Care of Adult II
Concordia, St. Paul
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Case Studies/Scenario-Based Questions
, Nur 417 exam 1
1. The nurse is caring for a patient who has an intraaortic balloon pump in place. Which action
should be included in the plan of care?
a. Avoid the use of anticoagulant medications.
b. Measure the patient's urinary output every hour.
c. Provide passive range of motion for all extremities.
d. Position the patient supine with head flat at all times.
ANSWER :B
Monitoring urine output will help determine whether the patient's cardiac output has improved and also help
monitor for balloon displacement blocking the renal arteries. The head of the bed can be elevated up to 30
degrees. Heparin is used to prevent thrombus formation. Limited movement is allowed for the extremity
with the balloon insertion site to prevent displacement of the balloon.
2. Which hemodynamic parameter best reflects the effectiveness of drugs that the nurse gives
to reduce a patient's left ventricular afterload?
a. Mean arterial pressure (MAP)
b. Systemic vascular resistance (SVR)
c. Pulmonary vascular resistance (PVR)
d. Pulmonary artery wedge pressure (PAWP)
ANSWER: B
SVR reflects the resistance to ventricular ejection, or afterload. The other parameters may be monitored but
do not reflect afterload as directly.
3. After surgery for an abdominal aortic aneurysm, a patient's central venous pressure (CVP)
monitor indicates low pressures. Which action should the nurse take?