the emergency department has a
| | | | | | | | | | | | | |
pulse deficit of 46 beats. Which intervention would the nurse anticipate for this
| | | | | | | | | | | | |
patient? |
a. Cardiac catheterization
| | |
b. Hourly blood pressure checks
| | | | |
c. Electrocardiographic monitoring
| | |
d. Emergent synchronized cardioversion - CORRECT ANSWER✔✔-ANS: C Pulse
| | | | | | | | |
deficit is a difference between simultaneously obtained apical and radial pulses. It
| | | | | | | | | | |
indicates that there may be a cardiac dysrhythmia that would best be detected
| | | | | | | | | | | | | |
with ECG monitoring. Frequent BP monitoring, cardiac catheterization, and
| | | | | | | | |
emergent cardioversion are used for diagnosis and/or treatment of cardiovascular
| | | | | | | | |
disorders but would not be as helpful in determining the immediate reason for
| | | | | | | | | | | | | |
the pulse deficit.
| |
The standard policy on the cardiac unit states, "Notify the health care provider for
| | | | | | | | | | | | |
mean arterial pressure (MAP) less than 70 mm Hg." Which patient's status would
| | | | | | | | | | | | |
the nurse report to the health care provider?
| | | | | | | | |
a. Postoperative patient with a BP of 116/42 mm Hg.
| | | | | | | | | |
b. Newly admitted patient with a BP of 150/87 mm Hg.
| | | | | | | | | | |
c. Patient with left ventricular failure who has a BP of 110/70 mm Hg.
| | | | | | | | | | | | | |
d. Patient with a myocardial infarction who has a BP of 140/86 mm Hg. -
| | | | | | | | | | | | | | |
CORRECT ANSWER✔✔-ANS: A The mean arterial pressure (MAP) is calculated
| | | | | | | | | |
,using the formula MAP = (systolic BP + 2 diastolic BP)/3. The MAP for the
| | | | | | | | | | | | | | |
postoperative patient is 67. The MAP in the other three patients is higher than 70
| | | | | | | | | | | | | |
mm Hg.
| |
***Which hemodynamic parameter most directly reflects the effectiveness of
| | | | | | | | |
drugs given to reduce a patient's left ventricular afterload?
| | | | | | | | |
a. Cardiac output (CO)
| | | |
b. Systemic vascular resistance (SVR)
| | | | |
c. Pulmonary vascular resistance (PVR)
| | | | |
d. Pulmonary artery wedge pressure (PAWP) - CORRECT ANSWER✔✔-ANS: B SVR
| | | | | | | | | | |
reflects the resistance to left ventricular ejection, or afterload. Other parameters
| | | | | | | | | | |
may be monitored but do not reflect left-sided afterload as directly.
| | | | | | | | | |
**After surgery, a patient's central venous pressure (CVP) monitor indicates low
| | | | | | | | | | |
pressures. Which action would the nurse take? | | | | | | |
a. Administer IV diuretic medications.
| | | | |
b. Increase the IV fluid infusion per protocol.
| | | | | | | |
c. Increase the infusion rate of IV vasodilators.
| | | | | | | |
d. Elevate the head of the patient's bed to 45 degrees. - CORRECT ANSWER✔✔-
| | | | | | | | | | | | |
ANS: B A low CVP indicates decreased preload from hypovolemia and a need for
| | | | | | | | | | | | | |
an increase in the infusion rate. Diuretic administration will contribute to
| | | | | | | | | | |
hypovolemia and elevation of the head or increasing vasodilators may decrease
| | | | | | | | | | |
cerebral perfusion. |
*Which parameter will the nurse use to evaluate changes in a patient's right
| | | | | | | | | | | | |
ventricular afterload? | |
a. Central venous pressure (CVP)
| | | | |
, b. Systemic vascular resistance (SVR)
| | | | |
c. Pulmonary vascular resistance (PVR)
| | | | |
d. Pulmonary artery wedge pressure (PAWP) - CORRECT ANSWER✔✔-ANS: C PVR
| | | | | | | | | | |
is a measure of right ventricular afterload, which is elevated in conditions such as
| | | | | | | | | | | | | |
pulmonary hypertension The other parameters do not directly assess for right
| | | | | | | | | | |
ventricular afterload |
A patient requires arterial pressure monitoring. Which action would the nurse
| | | | | | | | | | |
plan to take? | | |
a. Balance and calibrate the monitoring equipment every 2 hours.
