230 EXAM QUESTIONS NR 341 / NR341 COMPLEX ADULT
HEALTH 2026/2027 || COMPREHENSIVE MEDICAL-
SURGICAL NURSING EXAM PREPARATION WITH UPDATED
ACUTE AND CHRONIC CARE CONCEPTS, PRIORITIZATION,
AND CLINICAL DECISION-MAKING REVIEW || REAL NR341
EXAM-STYLE QUESTIONS WITH VERIFIED DETAILED
ACCURATE ANSWERS LATEST EDITION || ELITE A+
PREMIUM QUALITY GUARANTEED
While caring for a patient with a small bowel obstruction, the nurse assesses a
pulmonary artery occlusion pressure (PAOP) of 1 mm Hg and hourly urine
output of 5 mL. The nurse anticipates which therapeutic intervention?
Diuretics
Intravenous fluids
Negative inotropic agents
Vasopressors - THE CORRECT ANSWER - ANS: B
The nurse is caring for a patient who has had an arterial line inserted. To reduce
the risk of complications, what is the priority nursing intervention?
Apply a pressure dressing to the insertion site.
Ensure that all tubing connections are tightened.
Obtain a portable x-ray to confirm placement.
Restrain the affected extremity for 24 hours. - THE CORRECT ANSWER
- ANS: B
While caring for a patient with a pulmonary artery catheter, the nurse notes the
pulmonary artery occlusion pressure (PAOP) to be significantly higher than
previously recorded values. The nurse assesses respirations to be unlabored at
16 breaths/min, oxygen saturation of 98% on 3 L of oxygen via nasal cannula,
and lungs clear to auscultation bilaterally. What is the priority nursing action?
A. Increase supplemental oxygen and notify respiratory therapy. B.Notify the
provider immediately of the assessment findings.
C. Obtain a stat chest x-ray film to verify proper catheter placement.
D.Zero reference and level the catheter at the phlebostatic axis. - THE
CORRECT ANSWER - ANS: D
A patient is admitted to the hospital with multiple trauma and extensive blood
loss. The nurse assesses vital signs to be BP 80/50 mm Hg, heart rate 135
beats/min, respirations 36 breaths/min, cardiac output (CO) of 2 L/min,
systemic vascular resistance of 3000 dynes/sec/cm-5, and a hematocrit of 20%.
,The nurse anticipates administration of which the following therapies or
medications?
Blood transfusion
Furosemide
Dobutamine infusion
Dopamine hydrochloride infusion. - THE CORRECT ANSWER - ANS: A
After pulmonary artery catheter insertion, the nurse assesses a pulmonary artery
pressure of 45/25 mm Hg, a pulmonary artery occlusion pressure (PAOP) of 20
mm Hg, a cardiac output of 2.6 L/min and a cardiac index of 1.9 L/min/m2.
Which provider order is of the highest priority?
Apply 50% oxygen via Venturi mask.
B Insert an indwelling urinary catheter.
C Begin a dobutamine infusion.
D Obtain stat cardiac enzymes and troponin. - THE CORRECT ANSWER
- ANS: C
The nurse is caring for a patient with a left subclavian central venous catheter
(CVC) and a left radial arterial line. Which assessment finding by the nurse
requires immediate action?
A dampened arterial line waveform
Numbness and tingling in the left hand
Slight bloody drainage at subclavian insertion site
Slight redness at subclavian insertion site. - THE CORRECT ANSWER -
ANS: B
The provider writes an order to discontinue a patient's left radial arterial line.
When discontinuing the patient's invasive line, what is the priority nursing
action?
Apply an air occlusion dressing to insertion site.
Apply pressure to the insertion site for 5 minutes.
Elevate the affected limb on pillows for 24 hours.
Keep the patient's wrist in a neutral position. - THE CORRECT ANSWER
- ANS: B
Following insertion of a central venous catheter, the nurse obtains a stat chest x-
ray film to verify proper catheter placement. The radiologist reports to the
nurse: "The tip of the catheter is located in the superior vena cava." What is the
best interpretation of these results by the nurse?
The catheter is not positioned correctly and should be removed. B. The catheter
position increases the risk of ventricular dysrhythmias.
,The distal tip of the catheter is in the appropriate position.
The physician should be called to advance the catheter into the pulmonary
artery. - THE CORRECT ANSWER - ANS: C
While inflating the balloon of a pulmonary artery catheter (PAC) with 1.0 mL of
air to obtain a pulmonary artery occlusion pressure (PAOP), the nurse
encounters resistance. What is the best nursing action?
