Galen NSG 4100 Exam 3 | Adult Health III (2026) Actual Q&A
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1. A nurse is reviewing hemodynamic values for a patient in the ICU. The patient's central
venous pressure (CVP) is 1 mm Hg. How should the nurse interpret this finding?
A) It indicates increased right ventricular preload.
B) It suggests the patient is hypervolemic.
C) It reflects reduced right ventricular preload (hypovolemia).
D) It is a normal finding indicating adequate fluid status.
Correct Answer: It reflects reduced right ventricular preload (hypovolemia).
Rationale: Normal CVP is 2-6 mm Hg. A CVP of 1 mm Hg is below normal, indicating the right
ventricle has insufficient filling volume (preload), which is seen in hypovolemia.
2. Which of the following parameters represents the resistance the heart must overcome to
eject blood into the systemic circulation?
A) Preload
B) Afterload
C) Cardiac output
D) Stroke volume
Correct Answer: Afterload
Rationale: Afterload is defined as the systemic vascular resistance (SVR) or the pressure the left
ventricle must generate to open the aortic valve and push blood out.
,3. A patient has a pulmonary artery catheter (Swan-Ganz) in place. The nurse measures a
pulmonary artery wedge pressure (PAWP). What does this value primarily reflect?
A) Right ventricular function
B) Left atrial pressure and left ventricular end-diastolic pressure (left-sided preload)
C) Central venous pressure
D) Systemic vascular resistance
Correct Answer: Left atrial pressure and left ventricular end-diastolic pressure (left-sided
preload)
Rationale: The PAWP is an indirect measurement of left atrial pressure. When the balloon is
inflated, it "wedges" in a small pulmonary artery, creating a static column of blood that reflects
pressure back from the left side of the heart during diastole (preload).
4. The nurse is calculating a patient's cardiac output (CO). Which formula is correct?
A) CO = (Heart Rate x Preload) / Afterload
B) CO = Stroke Volume x Blood Pressure
C) CO = Stroke Volume x Heart Rate
D) CO = (Preload x Afterload) / Heart Rate
Correct Answer: CO = Stroke Volume x Heart Rate
Rationale: Cardiac output, measured in liters per minute, is the product of stroke volume (the
amount of blood ejected with each beat) and heart rate (the number of beats per minute).
5. While caring for a patient with an arterial line, the nurse observes the waveform is dampened
and it is not possible to flush the line. What is the priority nursing action?
A) Increase the pressure of the flush bag to 600 mmHg.
,B) Attempt to aspirate blood from the line. If unsuccessful, remove the dressing to assess the
insertion site.
C) Administer a bolus of normal saline to clear the line.
D) Document the finding and continue to monitor vital signs manually.
Correct Answer: Attempt to aspirate blood from the line. If unsuccessful, remove the dressing to
assess the insertion site.
Rationale: A dampened waveform with inability to flush suggests the line is occluded or kinked.
The nurse should first try to aspirate. If unable, the site should be assessed for dislodgement or
hematoma.
6. The absence of impulse initiation in the heart results in electrical asystole. This results in:
A) Decreased cardiac output
B) Zero cardiac output
C) Increased cardiac output
D) Irregular cardiac output
Correct Answer: Zero cardiac output
Rationale: Asystole is the complete absence of electrical activity in the heart, resulting in zero
cardiac output.
7. Which of the following is a cause of asystole? (Select all that apply.)
A) Myocardial infarction
B) Electrical shock
C) Electrolyte disturbances
D) Acidosis
, E) All of the above
Correct Answer: All of the above
Rationale: Causes of asystole include myocardial infarction, electrical shock, severe electrolyte
disturbances (particularly hyperkalemia), acidosis, and excessive parasympathetic activity.
8. Manifestations of ventricular tachycardia include:
A) Increased cardiac output
B) Decrease of cardiac output resulting in loss of consciousness
C) Hypertension
D) Bradycardia
Correct Answer: Decrease of cardiac output resulting in loss of consciousness
Rationale: Ventricular tachycardia causes decreased cardiac output due to ineffective ventricular
filling and contraction, potentially leading to loss of consciousness, unresponsiveness, and
pulselessness.
9. A patient is unresponsive, apneic, and pulseless. The cardiac monitor displays ventricular
fibrillation. The crash cart is at the bedside. What is the nurse's priority action?
