1
NUR 417
NUR 417: Exam1 Care of Adult II – Concordia
University St. Paul
how to calculate stroke volume - ANS end diastolic volume - end systolic
volume
SV = CO / HR
Which item would the nurse zero to establish accurate
hemodynamic monitoring for a patient?
a. Pressure monitoring system to phlebostatic axis
b. Pressure monitoring system to the level of the midclavicular line
c. Cardiac output monitoring system to the level of the left
ventricle
d. Pressure monitoring system to the level of the catheter
tip in the patient - ANS A
What factor will cause a decrease in cardiac output (CO)?
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a. Decreased afterload
b. Decreased heart rate (HR)
c. Increased stroke volume (SV)
d. Decreased systemic vascular resistance (SVR) - ANS b. Decreased heart
rate (HR) causes decreased cardiac output (CO
The patient has experienced an increased preload, which supports an increase
in CO.
What nursing action contributes to an increased preload?
a. Diuretic administration
b. Dopamine administration
c. Increased fluid administration
d. Calcium channel blocker administration - ANS c. Increased fluid
administration increases preload, which will increase CO
During hemodynamic monitoring, the nurse finds that the patient has a
decreased CO
with unchanged pulmonary artery wedge pressure (PAWP), HR, and SVR.
The nurse
identifies that the patient has a decrease in what?
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a. Preload
b. Afterload
c. Contractility
d. Stroke volume - ANS c. CO is dependent on HR and SV. SV is determined
by preload, afterload, and
contractility. If CO is decreased and HR is unchanged, SV is the variable
factor. If the
preload (determined by pulmonary artery wedge pressure [PAWP]) and the
afterload
(determined by SVR) are unchanged, the factor that is changed is the
contractility of
the myocardium.
Before taking hemodynamic measurements, how must the nurse reference the
monitoring equipment?
a. Position the stopcock nearest the transducer level with the phlebostatic axis.
b. Place the transducer on the left side of the chest at the fourth intercostal
space.
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c. Confirm that when pressure in the system is zero, the equipment is
functioning.
d. Place the patient in a left lateral position with the transducer level with the
top surface of the mattress. - ANS A
What is a rationale for the use of arterial pressure-based CO (APCO)
monitoring
instead of a pulmonary artery catheter?
a. Dysrhythmia
b. Atrial fibrillation
c. Less invasive technique
d. Mechanical atrial or mitral valve - ANS c. Arterial pressure-based CO
(APCO) monitoring is used because of decreased risk with this less invasive
technology than pulmonary artery pressure (PAP) monitoring. PAP
monitoring is contraindicated for patients with coagulopathy and mechanical
tricuspid or pulmonic valves.
The nurse observes a PAWP waveform on the monitor when the balloon of
the
NUR 417
NUR 417
NUR 417: Exam1 Care of Adult II – Concordia
University St. Paul
how to calculate stroke volume - ANS end diastolic volume - end systolic
volume
SV = CO / HR
Which item would the nurse zero to establish accurate
hemodynamic monitoring for a patient?
a. Pressure monitoring system to phlebostatic axis
b. Pressure monitoring system to the level of the midclavicular line
c. Cardiac output monitoring system to the level of the left
ventricle
d. Pressure monitoring system to the level of the catheter
tip in the patient - ANS A
What factor will cause a decrease in cardiac output (CO)?
NUR 417
, 2
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a. Decreased afterload
b. Decreased heart rate (HR)
c. Increased stroke volume (SV)
d. Decreased systemic vascular resistance (SVR) - ANS b. Decreased heart
rate (HR) causes decreased cardiac output (CO
The patient has experienced an increased preload, which supports an increase
in CO.
What nursing action contributes to an increased preload?
a. Diuretic administration
b. Dopamine administration
c. Increased fluid administration
d. Calcium channel blocker administration - ANS c. Increased fluid
administration increases preload, which will increase CO
During hemodynamic monitoring, the nurse finds that the patient has a
decreased CO
with unchanged pulmonary artery wedge pressure (PAWP), HR, and SVR.
The nurse
identifies that the patient has a decrease in what?
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, 3
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a. Preload
b. Afterload
c. Contractility
d. Stroke volume - ANS c. CO is dependent on HR and SV. SV is determined
by preload, afterload, and
contractility. If CO is decreased and HR is unchanged, SV is the variable
factor. If the
preload (determined by pulmonary artery wedge pressure [PAWP]) and the
afterload
(determined by SVR) are unchanged, the factor that is changed is the
contractility of
the myocardium.
Before taking hemodynamic measurements, how must the nurse reference the
monitoring equipment?
a. Position the stopcock nearest the transducer level with the phlebostatic axis.
b. Place the transducer on the left side of the chest at the fourth intercostal
space.
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c. Confirm that when pressure in the system is zero, the equipment is
functioning.
d. Place the patient in a left lateral position with the transducer level with the
top surface of the mattress. - ANS A
What is a rationale for the use of arterial pressure-based CO (APCO)
monitoring
instead of a pulmonary artery catheter?
a. Dysrhythmia
b. Atrial fibrillation
c. Less invasive technique
d. Mechanical atrial or mitral valve - ANS c. Arterial pressure-based CO
(APCO) monitoring is used because of decreased risk with this less invasive
technology than pulmonary artery pressure (PAP) monitoring. PAP
monitoring is contraindicated for patients with coagulopathy and mechanical
tricuspid or pulmonic valves.
The nurse observes a PAWP waveform on the monitor when the balloon of
the
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