Add an additional 0.5 mL of air to the balloon and repeat the procedure.
Advance the catheter with the balloon deflated and repeat the procedure.
Deflate the balloon and obtain a chest x-ray study to determine line placement.
Lock the balloon in the inflated position, and flush the distal port of the PAC
with normal saline. - THE CORRECT ANSWER - ANS: C
The nurse is caring for a patient following insertion of a left subclavian central
venous catheter (CVC). Which assessment finding 2 hours after insertion by the
nurse warrants immediate action?
A Diminished breath sounds over left lung field
B Localized pain at catheter insertion site
C Measured central venous pressure of 5 mm Hg
D. Slight bloody drainage around insertion site - THE CORRECT
ANSWER - ANS: A
The nurse is caring for a mechanically ventilated patient with a pulmonary
artery catheter who is receiving continuous enteral tube feedings. When
obtaining continuous hemodynamic monitoring measurements, what is the best
nursing action?
A Do not document hemodynamic values until the patient can be placed in the
supine position.
B Level and zero reference the air-fluid interface of the transducer with the
patient in the supine position and record hemodynamic values.
C Level and zero reference the air-fluid interface of the transducer with the
patient's head of bed elevated to 30 degrees and record hemodynamic values.
D. Level and zero reference the air-fluid interface of the transducer with the
patient supine in the side-lying position and record hemodynamic values. -
THE CORRECT ANSWER - ANS: C
Indication for arterial line placement? - THE CORRECT ANSWER -
Hemodynamic monitoring
Multiple blood samples
Diagnostic or interventional radiology procedures
Continuous cardiac output monitoring
, What test must be preformed prior to an arterial line placement? - THE
CORRECT ANSWER - Allen's test
How often should a fast flush test be preformed? - THE CORRECT
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? - THE
CORRECT ANSWER - Radial
Femoral
Axillary
Dorsalis Pedis
Brachial Arteries
Positioning for radial arterial line placement: - THE CORRECT 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? - THE CORRECT
ANSWER - Every 7 days
Causes of inaccuracy in arterial line readings: - THE CORRECT
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? - THE CORRECT ANSWER - The
pressure in which the heart must pump against in order to eject blood during
systole.
HEALTH 2026/2027 || COMPREHENSIVE MEDICAL-
SURGICAL NURSING EXAM PREPARATION WITH UPDATED
ACUTE AND CHRONIC CARE CONCEPTS, PRIORITIZATION,
AND CLINICAL DECISION-MAKING REVIEW || REAL NR341
EXAM-STYLE QUESTIONS WITH VERIFIED DETAILED
ACCURATE ANSWERS LATEST EDITION || ELITE A+
PREMIUM QUALITY GUARANTEED
While caring for a patient with a small bowel obstruction, the nurse assesses a
pulmonary artery occlusion pressure (PAOP) of 1 mm Hg and hourly urine
output of 5 mL. The nurse anticipates which therapeutic intervention?
Diuretics
Intravenous fluids
Negative inotropic agents
Vasopressors - THE CORRECT ANSWER - ANS: B
The nurse is caring for a patient who has had an arterial line inserted. To reduce
the risk of complications, what is the priority nursing intervention?
Apply a pressure dressing to the insertion site.
Ensure that all tubing connections are tightened.
Obtain a portable x-ray to confirm placement.
Restrain the affected extremity for 24 hours. - THE CORRECT ANSWER
- ANS: B
While caring for a patient with a pulmonary artery catheter, the nurse notes the
pulmonary artery occlusion pressure (PAOP) to be significantly higher than
previously recorded values. The nurse assesses respirations to be unlabored at
16 breaths/min, oxygen saturation of 98% on 3 L of oxygen via nasal cannula,
and lungs clear to auscultation bilaterally. What is the priority nursing action?
A. Increase supplemental oxygen and notify respiratory therapy. B.Notify the
provider immediately of the assessment findings.
C. Obtain a stat chest x-ray film to verify proper catheter placement.
D.Zero reference and level the catheter at the phlebostatic axis. - THE
CORRECT ANSWER - ANS: D
A patient is admitted to the hospital with multiple trauma and extensive blood
loss. The nurse assesses vital signs to be BP 80/50 mm Hg, heart rate 135
beats/min, respirations 36 breaths/min, cardiac output (CO) of 2 L/min,
systemic vascular resistance of 3000 dynes/sec/cm-5, and a hematocrit of 20%.
