ATI MED SURG FINAL EXAM ALL PRACICE
QUESTIONS AND ANSWERS 2022
What is normal range for troponin I? When are elevated levels first detectable after
myocardial injury and what is expected duration of the elevated levels? - CORRECT
ANSWER Less than 0.03, three hours, 7 to 10 days
What is normal range for myoglobin? When are elevated levels first detectable
after myocardial injury and what is expected duration of the elevated levels? -
CORRECT ANSWER Less than 90 mcg/L, two hours, 24 hours
While an echocardiogram is being performed what side should the patient lie on? -
CORRECT ANSWER Left side and remain still
What are indications for an echocardiogram - CORRECT ANSWER
Cardiomyopathy Heart failure
Angina
Myocardial infarction
What are indications for stress test - CORRECT ANSWER
Dysrhythmias HF
Angin
a MI
What are two medications that are prescribed for pharmacological stress test -
CORRECT ANSWER Dobutamine
Adenosine
What do you instruct the patient to do 2 to 4 hours before a stress test - CORRECT
ANSWER Avoid tobacco, alcohol and caffeine
Hemodynamic monitoring involves special indwelling catheters that provide
information about blood volume and perfusion, fluid status and how well the heart
is pumping. Arterial lines are placed in the radial (most common), brachial or
femoral artery. What should you Monitor for? -
,ATI MED SURG FINAL EXAM ALL PRACICE
QUESTIONS AND ANSWERS 2022
CORRECT ANSWER Monitor circulation in the limb with the arterial line. Such as
capillary refill, temperature, color. Arterial lines are not used for IV fluid
administration
The pulmonary artery (PA) catheter is inserted into a large vein (internal jugular,
femoral, subclavian, brachial) and threaded through the right atria and ventricles
into a branch of the pulmonary artery. PA catheters have multiple lumens, ports and
components that allow for various hemodynamic measurements, blood sampling
and - CORRECT ANSWER Infusion of IV fluids
What are the different lumens used for? - CORRECT ANSWER
What is the expected reference range for CVP (Central venous pressure) -
CORRECT ANSWER 1 to 8 MM HG
What is the expected reference range for pulmonary artery systolic (PAS) -
CORRECT ANSWER 15 to 26
What is the expected range for pulmonary artery diastolic (PAD) - CORRECT ANSWER
5 to 15
What is expected range for pulmonary artery wedge pressure (PAWP)? - CORRECT
ANSWER 4 to 12
What is the expected range for cardiac output - CORRECT ANSWER 4 to 7 L/minute
What is expected range for mixed venous oxygen saturation - CORRECT
ANSWER 60% to 80%
When should a nurse anticipate lower hemodynamic values? - CORRECT ANSWER
In older patients especially if dehydration is a complication
What position should the patient be in with hemodynamic monitoring - CORRECT
ANSWER Supine or Trendelenburg
,ATI MED SURG FINAL EXAM ALL PRACICE
QUESTIONS AND ANSWERS 2022
What are post procedure nursing interventions for hemodynamic monitoring -
CORRECT ANSWER 1. Obtain chest x-ray to confirm catheter placement
2. Continually monitor vitals
3. Compare NIBP to arterial blood pressure
4. Observe and document waveforms. Report changes in waveforms to the provider
5. Document catheter placement each shift and as needed
6. Place the patient in supine position prior to recording hemodynamic values
( HOB can be elevated 15° to 30°)
What are complications of hemodynamic monitoring - CORRECT ANSWER
What are nursing actions preprocedure before an angiography - CORRECT
ANSWER 1. Patient is NPO for at least eight hours before
2. Assess for iodine/shellfish allergy
3. Assess renal function
4. Teach the client that the affected leg must remain straight after the procedure
5. The other normal stuff like ensure informed consent blah blah
What are post procedure nursing interventions for an angiography - CORRECT
ANSWER 1. Assess vitals every 15 minutes for One hour, every 30 minutes for one
hour, every hour for four hours and then every four hours
