NR571 WEEK 4 MIDTERM EXAM QUESTIONS
AND VERIFIED CORRECT ANSWERS JULY 31
2026 | CHAMBERLAIN SCHOOL OF NURSING |
COMPLETE 100 Q&A WITH RATIONALES |
INSTANT DOWNLOAD PDF]
SECTION 1: HEMODYNAMIC MONITORING & SHOCK SYNDROMES
Question 1
A patient with septic shock has an arterial line placed. The nurse practitioner is
assessing the waveform and notes a dicrotic notch. This finding indicates:
A) The patient is experiencing severe peripheral vasoconstriction
B) The aortic valve has closed, reflecting normal arterial pressure waveform
C) There is significant aortic regurgitation present
D) The catheter is positioned in the pulmonary artery
Answer: B
Rationale: The dicrotic notch on an arterial pressure waveform represents aortic
valve closure and is a normal finding that reflects proper arterial line function and
waveform morphology. It indicates the transition from systole to diastole and is
not a sign of pathology .
Question 2
During hemodynamic monitoring, the nurse practitioner zeroes the transducer at
the phlebostatic axis. This level corresponds to:
,A) The fourth intercostal space, midaxillary line
B) The fifth intercostal space, midclavicular line
C) The second intercostal space, sternal border
D) The xiphoid process level
Answer: A
Rationale: The phlebostatic axis is located at the fourth intercostal space at the
midaxillary line, which corresponds to the level of the right atrium and ensures
accurate pressure measurements regardless of patient position .
Question 3
A patient in cardiogenic shock has the following hemodynamic profile: CVP 14
mmHg, PAWP 24 mmHg, CI 1.8 L/min/m², SVR 1800 dynes/sec/cm⁵. The nurse
practitioner recognizes this pattern as consistent with:
A) Hypovolemic shock with decreased preload
B) Cardiogenic shock with increased afterload and decreased contractility
C) Septic shock with vasodilation
D) Obstructive shock from cardiac tamponade
Answer: B
Rationale: Elevated CVP and PAWP indicate increased preload (fluid backup), low
cardiac index reflects decreased contractility, and elevated SVR demonstrates
increased afterload—collectively consistent with cardiogenic shock. This pattern
distinguishes cardiogenic from other shock types .
Question 4
The nurse practitioner is evaluating fluid responsiveness using bedside ultrasound.
Assessment of the inferior vena cava (IVC) shows a collapsibility index of 20%
during spontaneous breathing. This finding suggests:
,A) The patient is fluid overloaded and requires diuresis
B) The patient is likely fluid responsive and will benefit from volume expansion
C) The IVC is dilated and right ventricular failure is present
D) The patient is euvolemic and no fluid is needed
Answer: B
Rationale: An IVC collapsibility index greater than 15% during spontaneous
breathing indicates the patient is likely fluid responsive, and volume expansion will
increase stroke volume. This is a key component of dynamic assessment for fluid
management .
Question 5
A patient has a pulmonary artery catheter in place. The nurse practitioner
measures a mixed venous oxygen saturation (SvO₂) of 45%. This value indicates:
A) Adequate oxygen delivery exceeds oxygen consumption
B) Tissue oxygen extraction is increased, suggesting inadequate oxygen delivery
C) The patient has significant left-to-right shunt
D) Pulmonary artery catheter is malpositioned in the right ventricle
Answer: B
Rationale: Normal SvO₂ is 60-80%; a value of 45% indicates increased oxygen
extraction by tissues, suggesting that oxygen delivery is inadequate relative to
metabolic demand. This is often seen in shock states or severe anemia .
Question 6
During a FAST exam, the nurse practitioner identifies anechoic fluid in Morison's
pouch. This finding is most consistent with:
A) Pericardial effusion
B) Hemoperitoneum from solid organ injury
, C) Pleural effusion
D) Ileus with bowel distension
Answer: B
Rationale: Morison's pouch is the hepatorenal recess, and anechoic free fluid in
this location during FAST exam is highly suggestive of hemoperitoneum, typically
from liver or renal injury. This is a critical finding in trauma assessment .
Question 7
The nurse practitioner is assessing preload in a mechanically ventilated patient.
The most accurate statement regarding preload is:
A) Preload is best measured by systemic vascular resistance
B) Preload represents the volume and pressure stretching the ventricle at end-
diastole
C) Preload is equivalent to afterload
D) Preload is measured by cardiac output
Answer: B
Rationale: Preload represents the volume and pressure stretching the ventricle at
end-diastole. It reflects the degree of myocardial fiber stretch before contraction
and is influenced by venous return and ventricular compliance .
Question 8
A patient with distributive shock (septic) has the following hemodynamic profile.
Which of the following is consistent with this type of shock?
