NUR 417 EXAM 1 QUESTIONS AND
CORRECT ANSWERS
A nurse is planning care for a client who has prerenal acute kidney injury
following abdominal aortic aneurysm repair. Urinary output is 60 ml in
the past 2 hours, and blood pressure is 92/58. the nurse should expect
which of the following interventions.
a. prepare the client for CT scan with contrast dye
b. plan to administer nitro
c. prepare to administer a fluid challenge
d. plan trendelenburg - CORRECT ANSWER- c
a nurse is planning care for a client who has septic shock. which is the
priority
a. maintain adequate fluid volume with IV infusions
b. administer antibiotic therapy
c. monitor hemodynamic status
d. admin vasopressor - CORRECT ANSWER- a
nurse in ED completing assessment on client in shock. Which would the
nurse expect
a. heart rate 60
b. seizure activity
c. resp rate 42
d. increased urine output
e. weak thready pulse - CORRECT ANSWER- b, c, e
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)
CORRECT ANSWERS
A nurse is planning care for a client who has prerenal acute kidney injury
following abdominal aortic aneurysm repair. Urinary output is 60 ml in
the past 2 hours, and blood pressure is 92/58. the nurse should expect
which of the following interventions.
a. prepare the client for CT scan with contrast dye
b. plan to administer nitro
c. prepare to administer a fluid challenge
d. plan trendelenburg - CORRECT ANSWER- c
a nurse is planning care for a client who has septic shock. which is the
priority
a. maintain adequate fluid volume with IV infusions
b. administer antibiotic therapy
c. monitor hemodynamic status
d. admin vasopressor - CORRECT ANSWER- a
nurse in ED completing assessment on client in shock. Which would the
nurse expect
a. heart rate 60
b. seizure activity
c. resp rate 42
d. increased urine output
e. weak thready pulse - CORRECT ANSWER- b, c, e
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)
