Hemodynamics Practice Exam Questions
With Correct Answers
For |questions |1-3: |the |following |hemodynamic |profile |has |been |obtained |for |a |patient:
BP |112/60
PA |44/24
SVR |1600
SVI |23
RA |3
PAOP |22
CI |1.9
SvO2 |0.58
what |conclusion |is |correct?
a. |the |patient |is |hypovolemic
b. |the |patient |has |evidence |of |left |ventricular |failure
c. |the |patient |seems |to |have |severe |sepsis
d. |the |patient |has |developed |ARDS |- |CORRECT |ANSWER✔✔-b. |the |patient |has |evidence |of |left
|ventricular |failurej
looking |at |the |values, |the |one |of |most |significance |is |the |PAOP |of |22 |mmHg. |left |heart |failure |
is |the |only |one |listed |that |would |result |in |an |elevated |PAOP.
LV |failure |means |the |LV |is |not |emptying |normally, |so |there |is |a |backup |of |volume |- |reflected |in
|a |higher |pressure |on |the |left |side |of |the |heart
, shortly |after |obtaining |the |values |above, |you |inflated |(wedge) |the |catheter |balloon |and |
obtained |giant |V |waves |on |the |PAOP |tracing. |what |is |the |most |likely |problem?
a. |the |patient |has |evidence |of |mitral |valve |regurgitation
b. |the |PA |catheter |has |fallen |back |into |the |RV
c. |the |PA |catheter |needs |to |be |advanced
d. |the |PAOP |seems |to |be |40 |mmHg |- |CORRECT |ANSWER✔✔-a. |the |patient |has |evidence |of |
mitral |valve |regurgitation
what |would |be |the |most |appropriate |intervention |related |to |the |waveform |above?
a. |call |the |physician |for |possible |catheter |repositioning
b. |document |the |strip, |administer |the |PRN |order |for |lasix |for |PAOP |>16, |and |reassess |in |1 |hr
c. |label |the |balloon |"do |not |wedge"
d. |document |the |strip, |interpret |the |pressure, |and |notify |the |physician |- |CORRECT |
ANSWER✔✔-d. |document |the |strip, |interpret |the |pressure, |and |notify |the |physician |
physician |needs |to |be |notified
there |is |no |problem |with |the |PA |catheter |
doesn't |automatically |require |a |diuretic |(but |sometimes |it |does)
balloon |is |OK, |does |not |need |to |be |labeled
The |patient |with |continuous |SvO2 |monitoring |has |a |sustained |decrease |in |SvO2 |to |0.50. |
Priority |interventions |would |include |each |of |the |following |EXCEPT:
a. |check |urine |output
b. |check |BP |and |CO/CI
c. |check |O2 |sat |with |pulse |ox |(SpO2)
d. |check |temperature |- |CORRECT |ANSWER✔✔-a. |check |urine |output
With Correct Answers
For |questions |1-3: |the |following |hemodynamic |profile |has |been |obtained |for |a |patient:
BP |112/60
PA |44/24
SVR |1600
SVI |23
RA |3
PAOP |22
CI |1.9
SvO2 |0.58
what |conclusion |is |correct?
a. |the |patient |is |hypovolemic
b. |the |patient |has |evidence |of |left |ventricular |failure
c. |the |patient |seems |to |have |severe |sepsis
d. |the |patient |has |developed |ARDS |- |CORRECT |ANSWER✔✔-b. |the |patient |has |evidence |of |left
|ventricular |failurej
looking |at |the |values, |the |one |of |most |significance |is |the |PAOP |of |22 |mmHg. |left |heart |failure |
is |the |only |one |listed |that |would |result |in |an |elevated |PAOP.
LV |failure |means |the |LV |is |not |emptying |normally, |so |there |is |a |backup |of |volume |- |reflected |in
|a |higher |pressure |on |the |left |side |of |the |heart
, shortly |after |obtaining |the |values |above, |you |inflated |(wedge) |the |catheter |balloon |and |
obtained |giant |V |waves |on |the |PAOP |tracing. |what |is |the |most |likely |problem?
a. |the |patient |has |evidence |of |mitral |valve |regurgitation
b. |the |PA |catheter |has |fallen |back |into |the |RV
c. |the |PA |catheter |needs |to |be |advanced
d. |the |PAOP |seems |to |be |40 |mmHg |- |CORRECT |ANSWER✔✔-a. |the |patient |has |evidence |of |
mitral |valve |regurgitation
what |would |be |the |most |appropriate |intervention |related |to |the |waveform |above?
a. |call |the |physician |for |possible |catheter |repositioning
b. |document |the |strip, |administer |the |PRN |order |for |lasix |for |PAOP |>16, |and |reassess |in |1 |hr
c. |label |the |balloon |"do |not |wedge"
d. |document |the |strip, |interpret |the |pressure, |and |notify |the |physician |- |CORRECT |
ANSWER✔✔-d. |document |the |strip, |interpret |the |pressure, |and |notify |the |physician |
physician |needs |to |be |notified
there |is |no |problem |with |the |PA |catheter |
doesn't |automatically |require |a |diuretic |(but |sometimes |it |does)
balloon |is |OK, |does |not |need |to |be |labeled
The |patient |with |continuous |SvO2 |monitoring |has |a |sustained |decrease |in |SvO2 |to |0.50. |
Priority |interventions |would |include |each |of |the |following |EXCEPT:
a. |check |urine |output
b. |check |BP |and |CO/CI
c. |check |O2 |sat |with |pulse |ox |(SpO2)
d. |check |temperature |- |CORRECT |ANSWER✔✔-a. |check |urine |output