,The nurse anticipates administration of which the following therapies or
medications?
Blood transfusion
Furosemide
Dobutamine infusion
Dopamine hydrochloride infusion. - THE CORRECT ANSWER - ANS: A
After pulmonary artery catheter insertion, the nurse assesses a pulmonary artery
pressure of 45/25 mm Hg, a pulmonary artery occlusion pressure (PAOP) of 20
mm Hg, a cardiac output of 2.6 L/min and a cardiac index of 1.9 L/min/m2.
Which provider order is of the highest priority?
Apply 50% oxygen via Venturi mask.
B Insert an indwelling urinary catheter.
C Begin a dobutamine infusion.
D Obtain stat cardiac enzymes and troponin. - THE CORRECT ANSWER
- ANS: C
The nurse is caring for a patient with a left subclavian central venous catheter
(CVC) and a left radial arterial line. Which assessment finding by the nurse
requires immediate action?
A dampened arterial line waveform
Numbness and tingling in the left hand
Slight bloody drainage at subclavian insertion site
Slight redness at subclavian insertion site. - THE CORRECT ANSWER -
ANS: B
The provider writes an order to discontinue a patient's left radial arterial line.
When discontinuing the patient's invasive line, what is the priority nursing
action?
Apply an air occlusion dressing to insertion site.
Apply pressure to the insertion site for 5 minutes.
Elevate the affected limb on pillows for 24 hours.
Keep the patient's wrist in a neutral position. - THE CORRECT ANSWER
- ANS: B
Following insertion of a central venous catheter, the nurse obtains a stat chest x-
ray film to verify proper catheter placement. The radiologist reports to the
nurse: "The tip of the catheter is located in the superior vena cava." What is the
best interpretation of these results by the nurse?
The catheter is not positioned correctly and should be removed. B. The catheter
position increases the risk of ventricular dysrhythmias.
,The distal tip of the catheter is in the appropriate position.
The physician should be called to advance the catheter into the pulmonary
artery. - THE CORRECT ANSWER - ANS: C
While inflating the balloon of a pulmonary artery catheter (PAC) with 1.0 mL of
air to obtain a pulmonary artery occlusion pressure (PAOP), the nurse
encounters resistance. What is the best nursing action?
Add an additional 0.5 mL of air to the balloon and repeat the procedure.
Advance the catheter with the balloon deflated and repeat the procedure.
Deflate the balloon and obtain a chest x-ray study to determine line placement.
Lock the balloon in the inflated position, and flush the distal port of the PAC
with normal saline. - THE CORRECT ANSWER - ANS: C
The nurse is caring for a patient following insertion of a left subclavian central
venous catheter (CVC). Which assessment finding 2 hours after insertion by the
nurse warrants immediate action?
A Diminished breath sounds over left lung field
B Localized pain at catheter insertion site
C Measured central venous pressure of 5 mm Hg
D. Slight bloody drainage around insertion site - THE CORRECT
ANSWER - ANS: A
The nurse is caring for a mechanically ventilated patient with a pulmonary
artery catheter who is receiving continuous enteral tube feedings. When
obtaining continuous hemodynamic monitoring measurements, what is the best
nursing action?
A Do not document hemodynamic values until the patient can be placed in the
supine position.
B Level and zero reference the air-fluid interface of the transducer with the
patient in the supine position and record hemodynamic values.
C Level and zero reference the air-fluid interface of the transducer with the
patient's head of bed elevated to 30 degrees and record hemodynamic values.
D. Level and zero reference the air-fluid interface of the transducer with the
patient supine in the side-lying position and record hemodynamic values. -
THE CORRECT ANSWER - ANS: C
Indication for arterial line placement? - THE CORRECT ANSWER -
Hemodynamic monitoring
Multiple blood samples
Diagnostic or interventional radiology procedures
Continuous cardiac output monitoring
, What test must be preformed prior to an arterial line placement? - THE
CORRECT ANSWER - Allen's test
How often should a fast flush test be preformed? - THE CORRECT
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? - THE
CORRECT ANSWER - Radial
Femoral
Axillary
Dorsalis Pedis
Brachial Arteries
Positioning for radial arterial line placement: - THE CORRECT 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? - THE CORRECT
ANSWER - Every 7 days
Causes of inaccuracy in arterial line readings: - THE CORRECT
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? - THE CORRECT ANSWER - The
pressure in which the heart must pump against in order to eject blood during
systole.
