NR 304 Hemodynamic monitoring ATI,
Cardiac Questions with 100% Correct Answers
1. A nurse is evaluating the central venous pressure (CVP) of a client who has sustained
multiple traumas. Which of the following interpretations of a low CVP pressure should
the nurse make?
A. Fluid overload
Rationale: The CVP is the pressure in the vena cava, or right atrium, and is reflective of
preload. A client who has fluid overload would have a high CVP value.
B. Left ventricular failure
Rationale: Left ventricular failure can be detected by an elevated pulmonary artery
wedge pressure.
C. Intracardiac shunt
Rationale: Intracardiac shunt can be detected by an elevated pulmonary artery wedge
pressure.
D. Hypovolemia
Rationale: A low CVP indicates reduced right ventricular preload, which can be seen in
clients who are experiencing hypovolemia, excessive blood loss, or overdiuresis
D.Hypovolemia
2. A nurse is monitoring the pulmonary artery wedge pressure (PAWP) for a client. The
nurse should identity that a reading of 15 mm Hg is an indication of which of the
following conditions?
A. Fluid volume deficit
Rationale: A client who has fluid volume deficit is more likely to have a decreased
PAWP.
,B. Right ventricular failure
Rationale: An increased right atrium (RA) pressure can indicate right ventricular
failure. A decreased RA pressure usually indicates hypovolemia.
C. Mitral regurgitation
Rationale: Hemodynamic monitoring allows the nurse to monitor the pressures within
the heart and the great vessels. The PAWP reflects left atrial pressure. A reading of 15
mm Hg is above the expected reference range, which can indicate mitral regurgitation,
hypervolemia, or left ventricular failure. The nurse should monitor for trends in value,
which can be more reliable than individual values.
D. Afterload reduction
Rationale: A client who has afterload reduction is more likely to have a decreased
PAWP.
C.Mitral regurgitation
PAWP.
3. A nurse is monitoring the cardiac output of a client who has left-sided heart failure
using pulse pressure analysis. Which of the following findings can compromise the
readings?
A. The client is experiencing premature atrial contractions.
Rationale:
Pulse pressure devices require the presence of optimal arterial waveforms in order to
capture accurate data. Therefore, a dysrhythmia, such as premature atrial contractions,
will compromise the readings.
B. The client has a decreased oxygen saturation level.
Rationale: Decreased oxygen saturation is a manifestation of heart failure that does not
compromise cardiac output readings.
, C. The client has bilateral wheezes.
Rationale: Bilateral wheezes are a manifestation of heart failure that do not
compromise cardiac output readings.
D. The client has lower leg edema.
Rationale: Lower leg edema is a manifestation of heart failure that does not
compromise cardiac output readings.
A.The client is experiencing premature atrial contractions.
4. A nurse is teaching a client who has septic shock about the development of
disseminated intravascular coagulation (DIC). Which of the following statements should
the nurse make?
A. "DIC is controllable with lifelong heparin usage."
Rationale: DIC is not controlled with lifelong heparin usage. Heparin is administered to
minimize the formation of microthrombi, which improves tissue perfusion.
B. "DIC is characterized by an elevated platelet count."
Rationale: DIC causes bleeding in part due to a decreased platelet count, rather than an
elevated platelet count.
C. "DIC is caused by abnormal coagulation involving fibrinogen."
Rationale: DIC is caused by abnormal coagulation involving the formation of multiple
small clots that consume clotting factors and fibrinogen faster than the body can
produce them, increasing the risk for hemorrhage.
D. "DIC is a genetic disorder involving a vitamin K deficiency."
Rationale: DIC is not a genetic disorder and does not involve vitamin K deficiency. The
effect of vitamin K is to prolong bleeding time.
C.DIC is caused by abnormal coagulation involving fibrinogen.
Cardiac Questions with 100% Correct Answers
1. A nurse is evaluating the central venous pressure (CVP) of a client who has sustained
multiple traumas. Which of the following interpretations of a low CVP pressure should
the nurse make?
A. Fluid overload
Rationale: The CVP is the pressure in the vena cava, or right atrium, and is reflective of
preload. A client who has fluid overload would have a high CVP value.
B. Left ventricular failure
Rationale: Left ventricular failure can be detected by an elevated pulmonary artery
wedge pressure.
C. Intracardiac shunt
Rationale: Intracardiac shunt can be detected by an elevated pulmonary artery wedge
pressure.
D. Hypovolemia
Rationale: A low CVP indicates reduced right ventricular preload, which can be seen in
clients who are experiencing hypovolemia, excessive blood loss, or overdiuresis
D.Hypovolemia
2. A nurse is monitoring the pulmonary artery wedge pressure (PAWP) for a client. The
nurse should identity that a reading of 15 mm Hg is an indication of which of the
following conditions?
A. Fluid volume deficit
Rationale: A client who has fluid volume deficit is more likely to have a decreased
PAWP.
,B. Right ventricular failure
Rationale: An increased right atrium (RA) pressure can indicate right ventricular
failure. A decreased RA pressure usually indicates hypovolemia.
C. Mitral regurgitation
Rationale: Hemodynamic monitoring allows the nurse to monitor the pressures within
the heart and the great vessels. The PAWP reflects left atrial pressure. A reading of 15
mm Hg is above the expected reference range, which can indicate mitral regurgitation,
hypervolemia, or left ventricular failure. The nurse should monitor for trends in value,
which can be more reliable than individual values.
D. Afterload reduction
Rationale: A client who has afterload reduction is more likely to have a decreased
PAWP.
C.Mitral regurgitation
PAWP.
3. A nurse is monitoring the cardiac output of a client who has left-sided heart failure
using pulse pressure analysis. Which of the following findings can compromise the
readings?
A. The client is experiencing premature atrial contractions.
Rationale:
Pulse pressure devices require the presence of optimal arterial waveforms in order to
capture accurate data. Therefore, a dysrhythmia, such as premature atrial contractions,
will compromise the readings.
B. The client has a decreased oxygen saturation level.
Rationale: Decreased oxygen saturation is a manifestation of heart failure that does not
compromise cardiac output readings.
, C. The client has bilateral wheezes.
Rationale: Bilateral wheezes are a manifestation of heart failure that do not
compromise cardiac output readings.
D. The client has lower leg edema.
Rationale: Lower leg edema is a manifestation of heart failure that does not
compromise cardiac output readings.
A.The client is experiencing premature atrial contractions.
4. A nurse is teaching a client who has septic shock about the development of
disseminated intravascular coagulation (DIC). Which of the following statements should
the nurse make?
A. "DIC is controllable with lifelong heparin usage."
Rationale: DIC is not controlled with lifelong heparin usage. Heparin is administered to
minimize the formation of microthrombi, which improves tissue perfusion.
B. "DIC is characterized by an elevated platelet count."
Rationale: DIC causes bleeding in part due to a decreased platelet count, rather than an
elevated platelet count.
C. "DIC is caused by abnormal coagulation involving fibrinogen."
Rationale: DIC is caused by abnormal coagulation involving the formation of multiple
small clots that consume clotting factors and fibrinogen faster than the body can
produce them, increasing the risk for hemorrhage.
D. "DIC is a genetic disorder involving a vitamin K deficiency."
Rationale: DIC is not a genetic disorder and does not involve vitamin K deficiency. The
effect of vitamin K is to prolong bleeding time.
C.DIC is caused by abnormal coagulation involving fibrinogen.
