NUR 417 exam 1 QUESTIONS AND ANSWERS
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An older adult patient who has just arrived in the emergency department has a pulse deficit of 46
beats. Which intervention would the nurse anticipate for this patient?
a. Cardiac catheterization
b. Hourly blood pressure checks
c. Electrocardiographic monitoring
d. Emergent synchronized cardioversion
CORRECT ANS: C Pulse deficit is a difference between simultaneously obtained apical and
radial pulses. It indicates that there may be a cardiac dysrhythmia that would best be detected
with ECG monitoring. Frequent BP monitoring, cardiac catheterization, and emergent
cardioversion are used for diagnosis and/or treatment of cardiovascular disorders but would not
be as helpful in determining the immediate reason for the pulse deficit.
The standard policy on the cardiac unit states, "Notify the health care provider for mean arterial
pressure (MAP) less than 70 mm Hg." Which patient's status would the nurse report to the health
care provider?
a. Postoperative patient with a BP of 116/42 mm Hg.
b. Newly admitted patient with a BP of 150/87 mm Hg.
c. Patient with left ventricular failure who has a BP of 110/70 mm Hg.
d. Patient with a myocardial infarction who has a BP of 140/86 mm Hg.
CORRECT ANS: A The mean arterial pressure (MAP) is calculated using the formula MAP =
(systolic BP + 2 diastolic BP)/3. The MAP for the postoperative patient is 67. The MAP in the
other three patients is higher than 70 mm Hg.
***Which hemodynamic parameter most directly reflects the effectiveness of drugs given to
reduce a patient's left ventricular afterload?
a. Cardiac output (CO)
b. Systemic vascular resistance (SVR)
c. Pulmonary vascular resistance (PVR)
d. Pulmonary artery wedge pressure (PAWP)
CORRECT ANS: B SVR reflects the resistance to left ventricular ejection, or afterload. Other
parameters may be monitored but do not reflect left-sided afterload as directly.
, **After surgery, a patient's central venous pressure (CVP) monitor indicates low pressures.
Which action would the nurse take?
a. Administer IV diuretic medications.
b. Increase the IV fluid infusion per protocol.
c. Increase the infusion rate of IV vasodilators.
d. Elevate the head of the patient's bed to 45 degrees.
CORRECT ANS: B 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.
*Which parameter will the nurse use to evaluate changes in a patient's right ventricular afterload?
a. Central venous pressure (CVP)
b. Systemic vascular resistance (SVR)
c. Pulmonary vascular resistance (PVR)
d. Pulmonary artery wedge pressure (PAWP)
CORRECT ANS: C 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
A patient requires arterial pressure monitoring. Which action would the nurse plan to take?
a. Balance and calibrate the monitoring equipment every 2 hours.
b. Position the zero-reference stopcock line level with the phlebostatic axis.
c. Disconnect the low pressure alarm to avoid disturbing the patient's sleep.
d. Ensure that the patient is supine with the head of the bed flat for all readings.
CORRECT ANS: B 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.
*Which measurement would be the most sensitive indicator of cardiac function?
a. Central venous pressure (CVP)
b. Systemic vascular resistance (SVR)
c. Pulmonary vascular resistance (PVR)
d. Pulmonary artery wedge pressure (PAWP)
CORRECT ANS: D
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.
LATEST AND COMPREHENSIVE VERSION WITH
VERIFIED ANSWERS GUARANTEED PASS WITH
INSTANT PDF DOWNLOAD
An older adult patient who has just arrived in the emergency department has a pulse deficit of 46
beats. Which intervention would the nurse anticipate for this patient?
a. Cardiac catheterization
b. Hourly blood pressure checks
c. Electrocardiographic monitoring
d. Emergent synchronized cardioversion
CORRECT ANS: C Pulse deficit is a difference between simultaneously obtained apical and
radial pulses. It indicates that there may be a cardiac dysrhythmia that would best be detected
with ECG monitoring. Frequent BP monitoring, cardiac catheterization, and emergent
cardioversion are used for diagnosis and/or treatment of cardiovascular disorders but would not
be as helpful in determining the immediate reason for the pulse deficit.
The standard policy on the cardiac unit states, "Notify the health care provider for mean arterial
pressure (MAP) less than 70 mm Hg." Which patient's status would the nurse report to the health
care provider?
a. Postoperative patient with a BP of 116/42 mm Hg.
b. Newly admitted patient with a BP of 150/87 mm Hg.
c. Patient with left ventricular failure who has a BP of 110/70 mm Hg.
d. Patient with a myocardial infarction who has a BP of 140/86 mm Hg.
CORRECT ANS: A The mean arterial pressure (MAP) is calculated using the formula MAP =
(systolic BP + 2 diastolic BP)/3. The MAP for the postoperative patient is 67. The MAP in the
other three patients is higher than 70 mm Hg.
***Which hemodynamic parameter most directly reflects the effectiveness of drugs given to
reduce a patient's left ventricular afterload?
a. Cardiac output (CO)
b. Systemic vascular resistance (SVR)
c. Pulmonary vascular resistance (PVR)
d. Pulmonary artery wedge pressure (PAWP)
CORRECT ANS: B SVR reflects the resistance to left ventricular ejection, or afterload. Other
parameters may be monitored but do not reflect left-sided afterload as directly.
, **After surgery, a patient's central venous pressure (CVP) monitor indicates low pressures.
Which action would the nurse take?
a. Administer IV diuretic medications.
b. Increase the IV fluid infusion per protocol.
c. Increase the infusion rate of IV vasodilators.
d. Elevate the head of the patient's bed to 45 degrees.
CORRECT ANS: B 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.
*Which parameter will the nurse use to evaluate changes in a patient's right ventricular afterload?
a. Central venous pressure (CVP)
b. Systemic vascular resistance (SVR)
c. Pulmonary vascular resistance (PVR)
d. Pulmonary artery wedge pressure (PAWP)
CORRECT ANS: C 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
A patient requires arterial pressure monitoring. Which action would the nurse plan to take?
a. Balance and calibrate the monitoring equipment every 2 hours.
b. Position the zero-reference stopcock line level with the phlebostatic axis.
c. Disconnect the low pressure alarm to avoid disturbing the patient's sleep.
d. Ensure that the patient is supine with the head of the bed flat for all readings.
CORRECT ANS: B 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.
*Which measurement would be the most sensitive indicator of cardiac function?
a. Central venous pressure (CVP)
b. Systemic vascular resistance (SVR)
c. Pulmonary vascular resistance (PVR)
d. Pulmonary artery wedge pressure (PAWP)
CORRECT ANS: D
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.