A) High PCWP, low CO, high SVR
B) Low PCWP, low CO, low SVR
C) Low PCWP, high SVR, low CO
D) High CVP, low CO, high SVR
AND VERIFIED CORRECT ANSWERS JULY 31
2026 | CHAMBERLAIN SCHOOL OF NURSING |
COMPLETE 100 Q&A WITH RATIONALES |
INSTANT DOWNLOAD PDF]
SECTION 1: HEMODYNAMIC MONITORING & SHOCK SYNDROMES
Question 1
A patient with septic shock has an arterial line placed. The nurse practitioner is
assessing the waveform and notes a dicrotic notch. This finding indicates:
A) The patient is experiencing severe peripheral vasoconstriction
B) The aortic valve has closed, reflecting normal arterial pressure waveform
C) There is significant aortic regurgitation present
D) The catheter is positioned in the pulmonary artery
Answer: B
Rationale: The dicrotic notch on an arterial pressure waveform represents aortic
valve closure and is a normal finding that reflects proper arterial line function and
waveform morphology. It indicates the transition from systole to diastole and is
not a sign of pathology .
Question 2
During hemodynamic monitoring, the nurse practitioner zeroes the transducer at
the phlebostatic axis. This level corresponds to:
,A) The fourth intercostal space, midaxillary line
B) The fifth intercostal space, midclavicular line
C) The second intercostal space, sternal border
D) The xiphoid process level
Answer: A
Rationale: The phlebostatic axis is located at the fourth intercostal space at the
midaxillary line, which corresponds to the level of the right atrium and ensures
accurate pressure measurements regardless of patient position .
Question 3
A patient in cardiogenic shock has the following hemodynamic profile: CVP 14
mmHg, PAWP 24 mmHg, CI 1.8 L/min/m², SVR 1800 dynes/sec/cm⁵. The nurse
practitioner recognizes this pattern as consistent with:
A) Hypovolemic shock with decreased preload
B) Cardiogenic shock with increased afterload and decreased contractility
C) Septic shock with vasodilation
D) Obstructive shock from cardiac tamponade
Answer: B
Rationale: Elevated CVP and PAWP indicate increased preload (fluid backup), low
cardiac index reflects decreased contractility, and elevated SVR demonstrates
increased afterload—collectively consistent with cardiogenic shock. This pattern
distinguishes cardiogenic from other shock types .
Question 4
The nurse practitioner is evaluating fluid responsiveness using bedside ultrasound.
Assessment of the inferior vena cava (IVC) shows a collapsibility index of 20%
during spontaneous breathing. This finding suggests:
,A) The patient is fluid overloaded and requires diuresis
B) The patient is likely fluid responsive and will benefit from volume expansion
C) The IVC is dilated and right ventricular failure is present
D) The patient is euvolemic and no fluid is needed
Answer: B
Rationale: An IVC collapsibility index greater than 15% during spontaneous
breathing indicates the patient is likely fluid responsive, and volume expansion will
increase stroke volume. This is a key component of dynamic assessment for fluid
management .
Question 5
A patient has a pulmonary artery catheter in place. The nurse practitioner
measures a mixed venous oxygen saturation (SvO₂) of 45%. This value indicates:
A) Adequate oxygen delivery exceeds oxygen consumption
B) Tissue oxygen extraction is increased, suggesting inadequate oxygen delivery
C) The patient has significant left-to-right shunt
D) Pulmonary artery catheter is malpositioned in the right ventricle
Answer: B
Rationale: Normal SvO₂ is 60-80%; a value of 45% indicates increased oxygen
extraction by tissues, suggesting that oxygen delivery is inadequate relative to
metabolic demand. This is often seen in shock states or severe anemia .
Question 6
During a FAST exam, the nurse practitioner identifies anechoic fluid in Morison's
pouch. This finding is most consistent with:
A) Pericardial effusion
B) Hemoperitoneum from solid organ injury
, C) Pleural effusion
D) Ileus with bowel distension
Answer: B
Rationale: Morison's pouch is the hepatorenal recess, and anechoic free fluid in
this location during FAST exam is highly suggestive of hemoperitoneum, typically
from liver or renal injury. This is a critical finding in trauma assessment .
Question 7
The nurse practitioner is assessing preload in a mechanically ventilated patient.
The most accurate statement regarding preload is:
A) Preload is best measured by systemic vascular resistance
B) Preload represents the volume and pressure stretching the ventricle at end-
diastole
C) Preload is equivalent to afterload
D) Preload is measured by cardiac output
Answer: B
Rationale: Preload represents the volume and pressure stretching the ventricle at
end-diastole. It reflects the degree of myocardial fiber stretch before contraction
and is influenced by venous return and ventricular compliance .
Question 8
A patient with distributive shock (septic) has the following hemodynamic profile.
Which of the following is consistent with this type of shock?
A) High PCWP, low CO, high SVR
B) Low PCWP, low CO, low SVR
C) Low PCWP, high SVR, low CO
D) High CVP, low CO, high SVR
