NR 341 COMPLEX ADULT HEALTH LATEST EXAM 2025
QUESTIONS AND ANSWERS/ ALREADY GRADED A++
Indication for arterial line placement? - ANSWER Hemodynamic monitoring
Multiple blood samples
Diagnostic or interventional radiology procedures
Continuous cardiac output monitoring
What test must be performed prior to an arterial line placement? -
ANSWER Allen's test
How often should a fast flush test be performed? - ANSWER Every 8 hours
After blood draws
If the hemodynamic status changes
When changing tubing
What are the most common sites for arterial line insertion? - ANSWER
Radial
Femoral
Axillary
Dorsalis Pedis
Brachial Arteries
Positioning for radial arterial line placement: - ANSWER 30-60 degrees of
dorsiflexion with the aid of a roll of gauze and an armband.
Avoid hyperabduction of the thumb.
How often should the atrial line catheter be changed out? - ANSWER Every
7 days
Causes of inaccuracy in arterial line readings: - ANSWER Air bubbles in
the catheter system
Failure to zero the transducer air-fluid interface
Blood in the catheter system
Blood clot at the catheter tip
Kinking of the tubing system
Catheter tip lodging against the arterial wall
Soft, compliant tubing
Long tubing
,Too many stopckcks (>3)
What is the pathology of afterload? - ANSWER The pressure in which the
heart must pump against in order to eject blood during systole.
Medications that reduce afterload/preload include? - ANSWER
Vasodilators
What is the pathology of preload? - ANSWER The filling pressure of the
heart at end of diastole.
What is systemic vascular resistance (SVR)? - ANSWER Resistance the
left ventricle must overcome to open the aortic valve and eject a volume of
blood into systemic circulation.
Systemic vascular resistance (SVR) is used for what calculations? -
ANSWER Blood pressure
Blood flow
Cardiac function
What is pulmonary vascular resistance (PVR)? - ANSWER Resistance the
right ventricle must overcome to open the pulmonic valve and eject a
volume of blood in the pulmonary vasculature.
What is pulmonary artery occlusion pressure (PAOP)? - ANSWER The
pressure created by the volume of blood that remains in the left heart at
end-diastole.
Inotropic drugs mode of action: - ANSWER Negative inotropic drugs
weaken the force of muscular contractions.
Positive inotropic drugs increase the strength of muscular contractions.
Inotropic drug examples: - ANSWER Dobutamine
Digoxin
Milrinone
Dopamine
Vasodilator mode of actions: - ANSWER Relaxes the smooth muscles of
the blood vessels opening them up.
,Vasodilator drug examples: - ANSWER CCBS:
Verapamil (Calan, Isoptin)
Diltiazem (Cardizem)
Atorvastatin (Lipitor)
Nitrates:
Sildenafil (Viagra)
Nitroprusside (Nipride, Nitropress)
ACE:
Captopril (Capoten)
Lisinopril (Prinivil, Zestril)
Kayexalate - ANSWER Exchanges K+ ions for Na+
Excess K+ ions are fecally excreted
Calcium Gluconate - ANSWER Prevents and treats cardiac toxicity related
to increased K+ levels
What is the purpose of Continuous Renal Replacement Therapy (CRRT)? -
ANSWER Dialysis
This is a blood filtering therapy that replaced the normal blood-filtering
function of the kidneys in patients with renal failure and acute kidney
injuries.
The prerenal system - ANSWER Delivers blood to the kidneys.
A prerenal block is: - ANSWER An interruption on the way to the kidneys.
The intrarenal system - ANSWER Processes ultra-filtrate by tubular
secretion & re-absorption.
An intrarenal block is: - ANSWER Direct damage to the kidneys.
The postrenal system - ANSWER Excretes kidney waste products through
the ureters, bladder, and urethra.
A postrenal block is: - ANSWER Obstruction of urine output.
Causes:
Enlarged prostate
Kidney stones
Bladder tumor
, Bladder injury
S/SX of the oliguric phase of acute kidney injury (AKI): - ANSWER <400
mL/24hr
Increase BUN, Cr, uric acid, K, Mg
Metabolic Acidosis
S/SX of the diuretic phase of acute kidney injury (AKI): - ANSWER Urine
output 1-3L/day
Decreased K & Na
S/SX of the risk stage of acute kidney injury (AKI): - ANSWER Cr
>1.5xbaseline
Urine output <0.5ml/kg/hr for 6+ hours
S/SX of the injury stage of acute kidney injury (AKI): - ANSWER Cr
>2xbaseline
Urine output <0.5ml/kg/hr for 12+ hours
S/SX of the risk failure of acute kidney injury (AKI): - ANSWER Cr
>3xbaseline
Urine output <0.3ml/kg/hr for 12+ hours
Priority assessment findings of acute kidney injury (AKI): - ANSWER
Respiratory:
Crackles
Pleural Effusion
Kussmaul respirations
Cardiovascular:
CHF, hypo/hypertension
Cardiac dysrhythmias
Pericarditis, pericardial effusion
Neurologic:
Altered mentation, confusion, lethargy
Decreased seizure threshold
S/SX of hypovolemic shock: - ANSWER Elevated HR, decreased BP,
tachypnea, oliguria, cool pale skin, decreased mental status, flat neck
veins, decreased CO CI RAP PAP PAOP, elevated SVR, decreased SvO2.
