Hemodynamic monitoring ATI Exam With
Solutions
1. |A |nurse |is |evaluating |the |central |venous |pressure |(CVP) |of |a |client |who |has |sustained |multiple |
traumas. |Which |of |the |following |interpretations |of |a |low |CVP |pressure |should |the |nurse |make?
A. |Fluid |overload
Rationale: |The |CVP |is |the |pressure |in |the |vena |cava, |or |right |atrium, |and |is |reflective |of |preload. |A |
client |who |has |fluid |overload |would |have |a |high |CVP |value.
B. |Left |ventricular |failure
Rationale: |Left |ventricular |failure |can |be |detected |by |an |elevated |pulmonary |artery |wedge |
pressure.
C. |Intracardiac |shunt
Rationale: |Intracardiac |shunt |can |be |detected |by |an |elevated |pulmonary |artery |wedge |pressure.
D. |Hypovolemia
Rationale: |A |low |CVP |indicates |reduced |right |ventricular |preload, |which |can |be |seen |in |clients |who |
are |experiencing |hypovolemia, |excessive |blood |loss, |or |overdiuresis |- |correct |answer |-
D.Hypovolemia
2. |A |nurse |is |monitoring |the |pulmonary |artery |wedge |pressure |(PAWP) |for |a |client. |The |nurse |
should |identity |that |a |reading |of |15 |mm |Hg |is |an |indication |of |which |of |the |following |conditions?
A. |Fluid |volume |deficit
Rationale: |A |client |who |has |fluid |volume |deficit |is |more |likely |to |have |a |decreased |PAWP.
B. |Right |ventricular |failure
Rationale: |An |increased |right |atrium |(RA) |pressure |can |indicate |right |ventricular |failure. |A |
decreased |RA |pressure |usually |indicates |hypovolemia.
C. |Mitral |regurgitation
Rationale: |Hemodynamic |monitoring |allows |the |nurse |to |monitor |the |pressures |within |the |heart |
and |the |great |vessels. |The |PAWP |reflects |left |atrial |pressure. |A |reading |of |15 |mm |Hg |is |above |the |
expected |reference |range, |which |can |indicate |mitral |regurgitation, |hypervolemia, |or |left |ventricular |
failure. |The |nurse |should |monitor |for |trends |in |value, |which |can |be |more |reliable |than |individual |
values.
D. |Afterload |reduction
, Ration |- |correct |answer |-C.Mitral |regurgitation
PAWP.
3. |A |nurse |is |monitoring |the |cardiac |output |of |a |client |who |has |left-sided |heart |failure |using |pulse |
pressure |analysis. |Which |of |the |following |findings |can |compromise |the |readings?
A. |The |client |is |experiencing |premature |atrial |contractions.
Rationale:
Pulse |pressure |devices |require |the |presence |of |optimal |arterial |waveforms |in |order |to |capture |
accurate |data. |Therefore, |a |dysrhythmia, |such |as |premature |atrial |contractions, |will |compromise |
the |readings.
B. |The |client |has |a |decreased |oxygen |saturation |level.
Rationale: |Decreased |oxygen |saturation |is |a |manifestation |of |heart |failure |that |does |not |
compromise |cardiac |output |readings.
C. |The |client |has |bilateral |wheezes.
Rationale: |Bilateral |wheezes |are |a |manifestation |of |heart |failure |that |do |not |compromise |cardiac |
output |readings.
D. |The |client |has |lower |leg |edema.
Rationale: |Lower |leg |edema |is |a |manifestation |of |heart |failure |that |does |not |compromise |cardiac |
outpu |- |correct |answer |-A.The |client |is |experiencing |premature |atrial |contractions.
4. |A |nurse |is |teaching |a |client |who |has |septic |shock |about |the |development |of |disseminated |
intravascular |coagulation |(DIC). |Which |of |the |following |statements |should |the |nurse |make?
A. |"DIC |is |controllable |with |lifelong |heparin |usage."
Rationale: |DIC |is |not |controlled |with |lifelong |heparin |usage. |Heparin |is |administered |to |minimize |
the |formation |of |microthrombi, |which |improves |tissue |perfusion.
B. |"DIC |is |characterized |by |an |elevated |platelet |count."
Rationale: |DIC |causes |bleeding |in |part |due |to |a |decreased |platelet |count, |rather |than |an |elevated |
platelet |count.
C. |"DIC |is |caused |by |abnormal |coagulation |involving |fibrinogen."
Rationale: |DIC |is |caused |by |abnormal |coagulation |involving |the |formation |of |multiple |small |clots |
that |consume |clotting |factors |and |fibrinogen |faster |than |the |body |can |produce |them, |increasing |the
|risk |for |hemorrhage.
