,NURS 4581 Final Exam | Adult Complex Needs (2026)
Q&A | University of Texas at Arlington
1. Which of the following best describes the primary purpose of the Allen test before radial
artery cannulation?
A) To assess ulnar nerve function
B) To evaluate collateral circulation to the hand
C) To measure arterial blood pressure
D) To determine the appropriate catheter size
Correct Answer: To evaluate collateral circulation to the hand
Rationale: The Allen test assesses collateral circulation to the hand before radial artery
cannulation. If ulnar refill occurs within 7 seconds, circulation is adequate. It does not
assess nerve function, measure blood pressure, or determine catheter size.
2. A nurse is reviewing a client's hemodynamic parameters and notes a central venous
pressure (CVP) of 3 mm Hg. How should the nurse interpret this finding?
A) Elevated right ventricular preload
B) Decreased right ventricular preload
C) Elevated left ventricular preload
D) Normal left ventricular preload
Correct Answer: Decreased right ventricular preload
Rationale: A CVP of 3 mm Hg is below the normal range of 2 to 8 mm Hg, indicating
decreased right ventricular preload. This may be caused by hypovolemia or reduced venous
return. It does not directly measure left ventricular preload.
,3. Which parameter reflects left ventricular afterload?
A) Central venous pressure (CVP)
B) Pulmonary artery wedge pressure (PAWP)
C) Systemic vascular resistance (SVR)
D) Cardiac output (CO)
Correct Answer: Systemic vascular resistance (SVR)
Rationale: SVR reflects left ventricular afterload, or arterial tone. Normal SVR is 800 to
1200 dynes/sec/cm⁵. CVP reflects right ventricular preload, PAWP reflects left ventricular
preload, and CO reflects contractility and volume.
4. A client with a pulmonary artery catheter develops ventricular ectopy during insertion.
What is the priority nursing action?
A) Continue monitoring
B) Notify the provider
C) Administer a bolus of normal saline
D) Reposition the client
Correct Answer: Notify the provider
Rationale: Ventricular ectopy during PA catheter insertion indicates myocardial irritation
and can progress to dangerous dysrhythmias. The nurse should notify the provider
immediately. Continuing to monitor or administering fluids does not address the
underlying cause.
5. Which of the following is a primary risk factor for the development of ARDS?
, A) Chronic kidney disease
B) Sepsis
C) Hypertension
D) Diabetes mellitus
Correct Answer: Sepsis
Rationale: Sepsis is a major risk factor for ARDS because it triggers a systemic
inflammatory response that damages the alveolar-capillary membrane. Chronic kidney
disease, hypertension, and diabetes are not primary risk factors for ARDS.
6. A client with ARDS has a pulmonary artery wedge pressure (PAWP) of 14 mm Hg. How
should the nurse interpret this finding?
A) Consistent with ARDS
B) Consistent with heart failure
C) Elevated and requires diuresis
D) Normal and expected
Correct Answer: Consistent with ARDS
Rationale: In ARDS, PAWP remains below 18 mm Hg, distinguishing it from cardiogenic
pulmonary edema. A PAWP of 14 mm Hg is within the normal range (6-12 mm Hg) and is
consistent with ARDS. Heart failure typically presents with PAWP above 18 mm Hg.
7. Which finding is the earliest indicator of respiratory distress in a client with ARDS?
A) Cyanosis
B) Anxiety
C) Bradycardia
Q&A | University of Texas at Arlington
1. Which of the following best describes the primary purpose of the Allen test before radial
artery cannulation?
A) To assess ulnar nerve function
B) To evaluate collateral circulation to the hand
C) To measure arterial blood pressure
D) To determine the appropriate catheter size
Correct Answer: To evaluate collateral circulation to the hand
Rationale: The Allen test assesses collateral circulation to the hand before radial artery
cannulation. If ulnar refill occurs within 7 seconds, circulation is adequate. It does not
assess nerve function, measure blood pressure, or determine catheter size.
2. A nurse is reviewing a client's hemodynamic parameters and notes a central venous
pressure (CVP) of 3 mm Hg. How should the nurse interpret this finding?
A) Elevated right ventricular preload
B) Decreased right ventricular preload
C) Elevated left ventricular preload
D) Normal left ventricular preload
Correct Answer: Decreased right ventricular preload
Rationale: A CVP of 3 mm Hg is below the normal range of 2 to 8 mm Hg, indicating
decreased right ventricular preload. This may be caused by hypovolemia or reduced venous
return. It does not directly measure left ventricular preload.
,3. Which parameter reflects left ventricular afterload?
A) Central venous pressure (CVP)
B) Pulmonary artery wedge pressure (PAWP)
C) Systemic vascular resistance (SVR)
D) Cardiac output (CO)
Correct Answer: Systemic vascular resistance (SVR)
Rationale: SVR reflects left ventricular afterload, or arterial tone. Normal SVR is 800 to
1200 dynes/sec/cm⁵. CVP reflects right ventricular preload, PAWP reflects left ventricular
preload, and CO reflects contractility and volume.
4. A client with a pulmonary artery catheter develops ventricular ectopy during insertion.
What is the priority nursing action?
A) Continue monitoring
B) Notify the provider
C) Administer a bolus of normal saline
D) Reposition the client
Correct Answer: Notify the provider
Rationale: Ventricular ectopy during PA catheter insertion indicates myocardial irritation
and can progress to dangerous dysrhythmias. The nurse should notify the provider
immediately. Continuing to monitor or administering fluids does not address the
underlying cause.
5. Which of the following is a primary risk factor for the development of ARDS?
, A) Chronic kidney disease
B) Sepsis
C) Hypertension
D) Diabetes mellitus
Correct Answer: Sepsis
Rationale: Sepsis is a major risk factor for ARDS because it triggers a systemic
inflammatory response that damages the alveolar-capillary membrane. Chronic kidney
disease, hypertension, and diabetes are not primary risk factors for ARDS.
6. A client with ARDS has a pulmonary artery wedge pressure (PAWP) of 14 mm Hg. How
should the nurse interpret this finding?
A) Consistent with ARDS
B) Consistent with heart failure
C) Elevated and requires diuresis
D) Normal and expected
Correct Answer: Consistent with ARDS
Rationale: In ARDS, PAWP remains below 18 mm Hg, distinguishing it from cardiogenic
pulmonary edema. A PAWP of 14 mm Hg is within the normal range (6-12 mm Hg) and is
consistent with ARDS. Heart failure typically presents with PAWP above 18 mm Hg.
7. Which finding is the earliest indicator of respiratory distress in a client with ARDS?
A) Cyanosis
B) Anxiety
C) Bradycardia