| | | | | | | | | |
b. Position the zero-reference stopcock line level with the phlebostatic axis.
| | | | | | | | | | |
c. Disconnect the low pressure alarm to avoid disturbing the patient's sleep.
| | | | | | | | | | | |
d. Ensure that the patient is supine with the head of the bed flat for all readings. -
| | | | | | | | | | | | | | | | |
CORRECT ANSWER✔✔-ANS: B For accurate measurement of pressures, the zero-
| | | | | | | | | |
reference level would be at the phlebostatic axis. There is no need to rebalance
| | | | | | | | | | | | | |
and recalibrate monitoring equipment every 2 hours. Accurate hemodynamic
| | | | | | | | |
readings are possible with the patient's head raised to 45 degrees or in the prone
| | | | | | | | | | | | | | |
position. Alarms should be activated; if the pressure in the line falls (e.g., when
| | | | | | | | | | | | | |
the line is disconnected), the low-pressure alarm sounds immediately and notifies
| | | | | | | | | |
staff to promptly correct the problem.
| | | | | |
*Which measurement would be the most sensitive indicator of cardiac function?
| | | | | | | | | | |
a. Central venous pressure (CVP)
| | | | |
b. Systemic vascular resistance (SVR)
| | | | |
c. Pulmonary vascular resistance (PVR)
| | | | |
d. Pulmonary artery wedge pressure (PAWP) - CORRECT ANSWER✔✔-ANS:D
| | | | | | | |
Answers
An older adult patient who has just arrived in the emergency department has a
| | | | | | | | | | | | | |
pulse deficit of 46 beats. Which intervention would the nurse anticipate for this
| | | | | | | | | | | | |
patient? |
a. Cardiac catheterization
| | |
b. Hourly blood pressure checks
| | | | |
c. Electrocardiographic monitoring
| | |
d. Emergent synchronized cardioversion - CORRECT ANSWER✔✔-ANS: C Pulse
| | | | | | | | |
deficit is a difference between simultaneously obtained apical and radial pulses. It
| | | | | | | | | | |
indicates that there may be a cardiac dysrhythmia that would best be detected
| | | | | | | | | | | | | |
with ECG monitoring. Frequent BP monitoring, cardiac catheterization, and
| | | | | | | | |
emergent cardioversion are used for diagnosis and/or treatment of cardiovascular
| | | | | | | | |
disorders but would not be as helpful in determining the immediate reason for
| | | | | | | | | | | | | |
the pulse deficit.
| |
The standard policy on the cardiac unit states, "Notify the health care provider for
| | | | | | | | | | | | |
mean arterial pressure (MAP) less than 70 mm Hg." Which patient's status would
| | | | | | | | | | | | |
the nurse report to the health care provider?
| | | | | | | | |
a. Postoperative patient with a BP of 116/42 mm Hg.
| | | | | | | | | |
b. Newly admitted patient with a BP of 150/87 mm Hg.
| | | | | | | | | | |
c. Patient with left ventricular failure who has a BP of 110/70 mm Hg.
| | | | | | | | | | | | | |
d. Patient with a myocardial infarction who has a BP of 140/86 mm Hg. -
| | | | | | | | | | | | | | |
CORRECT ANSWER✔✔-ANS: A The mean arterial pressure (MAP) is calculated
| | | | | | | | | |
,using the formula MAP = (systolic BP + 2 diastolic BP)/3. The MAP for the
| | | | | | | | | | | | | | |
postoperative patient is 67. The MAP in the other three patients is higher than 70
| | | | | | | | | | | | | |
mm Hg.