D. |"DIC |is |a |genetic |disorder |involving |a |vitamin |K |deficiency."
Solutions
1. |A |nurse |is |evaluating |the |central |venous |pressure |(CVP) |of |a |client |who |has |sustained |multiple |
traumas. |Which |of |the |following |interpretations |of |a |low |CVP |pressure |should |the |nurse |make?
A. |Fluid |overload
Rationale: |The |CVP |is |the |pressure |in |the |vena |cava, |or |right |atrium, |and |is |reflective |of |preload. |A |
client |who |has |fluid |overload |would |have |a |high |CVP |value.
B. |Left |ventricular |failure
Rationale: |Left |ventricular |failure |can |be |detected |by |an |elevated |pulmonary |artery |wedge |
pressure.
C. |Intracardiac |shunt
Rationale: |Intracardiac |shunt |can |be |detected |by |an |elevated |pulmonary |artery |wedge |pressure.
D. |Hypovolemia
Rationale: |A |low |CVP |indicates |reduced |right |ventricular |preload, |which |can |be |seen |in |clients |who |
are |experiencing |hypovolemia, |excessive |blood |loss, |or |overdiuresis |- |correct |answer |-
D.Hypovolemia
2. |A |nurse |is |monitoring |the |pulmonary |artery |wedge |pressure |(PAWP) |for |a |client. |The |nurse |
should |identity |that |a |reading |of |15 |mm |Hg |is |an |indication |of |which |of |the |following |conditions?
A. |Fluid |volume |deficit
Rationale: |A |client |who |has |fluid |volume |deficit |is |more |likely |to |have |a |decreased |PAWP.
B. |Right |ventricular |failure
Rationale: |An |increased |right |atrium |(RA) |pressure |can |indicate |right |ventricular |failure. |A |
decreased |RA |pressure |usually |indicates |hypovolemia.
C. |Mitral |regurgitation
Rationale: |Hemodynamic |monitoring |allows |the |nurse |to |monitor |the |pressures |within |the |heart |
and |the |great |vessels. |The |PAWP |reflects |left |atrial |pressure. |A |reading |of |15 |mm |Hg |is |above |the |
expected |reference |range, |which |can |indicate |mitral |regurgitation, |hypervolemia, |or |left |ventricular |
failure. |The |nurse |should |monitor |for |trends |in |value, |which |can |be |more |reliable |than |individual |
values.
D. |Afterload |reduction
, Ration |- |correct |answer |-C.Mitral |regurgitation
PAWP.
3. |A |nurse |is |monitoring |the |cardiac |output |of |a |client |who |has |left-sided |heart |failure |using |pulse |
pressure |analysis. |Which |of |the |following |findings |can |compromise |the |readings?
A. |The |client |is |experiencing |premature |atrial |contractions.
Rationale:
Pulse |pressure |devices |require |the |presence |of |optimal |arterial |waveforms |in |order |to |capture |
accurate |data. |Therefore, |a |dysrhythmia, |such |as |premature |atrial |contractions, |will |compromise |
the |readings.
B. |The |client |has |a |decreased |oxygen |saturation |level.
Rationale: |Decreased |oxygen |saturation |is |a |manifestation |of |heart |failure |that |does |not |
compromise |cardiac |output |readings.
C. |The |client |has |bilateral |wheezes.
Rationale: |Bilateral |wheezes |are |a |manifestation |of |heart |failure |that |do |not |compromise |cardiac |
output |readings.
D. |The |client |has |lower |leg |edema.
Rationale: |Lower |leg |edema |is |a |manifestation |of |heart |failure |that |does |not |compromise |cardiac |
outpu |- |correct |answer |-A.The |client |is |experiencing |premature |atrial |contractions.
4. |A |nurse |is |teaching |a |client |who |has |septic |shock |about |the |development |of |disseminated |
intravascular |coagulation |(DIC). |Which |of |the |following |statements |should |the |nurse |make?
A. |"DIC |is |controllable |with |lifelong |heparin |usage."
Rationale: |DIC |is |not |controlled |with |lifelong |heparin |usage. |Heparin |is |administered |to |minimize |
the |formation |of |microthrombi, |which |improves |tissue |perfusion.
B. |"DIC |is |characterized |by |an |elevated |platelet |count."
Rationale: |DIC |causes |bleeding |in |part |due |to |a |decreased |platelet |count, |rather |than |an |elevated |
platelet |count.
C. |"DIC |is |caused |by |abnormal |coagulation |involving |fibrinogen."
Rationale: |DIC |is |caused |by |abnormal |coagulation |involving |the |formation |of |multiple |small |clots |
that |consume |clotting |factors |and |fibrinogen |faster |than |the |body |can |produce |them, |increasing |the
|risk |for |hemorrhage.
D. |"DIC |is |a |genetic |disorder |involving |a |vitamin |K |deficiency."
