Critical Care Exam 1
CRITICAL CARE EXAM 1 NEWEST 2025/2026 COMPLETE ALL
QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+||BRAND NEW VERSION!
The nurse is caring for a patient with a left subclavian central venous catheter
(CVC) and a left radial arterial line. Which assessment finding by the nurse
requires immediate action?
a. A dampened arterial line waveform
b. Numbness and tingling in the left hand
c. Slight bloody drainage at subclavian insertion site
d. Slight redness at subclavian insertion site - ANSWER-b. Numbness and tingling
in the left hand
Numbness and tingling in the left hand, which is the location of an arterial
catheter, indicates possible neurovascular compromise and requires immediate
action. A dampened waveform can indicate problems with arterial line patency
but is not an emergent situation. Slight bloody drainage at the subclavian insertion
site is not an unusual finding. Slight redness at the insertion site, while of concern,
does not require immediate action.
The physician writes an order to discontinue a patient's left radial arterial line.
When discontinuing the patient's invasive line, what is the priority nursing action?
a. Apply an air occlusion dressing to insertion site.
b. Apply pressure to the insertion site for 5 minutes.
c. Elevate the affected limb on pillows for 24 hours.
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, Critical Care Exam 1
d. Keep the patient's wrist in a neutral position. - ANSWER-b. Apply pressure to
the insertion site for 5 minutes.
Upon removal of an invasive arterial line, adequate pressure must be applied for
at least 5 minutes to ensure adequate hemostasis. Application of an air occlusion
dressing is not standard of care following removal of an arterial line. Elevation of
the affected limb following removal of an arterial line is not a necessary
intervention. Neutral wrist position is optimum while the catheter is in place and
not necessary after catheter discontinuation.
Following insertion of a central venous catheter, the nurse obtains a stat chest x-
ray film to verify proper catheter placement. The radiologist reports to the nurse:
"The tip of the catheter is located in the superior vena cava." What is the best
interpretation of these results by the nurse?
a. The catheter is not positioned correctly and should be removed.
b. The catheter position increases the risk of ventricular dysrhythmias.
c. The distal tip of the catheter is in the appropriate position.
d. The physician should be called to advance the catheter into the pulmonary
artery. - ANSWER-c. The distal tip of the catheter is in the appropriate position.
X-ray results indicate proper position of the catheter. The tip of the central venous
catheter should rest just above the right atrium in the superior vena cava. The
central venous catheter is positioned correctly in the superior vena cava.
Dysrhythmias occur if the catheter migrates to the right ventricle. Central venous
catheters are placed into great vessels of the venous system and not advanced
into the pulmonary artery.
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, Critical Care Exam 1
While inflating the balloon of a pulmonary artery catheter (PAC) with 1.0 mL of air
to obtain a pulmonary artery occlusion pressure (PAOP), the nurse encounters
resistance. What is the best nursing action?
a. Add an additional 0.5 mL of air to the balloon and repeat the procedure.
b. Advance the catheter with the balloon deflated and repeat the procedure.
c. Deflate the balloon and obtain a chest x-ray study to determine line placement.
d. Lock the balloon in the inflated position and flush the distal port of the PAC with
normal saline. - ANSWER-c. Deflate the balloon and obtain a chest x-ray study to
determine line placement.
Balloon inflation should never be forced because the PAC may have migrated
further into the pulmonary artery, creating resistance to balloon inflation.
Verification of proper line placement is warranted to avoid pulmonary artery
rupture. In addition, the PAC waveform should be observed to assist in identifying
location of the tip of the PAC. In this scenario, adding additional air to the balloon
will further risk pulmonary artery rupture.
Advancing a pulmonary artery catheter is not within the nurses scope of practice.
Flushing the distal port with saline may be indicated to ensure patency; however,
the balloon of the PAC should never be locked in the inflated position as rupture
of the pulmonary artery may occur.
The nurse is caring for a patient following insertion of a left subclavian central
venous catheter (CVC). Which assessment finding 2 hours after insertion by the
nurse warrants immediate action?
a. Diminished breath sounds over left lung field
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, Critical Care Exam 1
b. Localized pain at catheter insertion site
c. Measured central venous pressure of 5 mm Hg
d. Slight bloody drainage around insertion site - ANSWER-a. Diminished breath
sounds over left lung field
Diminished breaths sounds over the lung field on the same side of the line
insertion site may be indicative of a pneumothorax. A pneumothorax, which can
develop slowly, is a major complication following insertion of central lines when
the subclavian route is used. Localized pain at catheter insertion site is not the
immediate priority in this scenario. A measured central venous pressure of 5 mm
Hg is normal. Slight bloody drainage at the insertion site soon after the procedure
does not require immediate action.
The nurse is caring for a mechanically ventilated patient with a pulmonary artery
catheter who is receiving continuous enteral tube feedings. When obtaining
continuous hemodynamic monitoring measurements, what is the best nursing
action?
a. Do not document hemodynamic values until the patient can be placed in the
supine position.
b. Level and zero reference the air-fluid interface of the transducer with the
patient in the supine position and record hemodynamic values.
c. Level and zero reference the air-fluid interface of the transducer with the
patient's head of bed elevated to 30 degrees and record hemodynamic values.
d. Level and zero reference the air-fluid interface of the transducer with the
patient supine in the side-lying position and record hemodynamic values. -
ANSWER-c. Level and zero reference the air-fluid interface of the transducer with
the patient's head of bed elevated to 30 degrees and record hemodynamic values.
