1
NUR 417
Exam1: NUR 417 Care of Adult II – Concordia
University St. Paul
1. After surgery, a patient's central venous pressure (CVP) monitor
indicates low pressures. Which action would the nurse take?
2. Administer IV diuretic medications.
3. Increase the IV fluid infusion per protocol.
4. Increase the infusion rate of IV vasodilators.
5. Elevate the head of the patient's bed to 45 degrees.: 2. Increase the IV fluid
infusion per protocol.
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.
NUR 417
, 2
NUR 417
2. Which parameter will the nurse use to evaluate changes in a patient's right
ventricular afterload?
1. Central venous pressure (CVP)
2. Systemic vascular resistance (SVR)
3. Pulmonary vascular resistance (PVR)
4. Pulmonary artery wedge pressure (PAWP): 3. Pulmonary vascular resistance
(PVR)
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.
3. A patient requires arterial pressure monitoring. Which action would the
nurse plan to take?
1. Balance and calibrate the monitoring equipment every 2 hours.
2. Position the zero-reference stopcock line level with the phlebostatic axis.
3. Disconnect the low pressure alarm to avoid disturbing the patient's sleep.
NUR 417
, 3
NUR 417
4. Ensure that the patient is supine with the head of the bed flat for all
readings.: 2. Position the zero-reference stopcock line level with the
phlebostatic axis.
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.
5. Which measurement would be the most sensitive indicator of cardiac
function?
1. Central venous pressure (CVP)
2. Systemic vascular resistance (SVR)
3. Pulmonary vascular resistance (PVR)
NUR 417
, 4
NUR 417
4. Pulmonary artery wedge pressure (PAWP): 4. Pulmonary artery wedge
pressure (PAWP)
PAWP reflects left ventricular end diastolic pressure (or left ventricular
preload) and is a sensitive indicator of cardiac function. The other values
would also provide useful information, but the most definitive measurement
of changes in cardiac function is the PAWP.
5. Which action would the nurse take first when the low pressure alarm
sounds for a patient who has an arterial line in the left radial artery?
1. Observe for dysrhythmias.
2. Fast flush the arterial line.
3. Check the left hand for pallor.
4. Re-zero the monitoring equipment.: 1. Observe for dysrhythmias.
The low pressure alarm indicates a drop in the patient's blood pressure, which
may be caused by dysrhythmias or line disconnection. There is no indication to
re-zero the equipment. Pallor of the left hand would be caused by occlusion of
NUR 417
NUR 417
Exam1: NUR 417 Care of Adult II – Concordia
University St. Paul
1. After surgery, a patient's central venous pressure (CVP) monitor
indicates low pressures. Which action would the nurse take?
2. Administer IV diuretic medications.
3. Increase the IV fluid infusion per protocol.
4. Increase the infusion rate of IV vasodilators.
5. Elevate the head of the patient's bed to 45 degrees.: 2. Increase the IV fluid
infusion per protocol.
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.
NUR 417
, 2
NUR 417
2. Which parameter will the nurse use to evaluate changes in a patient's right
ventricular afterload?
1. Central venous pressure (CVP)
2. Systemic vascular resistance (SVR)
3. Pulmonary vascular resistance (PVR)
4. Pulmonary artery wedge pressure (PAWP): 3. Pulmonary vascular resistance
(PVR)
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.
3. A patient requires arterial pressure monitoring. Which action would the
nurse plan to take?
1. Balance and calibrate the monitoring equipment every 2 hours.
2. Position the zero-reference stopcock line level with the phlebostatic axis.
3. Disconnect the low pressure alarm to avoid disturbing the patient's sleep.
NUR 417
, 3
NUR 417
4. Ensure that the patient is supine with the head of the bed flat for all
readings.: 2. Position the zero-reference stopcock line level with the
phlebostatic axis.
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.
5. Which measurement would be the most sensitive indicator of cardiac
function?
1. Central venous pressure (CVP)
2. Systemic vascular resistance (SVR)
3. Pulmonary vascular resistance (PVR)
NUR 417
, 4
NUR 417
4. Pulmonary artery wedge pressure (PAWP): 4. Pulmonary artery wedge
pressure (PAWP)
PAWP reflects left ventricular end diastolic pressure (or left ventricular
preload) and is a sensitive indicator of cardiac function. The other values
would also provide useful information, but the most definitive measurement
of changes in cardiac function is the PAWP.
5. Which action would the nurse take first when the low pressure alarm
sounds for a patient who has an arterial line in the left radial artery?
1. Observe for dysrhythmias.
2. Fast flush the arterial line.
3. Check the left hand for pallor.
4. Re-zero the monitoring equipment.: 1. Observe for dysrhythmias.
The low pressure alarm indicates a drop in the patient's blood pressure, which
may be caused by dysrhythmias or line disconnection. There is no indication to
re-zero the equipment. Pallor of the left hand would be caused by occlusion of
NUR 417