2. Assess the site for bleeding and hematoma with every vital sign check
3. Maintain bed rest for 4 to 6 hours after the procedure
4. Monitor urine output and administer IV fluids for hydration (contrast media acts
as an osmotic diuretic)
How long do patients receive anticoagulation therapy that have stent placement
- CORRECT ANSWER 6 to 8 weeks
What is cardiac tamponade - CORRECT ANSWER Fluid accumulation in the pericardial
sac
What are manifestations of cardiac tamponade - CORRECT ANSWER hypotension
, ATI MED SURG FINAL EXAM ALL PRACICE
QUESTIONS AND ANSWERS 2022
JVD
Muffled heart
sounds
Paradoxical pulse
What are nursing actions for cardiac tamponade - CORRECT ANSWER 1. Notify the
provider immediately
2. Administer IV fluids to combat hypotension as prescribed
3. Obtain a chest x-ray or echocardiogram to confirm diagnosis
4. Prepare the client for pericardiocentesis
What is retroperitoneal bleeding - CORRECT ANSWER Bleeding into the
abdominal cavity behind the peritoneum can occur due to femoral artery
puncture (after an angiography)
What are nursing actions for retroperitoneal bleeding - CORRECT ANSWER 1. Assess
for flank pain and hypotension
2. Notify the provider immediately
3. Administer IV fluids and blood products as prescribed
What are central catheter's appropriate for - CORRECT ANSWER Any fluids
due to rapid hemodilution in the superior vena cava
What is post procedure care for a PICC - CORRECT ANSWER
What should you do if there's an occlusion in the access device that impedes flow -
CORRECT ANSWER 1. Flush the line at least every 12 hours to maintain patency (3
mL for peripheral & 10 mL for central lines)
2. Administer urokinase to lyse obstructions per facility protocol
3. Flush implanted port after every use and at least once a month while implanted
What are nursing actions for a catheter thrombosis/emboli - CORRECT ANSWER 1.
Flush the line per facility protocol
2. Do not force fluid if resistance is encountered
QUESTIONS AND ANSWERS 2022
What is normal range for troponin I? When are elevated levels first detectable after
myocardial injury and what is expected duration of the elevated levels? - CORRECT
ANSWER Less than 0.03, three hours, 7 to 10 days
What is normal range for myoglobin? When are elevated levels first detectable
after myocardial injury and what is expected duration of the elevated levels? -
CORRECT ANSWER Less than 90 mcg/L, two hours, 24 hours
While an echocardiogram is being performed what side should the patient lie on? -
CORRECT ANSWER Left side and remain still
What are indications for an echocardiogram - CORRECT ANSWER
Cardiomyopathy Heart failure
Angina
Myocardial infarction
What are indications for stress test - CORRECT ANSWER
Dysrhythmias HF
Angin
a MI
What are two medications that are prescribed for pharmacological stress test -
CORRECT ANSWER Dobutamine
Adenosine
What do you instruct the patient to do 2 to 4 hours before a stress test - CORRECT
ANSWER Avoid tobacco, alcohol and caffeine
Hemodynamic monitoring involves special indwelling catheters that provide
information about blood volume and perfusion, fluid status and how well the heart
is pumping. Arterial lines are placed in the radial (most common), brachial or
femoral artery. What should you Monitor for? -
,ATI MED SURG FINAL EXAM ALL PRACICE
QUESTIONS AND ANSWERS 2022
CORRECT ANSWER Monitor circulation in the limb with the arterial line. Such as
capillary refill, temperature, color. Arterial lines are not used for IV fluid
administration
The pulmonary artery (PA) catheter is inserted into a large vein (internal jugular,
femoral, subclavian, brachial) and threaded through the right atria and ventricles
into a branch of the pulmonary artery. PA catheters have multiple lumens, ports and
components that allow for various hemodynamic measurements, blood sampling
and - CORRECT ANSWER Infusion of IV fluids
What are the different lumens used for? - CORRECT ANSWER