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CRITICAL CARE EXAM 1 NEWEST 2025/2026 COMPLETE ALL
QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+||BRAND NEW VERSION!
The nurse is caring for a patient with a left subclavian central venous catheter
(CVC) and a left radial arterial line. Which assessment finding by the nurse
requires immediate action?
a. A dampened arterial line waveform
b. Numbness and tingling in the left hand
c. Slight bloody drainage at subclavian insertion site
d. Slight redness at subclavian insertion site - ANSWER-b. Numbness and tingling
in the left hand
Numbness and tingling in the left hand, which is the location of an arterial
catheter, indicates possible neurovascular compromise and requires immediate
action. A dampened waveform can indicate problems with arterial line patency
but is not an emergent situation. Slight bloody drainage at the subclavian insertion
site is not an unusual finding. Slight redness at the insertion site, while of concern,
does not require immediate action.
The physician writes an order to discontinue a patient's left radial arterial line.
When discontinuing the patient's invasive line, what is the priority nursing action?
a. Apply an air occlusion dressing to insertion site.
b. Apply pressure to the insertion site for 5 minutes.
c. Elevate the affected limb on pillows for 24 hours.
1|Page
, Critical Care Exam 1
d. Keep the patient's wrist in a neutral position. - ANSWER-b. Apply pressure to
the insertion site for 5 minutes.
Upon removal of an invasive arterial line, adequate pressure must be applied for
at least 5 minutes to ensure adequate hemostasis. Application of an air occlusion
dressing is not standard of care following removal of an arterial line. Elevation of
the affected limb following removal of an arterial line is not a necessary
intervention. Neutral wrist position is optimum while the catheter is in place and
not necessary after catheter discontinuation.
Following insertion of a central venous catheter, the nurse obtains a stat chest x-
ray film to verify proper catheter placement. The radiologist reports to the nurse:
"The tip of the catheter is located in the superior vena cava." What is the best
interpretation of these results by the nurse?
a. The catheter is not positioned correctly and should be removed.
b. The catheter position increases the risk of ventricular dysrhythmias.
c. The distal tip of the catheter is in the appropriate position.
d. The physician should be called to advance the catheter into the pulmonary
artery. - ANSWER-c. The distal tip of the catheter is in the appropriate position.
X-ray results indicate proper position of the catheter. The tip of the central venous
catheter should rest just above the right atrium in the superior vena cava. The
central venous catheter is positioned correctly in the superior vena cava.
Dysrhythmias occur if the catheter migrates to the right ventricle. Central venous
catheters are placed into great vessels of the venous system and not advanced
into the pulmonary artery.
2|Page
, Critical Care Exam 1
While inflating the balloon of a pulmonary artery catheter (PAC) with 1.0 mL of air
to obtain a pulmonary artery occlusion pressure (PAOP), the nurse encounters
resistance. What is the best nursing action?
a. Add an additional 0.5 mL of air to the balloon and repeat the procedure.
b. Advance the catheter with the balloon deflated and repeat the procedure.
c. Deflate the balloon and obtain a chest x-ray study to determine line placement.
d. Lock the balloon in the inflated position and flush the distal port of the PAC with
normal saline. - ANSWER-c. Deflate the balloon and obtain a chest x-ray study to
determine line placement.
Balloon inflation should never be forced because the PAC may have migrated
further into the pulmonary artery, creating resistance to balloon inflation.
Verification of proper line placement is warranted to avoid pulmonary artery
rupture. In addition, the PAC waveform should be observed to assist in identifying
location of the tip of the PAC. In this scenario, adding additional air to the balloon
will further risk pulmonary artery rupture.
Advancing a pulmonary artery catheter is not within the nurses scope of practice.
Flushing the distal port with saline may be indicated to ensure patency; however,
the balloon of the PAC should never be locked in the inflated position as rupture
of the pulmonary artery may occur.
The nurse is caring for a patient following insertion of a left subclavian central
venous catheter (CVC). Which assessment finding 2 hours after insertion by the
nurse warrants immediate action?
a. Diminished breath sounds over left lung field
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, Critical Care Exam 1
b. Localized pain at catheter insertion site
c. Measured central venous pressure of 5 mm Hg
d. Slight bloody drainage around insertion site - ANSWER-a. Diminished breath
sounds over left lung field
Diminished breaths sounds over the lung field on the same side of the line
insertion site may be indicative of a pneumothorax. A pneumothorax, which can
develop slowly, is a major complication following insertion of central lines when
the subclavian route is used. Localized pain at catheter insertion site is not the
immediate priority in this scenario. A measured central venous pressure of 5 mm
Hg is normal. Slight bloody drainage at the insertion site soon after the procedure
does not require immediate action.
The nurse is caring for a mechanically ventilated patient with a pulmonary artery
catheter who is receiving continuous enteral tube feedings. When obtaining
continuous hemodynamic monitoring measurements, what is the best nursing
action?
a. Do not document hemodynamic values until the patient can be placed in the
supine position.
b. Level and zero reference the air-fluid interface of the transducer with the
patient in the supine position and record hemodynamic values.
c. Level and zero reference the air-fluid interface of the transducer with the
patient's head of bed elevated to 30 degrees and record hemodynamic values.
d. Level and zero reference the air-fluid interface of the transducer with the
patient supine in the side-lying position and record hemodynamic values. -
ANSWER-c. Level and zero reference the air-fluid interface of the transducer with
the patient's head of bed elevated to 30 degrees and record hemodynamic values.
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