Dehydration causes elevated HCT
QUESTIONS AND ANSWERS/ ALREADY GRADED A++
Indication for arterial line placement? - ANSWER Hemodynamic monitoring
Multiple blood samples
Diagnostic or interventional radiology procedures
Continuous cardiac output monitoring
What test must be performed prior to an arterial line placement? -
ANSWER Allen's test
How often should a fast flush test be performed? - ANSWER Every 8 hours
After blood draws
If the hemodynamic status changes
When changing tubing
What are the most common sites for arterial line insertion? - ANSWER
Radial
Femoral
Axillary
Dorsalis Pedis
Brachial Arteries
Positioning for radial arterial line placement: - ANSWER 30-60 degrees of
dorsiflexion with the aid of a roll of gauze and an armband.
Avoid hyperabduction of the thumb.
How often should the atrial line catheter be changed out? - ANSWER Every
7 days
Causes of inaccuracy in arterial line readings: - ANSWER Air bubbles in
the catheter system
Failure to zero the transducer air-fluid interface
Blood in the catheter system
Blood clot at the catheter tip
Kinking of the tubing system
Catheter tip lodging against the arterial wall
Soft, compliant tubing
Long tubing
,Too many stopckcks (>3)
What is the pathology of afterload? - ANSWER The pressure in which the
heart must pump against in order to eject blood during systole.
Medications that reduce afterload/preload include? - ANSWER
Vasodilators
What is the pathology of preload? - ANSWER The filling pressure of the
heart at end of diastole.
What is systemic vascular resistance (SVR)? - ANSWER Resistance the
left ventricle must overcome to open the aortic valve and eject a volume of
blood into systemic circulation.
Systemic vascular resistance (SVR) is used for what calculations? -
ANSWER Blood pressure
Blood flow
Cardiac function
What is pulmonary vascular resistance (PVR)? - ANSWER Resistance the
right ventricle must overcome to open the pulmonic valve and eject a
volume of blood in the pulmonary vasculature.
What is pulmonary artery occlusion pressure (PAOP)? - ANSWER The
pressure created by the volume of blood that remains in the left heart at
end-diastole.
Inotropic drugs mode of action: - ANSWER Negative inotropic drugs
weaken the force of muscular contractions.
Positive inotropic drugs increase the strength of muscular contractions.
Inotropic drug examples: - ANSWER Dobutamine
Digoxin
Milrinone
Dopamine
Vasodilator mode of actions: - ANSWER Relaxes the smooth muscles of
the blood vessels opening them up.
,Vasodilator drug examples: - ANSWER CCBS:
Verapamil (Calan, Isoptin)
Diltiazem (Cardizem)
Atorvastatin (Lipitor)
Nitrates:
Sildenafil (Viagra)
Nitroprusside (Nipride, Nitropress)
ACE:
Captopril (Capoten)
Lisinopril (Prinivil, Zestril)
Kayexalate - ANSWER Exchanges K+ ions for Na+
Excess K+ ions are fecally excreted
Calcium Gluconate - ANSWER Prevents and treats cardiac toxicity related
to increased K+ levels
What is the purpose of Continuous Renal Replacement Therapy (CRRT)? -
ANSWER Dialysis
This is a blood filtering therapy that replaced the normal blood-filtering
function of the kidneys in patients with renal failure and acute kidney
injuries.
The prerenal system - ANSWER Delivers blood to the kidneys.
A prerenal block is: - ANSWER An interruption on the way to the kidneys.
The intrarenal system - ANSWER Processes ultra-filtrate by tubular
secretion & re-absorption.
An intrarenal block is: - ANSWER Direct damage to the kidneys.
The postrenal system - ANSWER Excretes kidney waste products through
the ureters, bladder, and urethra.
A postrenal block is: - ANSWER Obstruction of urine output.
Causes:
Enlarged prostate
Kidney stones
Bladder tumor
, Bladder injury
S/SX of the oliguric phase of acute kidney injury (AKI): - ANSWER <400
mL/24hr
Increase BUN, Cr, uric acid, K, Mg
Metabolic Acidosis
S/SX of the diuretic phase of acute kidney injury (AKI): - ANSWER Urine
output 1-3L/day
Decreased K & Na
S/SX of the risk stage of acute kidney injury (AKI): - ANSWER Cr
>1.5xbaseline
Urine output <0.5ml/kg/hr for 6+ hours
S/SX of the injury stage of acute kidney injury (AKI): - ANSWER Cr
>2xbaseline
Urine output <0.5ml/kg/hr for 12+ hours
S/SX of the risk failure of acute kidney injury (AKI): - ANSWER Cr
>3xbaseline
Urine output <0.3ml/kg/hr for 12+ hours
Priority assessment findings of acute kidney injury (AKI): - ANSWER
Respiratory:
Crackles
Pleural Effusion
Kussmaul respirations
Cardiovascular:
CHF, hypo/hypertension
Cardiac dysrhythmias
Pericarditis, pericardial effusion
Neurologic:
Altered mentation, confusion, lethargy
Decreased seizure threshold
S/SX of hypovolemic shock: - ANSWER Elevated HR, decreased BP,
tachypnea, oliguria, cool pale skin, decreased mental status, flat neck
veins, decreased CO CI RAP PAP PAOP, elevated SVR, decreased SvO2.
Dehydration causes elevated HCT