What is the expected reference range for CVP (Central venous pressure) -
CORRECT ANSWER 1 to 8 MM HG
What is the expected reference range for pulmonary artery systolic (PAS) -
CORRECT ANSWER 15 to 26
What is the expected range for pulmonary artery diastolic (PAD) - CORRECT ANSWER
5 to 15
What is expected range for pulmonary artery wedge pressure (PAWP)? - CORRECT
ANSWER 4 to 12
What is the expected range for cardiac output - CORRECT ANSWER 4 to 7 L/minute
What is expected range for mixed venous oxygen saturation - CORRECT
ANSWER 60% to 80%
When should a nurse anticipate lower hemodynamic values? - CORRECT ANSWER
In older patients especially if dehydration is a complication
What position should the patient be in with hemodynamic monitoring - CORRECT
ANSWER Supine or Trendelenburg
,ATI MED SURG FINAL EXAM ALL PRACICE
QUESTIONS AND ANSWERS 2022
What are post procedure nursing interventions for hemodynamic monitoring -
CORRECT ANSWER 1. Obtain chest x-ray to confirm catheter placement
2. Continually monitor vitals
3. Compare NIBP to arterial blood pressure
4. Observe and document waveforms. Report changes in waveforms to the provider
5. Document catheter placement each shift and as needed
6. Place the patient in supine position prior to recording hemodynamic values
( HOB can be elevated 15° to 30°)
What are complications of hemodynamic monitoring - CORRECT ANSWER
What are nursing actions preprocedure before an angiography - CORRECT
ANSWER 1. Patient is NPO for at least eight hours before
2. Assess for iodine/shellfish allergy
3. Assess renal function
4. Teach the client that the affected leg must remain straight after the procedure
5. The other normal stuff like ensure informed consent blah blah
What are post procedure nursing interventions for an angiography - CORRECT
ANSWER 1. Assess vitals every 15 minutes for One hour, every 30 minutes for one
hour, every hour for four hours and then every four hours
2. Assess the site for bleeding and hematoma with every vital sign check
3. Maintain bed rest for 4 to 6 hours after the procedure
4. Monitor urine output and administer IV fluids for hydration (contrast media acts
as an osmotic diuretic)
How long do patients receive anticoagulation therapy that have stent placement
- CORRECT ANSWER 6 to 8 weeks
What is cardiac tamponade - CORRECT ANSWER Fluid accumulation in the pericardial
sac
What are manifestations of cardiac tamponade - CORRECT ANSWER hypotension
, ATI MED SURG FINAL EXAM ALL PRACICE
QUESTIONS AND ANSWERS 2022
JVD
Muffled heart
sounds
Paradoxical pulse
What are nursing actions for cardiac tamponade - CORRECT ANSWER 1. Notify the
provider immediately
2. Administer IV fluids to combat hypotension as prescribed
3. Obtain a chest x-ray or echocardiogram to confirm diagnosis
4. Prepare the client for pericardiocentesis
What is retroperitoneal bleeding - CORRECT ANSWER Bleeding into the
abdominal cavity behind the peritoneum can occur due to femoral artery
puncture (after an angiography)
What are nursing actions for retroperitoneal bleeding - CORRECT ANSWER 1. Assess
for flank pain and hypotension
2. Notify the provider immediately
3. Administer IV fluids and blood products as prescribed
What are central catheter's appropriate for - CORRECT ANSWER Any fluids
due to rapid hemodilution in the superior vena cava
What is post procedure care for a PICC - CORRECT ANSWER
What should you do if there's an occlusion in the access device that impedes flow -
CORRECT ANSWER 1. Flush the line at least every 12 hours to maintain patency (3
mL for peripheral & 10 mL for central lines)
2. Administer urokinase to lyse obstructions per facility protocol
3. Flush implanted port after every use and at least once a month while implanted
What are nursing actions for a catheter thrombosis/emboli - CORRECT ANSWER 1.
Flush the line per facility protocol
2. Do not force fluid if resistance is encountered
