Critical Care Test 1 verified questions and solution A+ grade
Which of the following situations may result in a low cardiac output and low cardiac index?
(Select all that apply.)
a. Exercise
b. Hypovolemia
c. Myocardial infarction
d.Shock - -ANS: B, C, D
Hypovolemia, myocardial infarction, and shock often result in a decreased cardiac output.
Cardiac output is usually increased with exercise.
Which nursing actions are most important for a patient with a right radial arterial line? (Select
all that apply.)
a. Checking the circulation to the right hand every 2 hours
b. Maintaining a pressurized flush solution to the arterial line setup
c.Monitoring the waveform on the monitor for dampening
d. Restraining all four extremities with soft limb restraints - -ANS: A, B, C
,Options A, B, and C are required to ensure proper functioning of the arterial line.
There is no need to restrain all extremities. Depending on the patients level of sedation, the
right hand may need gentle restraint
The nurse is preparing for insertion of a pulmonary artery catheter (PAC). During insertion of the
catheter, what are the priority nursing actions? (Select all that apply.)
a. Allay the patients anxiety by providing information about the procedure.
b.Ensure that a sterile field is maintained during the insertion procedure.
c. Inflate the balloon during the procedure when indicated by the physician.
d. Monitor the patients cardiac rhythm throughout the entire procedure.
e. Obtain informed consent by informing the patient of procedural risks. - -ANS: A, B, C, D
During insertion of a pulmonary artery catheter (PAC/Swan-Ganz), the nurse should allay the
patients anxiety, ensure that the sterile field is maintained to decrease the risk of infection,
inflate the balloon upon request of the physician to assist in catheter placement, and monitor
for dysrhythmias that may occur as the catheter passes through the right ventricle. Informed
consent may be witnessed by the nurse, but it is obtained by the physician and should occur
before the procedure begins.
The nurse is preparing to obtain a right atrial pressure (RAP/CVP) reading. What are the most
appropriate nursing actions? (Select all that apply.)
, a. Compare measured pressures with other physiological parameters.
b. Flush the central venous catheter with 20 mL of sterile saline.
c. Inflate the balloon with 3 mL of air and record the pressure tracing.
d. Obtain the right atrial pressure measurement during end exhalation.
e. Zero reference the transducer system at the level of the phlebostatic axis. - -ANS: A, D,
E
To obtain an accurate right atrial pressure (RAP/CVP) reading, the transducer system should be
zero referenced and leveled with the phlebostatic axis to ensure accurate readings; the value
should be obtained during end exhalation, and any obtained measure should be evaluated in
light of the patients physiological parameters and physical assessment. The catheter does not
need to be flushed before measurement because continuous saline flush is part of the RAP
system. There is no balloon with a right atrial pressure (RAP/CVP) catheter.
When performing an initial pulmonary artery occlusion pressure (PAOP), what are the best
nursing actions? (Select all that apply.)
a. Inflate the balloon for no more than 8 to 10 seconds while noting the waveform change.
b. Inflate the balloon with air, recording the volume necessary to obtain a reading.
c. Maintain the balloon in the inflated position for 8 hours following insertion.
Which of the following situations may result in a low cardiac output and low cardiac index?
(Select all that apply.)
a. Exercise
b. Hypovolemia
c. Myocardial infarction
d.Shock - -ANS: B, C, D
Hypovolemia, myocardial infarction, and shock often result in a decreased cardiac output.
Cardiac output is usually increased with exercise.
Which nursing actions are most important for a patient with a right radial arterial line? (Select
all that apply.)
a. Checking the circulation to the right hand every 2 hours
b. Maintaining a pressurized flush solution to the arterial line setup
c.Monitoring the waveform on the monitor for dampening
d. Restraining all four extremities with soft limb restraints - -ANS: A, B, C
,Options A, B, and C are required to ensure proper functioning of the arterial line.
There is no need to restrain all extremities. Depending on the patients level of sedation, the
right hand may need gentle restraint
The nurse is preparing for insertion of a pulmonary artery catheter (PAC). During insertion of the
catheter, what are the priority nursing actions? (Select all that apply.)
a. Allay the patients anxiety by providing information about the procedure.
b.Ensure that a sterile field is maintained during the insertion procedure.
c. Inflate the balloon during the procedure when indicated by the physician.
d. Monitor the patients cardiac rhythm throughout the entire procedure.
e. Obtain informed consent by informing the patient of procedural risks. - -ANS: A, B, C, D
During insertion of a pulmonary artery catheter (PAC/Swan-Ganz), the nurse should allay the
patients anxiety, ensure that the sterile field is maintained to decrease the risk of infection,
inflate the balloon upon request of the physician to assist in catheter placement, and monitor
for dysrhythmias that may occur as the catheter passes through the right ventricle. Informed
consent may be witnessed by the nurse, but it is obtained by the physician and should occur
before the procedure begins.
The nurse is preparing to obtain a right atrial pressure (RAP/CVP) reading. What are the most
appropriate nursing actions? (Select all that apply.)
, a. Compare measured pressures with other physiological parameters.
b. Flush the central venous catheter with 20 mL of sterile saline.
c. Inflate the balloon with 3 mL of air and record the pressure tracing.
d. Obtain the right atrial pressure measurement during end exhalation.
e. Zero reference the transducer system at the level of the phlebostatic axis. - -ANS: A, D,
E
To obtain an accurate right atrial pressure (RAP/CVP) reading, the transducer system should be
zero referenced and leveled with the phlebostatic axis to ensure accurate readings; the value
should be obtained during end exhalation, and any obtained measure should be evaluated in
light of the patients physiological parameters and physical assessment. The catheter does not
need to be flushed before measurement because continuous saline flush is part of the RAP
system. There is no balloon with a right atrial pressure (RAP/CVP) catheter.
When performing an initial pulmonary artery occlusion pressure (PAOP), what are the best
nursing actions? (Select all that apply.)
a. Inflate the balloon for no more than 8 to 10 seconds while noting the waveform change.
b. Inflate the balloon with air, recording the volume necessary to obtain a reading.
c. Maintain the balloon in the inflated position for 8 hours following insertion.