| |
***Which hemodynamic parameter most directly reflects the effectiveness of
| | | | | | | | |
drugs given to reduce a patient's left ventricular afterload?
| | | | | | | | |
a. Cardiac output (CO)
| | | |
b. Systemic vascular resistance (SVR)
| | | | |
c. Pulmonary vascular resistance (PVR)
| | | | |
d. Pulmonary artery wedge pressure (PAWP) - CORRECT ANSWER✔✔-ANS: B SVR
| | | | | | | | | | |
reflects the resistance to left ventricular ejection, or afterload. Other parameters
| | | | | | | | | | |
may be monitored but do not reflect left-sided afterload as directly.
| | | | | | | | | |
**After surgery, a patient's central venous pressure (CVP) monitor indicates low
| | | | | | | | | | |
pressures. Which action would the nurse take? | | | | | | |
a. Administer IV diuretic medications.
| | | | |
b. Increase the IV fluid infusion per protocol.
| | | | | | | |
c. Increase the infusion rate of IV vasodilators.
| | | | | | | |
d. Elevate the head of the patient's bed to 45 degrees. - CORRECT ANSWER✔✔-
| | | | | | | | | | | | |
ANS: B A low CVP indicates decreased preload from hypovolemia and a need for
| | | | | | | | | | | | | |
an increase in the infusion rate. Diuretic administration will contribute to
| | | | | | | | | | |
hypovolemia and elevation of the head or increasing vasodilators may decrease
| | | | | | | | | | |
cerebral perfusion. |
*Which parameter will the nurse use to evaluate changes in a patient's right
| | | | | | | | | | | | |
ventricular afterload? | |
a. Central venous pressure (CVP)
| | | | |
, b. Systemic vascular resistance (SVR)
| | | | |
c. Pulmonary vascular resistance (PVR)
| | | | |
d. Pulmonary artery wedge pressure (PAWP) - CORRECT ANSWER✔✔-ANS: C PVR
| | | | | | | | | | |
is a measure of right ventricular afterload, which is elevated in conditions such as
| | | | | | | | | | | | | |
pulmonary hypertension The other parameters do not directly assess for right
| | | | | | | | | | |
ventricular afterload |
A patient requires arterial pressure monitoring. Which action would the nurse
| | | | | | | | | | |
plan to take? | | |
a. Balance and calibrate the monitoring equipment every 2 hours.
| | | | | | | | | |
b. Position the zero-reference stopcock line level with the phlebostatic axis.
| | | | | | | | | | |
c. Disconnect the low pressure alarm to avoid disturbing the patient's sleep.
| | | | | | | | | | | |
d. Ensure that the patient is supine with the head of the bed flat for all readings. -
| | | | | | | | | | | | | | | | |
CORRECT ANSWER✔✔-ANS: B For accurate measurement of pressures, the zero-
| | | | | | | | | |
reference level would be at the phlebostatic axis. There is no need to rebalance
| | | | | | | | | | | | | |
and recalibrate monitoring equipment every 2 hours. Accurate hemodynamic
| | | | | | | | |
readings are possible with the patient's head raised to 45 degrees or in the prone
| | | | | | | | | | | | | | |
position. Alarms should be activated; if the pressure in the line falls (e.g., when
| | | | | | | | | | | | | |
the line is disconnected), the low-pressure alarm sounds immediately and notifies
| | | | | | | | | |
staff to promptly correct the problem.
| | | | | |
*Which measurement would be the most sensitive indicator of cardiac function?
| | | | | | | | | | |
a. Central venous pressure (CVP)
| | | | |
b. Systemic vascular resistance (SVR)
| | | | |
c. Pulmonary vascular resistance (PVR)
| | | | |
d. Pulmonary artery wedge pressure (PAWP) - CORRECT ANSWER✔✔-ANS:D
| | | | | | | |
