NUR417 / NUR 417 EXAM 1
Care of Adult II
Concordia, St. Paul
Actual Questions and Answers
This Exam contains:
➢ 100% Guarantee Pass.
➢ Expert Verified Explanation
➢ Multiple choice (single best answer)
➢ Select All That Apply (SATA)
➢ Fill-in-the-blank
➢ Case Studies/Scenario-Based Questions
,The nurse is caring for a patient who has an intraaortic balloon pump
in place. Which action should be included in the plan of care?
a. Avoid the use of anticoagulant medications.
b. Measure the patient's urinary output every hour.
c. Provide passive range of motion for all extremities.
d. Position the patient supine with head flat at all times.
Answer
B
Monitoring urine output will help determine whether the patient's cardiac
output has improved and also help monitor for balloon displacement
blocking the renal arteries. The head of the bed can be elevated up to 30
degrees. Heparin is used to prevent thrombus formation. Limited
movement is allowed for the extremity with the balloon insertion site to
prevent displacement of the balloon.
Which hemodynamic parameter best reflects the effectiveness of
drugs that the nurse gives to reduce a patient's left ventricular
afterload?
a. Mean arterial pressure (MAP)
b. Systemic vascular resistance (SVR)
c. Pulmonary vascular resistance (PVR)
d. Pulmonary artery wedge pressure (PAWP)
Answer
B
SVR reflects the resistance to ventricular ejection, or afterload. The other
parameters may be monitored but do not reflect afterload as directly.
,After surgery for an abdominal aortic aneurysm, a patient's central
venous pressure (CVP) monitor indicates low pressures. Which action
should 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.
ANSWER
B
A low CVP indicates 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.
The nurse is caring for a patient receiving a continuous
norepinephrine IV infusion. Which patient assessment finding
indicates that the infusion rate may need to be adjusted?
a. Heart rate is slow at 58 beats/min.
b. Mean arterial pressure (MAP) is 56 mm Hg.
c. Systemic vascular resistance (SVR) is elevated.
d. Pulmonary artery wedge pressure (PAWP) is low.
ANSWER
C
Vasoconstrictors such as norepinephrine will increase SVR, and this will
increase the work of the heart and decrease peripheral perfusion. The
infusion rate may need to be decreased. Bradycardia, hypotension (MAP of
56 mm Hg), and low PAWP are not associated with norepinephrine
infusion.
, When evaluating a patient with a central venous catheter, the nurse
observes that the insertion site is red and tender to touch and the
patient's temperature is 101.8° F. What should the nurse plan to do?
a. Discontinue the catheter and culture the tip.
b. Use the catheter only for fluid administration.
c. Change the flush system and monitor the site.
d. Check the site more frequently for any swelling.
ANSWER
A
The information indicates that the patient has a local and systemic infection
caused by the catheter, and the catheter should be discontinued to avoid
further complications such as endocarditis. Changing the flush system,
continued monitoring, or using the line for fluids will not help prevent or
treat the infection.
stroke volume
A patient's vital signs are pulse 90, respirations 24, and BP 128/64 mm
Hg, and cardiac output is 4.7 L/min. The patient's stroke volume is
_____ mL. (Round to the nearest whole number.)
ANSWER
52
Stroke volume = Cardiac output/heart rate52 mL = (4.7 L x 1000 mL/L)/90
An intraaortic balloon pump (IABP) is being used for a patient who is
in cardiogenic shock. Which assessment data indicate to the nurse
that the goals of treatment with the IABP are being met?
a. Urine output of 25 mL/hr
Care of Adult II
Concordia, St. Paul
Actual Questions and Answers
This Exam contains:
➢ 100% Guarantee Pass.
➢ Expert Verified Explanation
➢ Multiple choice (single best answer)
➢ Select All That Apply (SATA)
➢ Fill-in-the-blank
➢ Case Studies/Scenario-Based Questions
,The nurse is caring for a patient who has an intraaortic balloon pump
in place. Which action should be included in the plan of care?
a. Avoid the use of anticoagulant medications.
b. Measure the patient's urinary output every hour.
c. Provide passive range of motion for all extremities.
d. Position the patient supine with head flat at all times.
Answer
B
Monitoring urine output will help determine whether the patient's cardiac
output has improved and also help monitor for balloon displacement
blocking the renal arteries. The head of the bed can be elevated up to 30
degrees. Heparin is used to prevent thrombus formation. Limited
movement is allowed for the extremity with the balloon insertion site to
prevent displacement of the balloon.
Which hemodynamic parameter best reflects the effectiveness of
drugs that the nurse gives to reduce a patient's left ventricular
afterload?
a. Mean arterial pressure (MAP)
b. Systemic vascular resistance (SVR)
c. Pulmonary vascular resistance (PVR)
d. Pulmonary artery wedge pressure (PAWP)
Answer
B
SVR reflects the resistance to ventricular ejection, or afterload. The other
parameters may be monitored but do not reflect afterload as directly.
,After surgery for an abdominal aortic aneurysm, a patient's central
venous pressure (CVP) monitor indicates low pressures. Which action
should 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.
ANSWER
B
A low CVP indicates 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.
The nurse is caring for a patient receiving a continuous
norepinephrine IV infusion. Which patient assessment finding
indicates that the infusion rate may need to be adjusted?
a. Heart rate is slow at 58 beats/min.
b. Mean arterial pressure (MAP) is 56 mm Hg.
c. Systemic vascular resistance (SVR) is elevated.
d. Pulmonary artery wedge pressure (PAWP) is low.
ANSWER
C
Vasoconstrictors such as norepinephrine will increase SVR, and this will
increase the work of the heart and decrease peripheral perfusion. The
infusion rate may need to be decreased. Bradycardia, hypotension (MAP of
56 mm Hg), and low PAWP are not associated with norepinephrine
infusion.
, When evaluating a patient with a central venous catheter, the nurse
observes that the insertion site is red and tender to touch and the
patient's temperature is 101.8° F. What should the nurse plan to do?
a. Discontinue the catheter and culture the tip.
b. Use the catheter only for fluid administration.
c. Change the flush system and monitor the site.
d. Check the site more frequently for any swelling.
ANSWER
A
The information indicates that the patient has a local and systemic infection
caused by the catheter, and the catheter should be discontinued to avoid
further complications such as endocarditis. Changing the flush system,
continued monitoring, or using the line for fluids will not help prevent or
treat the infection.
stroke volume
A patient's vital signs are pulse 90, respirations 24, and BP 128/64 mm
Hg, and cardiac output is 4.7 L/min. The patient's stroke volume is
_____ mL. (Round to the nearest whole number.)
ANSWER
52
Stroke volume = Cardiac output/heart rate52 mL = (4.7 L x 1000 mL/L)/90
An intraaortic balloon pump (IABP) is being used for a patient who is
in cardiogenic shock. Which assessment data indicate to the nurse
that the goals of treatment with the IABP are being met?
a. Urine output of 25 mL/hr