A) Initiate CPR and ventilate with bag-mask
B) Deliver an unsynchronized shock immediately
C) Administer epinephrine 1 mg IV
D) Check for a carotid pulse for 10 seconds
Correct Answer: Deliver an unsynchronized shock immediately
1. A nurse is reviewing hemodynamic values for a patient in the ICU. The patient's central
venous pressure (CVP) is 1 mm Hg. How should the nurse interpret this finding?
A) It indicates increased right ventricular preload.
B) It suggests the patient is hypervolemic.
C) It reflects reduced right ventricular preload (hypovolemia).
D) It is a normal finding indicating adequate fluid status.
Correct Answer: It reflects reduced right ventricular preload (hypovolemia).
Rationale: Normal CVP is 2-6 mm Hg. A CVP of 1 mm Hg is below normal, indicating the right
ventricle has insufficient filling volume (preload), which is seen in hypovolemia.
2. Which of the following parameters represents the resistance the heart must overcome to
eject blood into the systemic circulation?
A) Preload
B) Afterload
C) Cardiac output
D) Stroke volume
Correct Answer: Afterload
Rationale: Afterload is defined as the systemic vascular resistance (SVR) or the pressure the left
ventricle must generate to open the aortic valve and push blood out.
,3. A patient has a pulmonary artery catheter (Swan-Ganz) in place. The nurse measures a
pulmonary artery wedge pressure (PAWP). What does this value primarily reflect?
A) Right ventricular function
B) Left atrial pressure and left ventricular end-diastolic pressure (left-sided preload)
C) Central venous pressure
D) Systemic vascular resistance
Correct Answer: Left atrial pressure and left ventricular end-diastolic pressure (left-sided
preload)
Rationale: The PAWP is an indirect measurement of left atrial pressure. When the balloon is
inflated, it "wedges" in a small pulmonary artery, creating a static column of blood that reflects
pressure back from the left side of the heart during diastole (preload).
4. The nurse is calculating a patient's cardiac output (CO). Which formula is correct?
A) CO = (Heart Rate x Preload) / Afterload
B) CO = Stroke Volume x Blood Pressure
C) CO = Stroke Volume x Heart Rate
D) CO = (Preload x Afterload) / Heart Rate
Correct Answer: CO = Stroke Volume x Heart Rate
Rationale: Cardiac output, measured in liters per minute, is the product of stroke volume (the
amount of blood ejected with each beat) and heart rate (the number of beats per minute).
5. While caring for a patient with an arterial line, the nurse observes the waveform is dampened
and it is not possible to flush the line. What is the priority nursing action?
A) Increase the pressure of the flush bag to 600 mmHg.
,B) Attempt to aspirate blood from the line. If unsuccessful, remove the dressing to assess the
insertion site.
C) Administer a bolus of normal saline to clear the line.
D) Document the finding and continue to monitor vital signs manually.
Correct Answer: Attempt to aspirate blood from the line. If unsuccessful, remove the dressing to
assess the insertion site.
Rationale: A dampened waveform with inability to flush suggests the line is occluded or kinked.
The nurse should first try to aspirate. If unable, the site should be assessed for dislodgement or
hematoma.
6. The absence of impulse initiation in the heart results in electrical asystole. This results in:
A) Decreased cardiac output
B) Zero cardiac output
C) Increased cardiac output
D) Irregular cardiac output
Correct Answer: Zero cardiac output
Rationale: Asystole is the complete absence of electrical activity in the heart, resulting in zero
cardiac output.
7. Which of the following is a cause of asystole? (Select all that apply.)
A) Myocardial infarction
B) Electrical shock
C) Electrolyte disturbances
D) Acidosis
, E) All of the above
Correct Answer: All of the above
Rationale: Causes of asystole include myocardial infarction, electrical shock, severe electrolyte
disturbances (particularly hyperkalemia), acidosis, and excessive parasympathetic activity.
8. Manifestations of ventricular tachycardia include:
A) Increased cardiac output
B) Decrease of cardiac output resulting in loss of consciousness
C) Hypertension
D) Bradycardia
Correct Answer: Decrease of cardiac output resulting in loss of consciousness
Rationale: Ventricular tachycardia causes decreased cardiac output due to ineffective ventricular
filling and contraction, potentially leading to loss of consciousness, unresponsiveness, and
pulselessness.
9. A patient is unresponsive, apneic, and pulseless. The cardiac monitor displays ventricular
fibrillation. The crash cart is at the bedside. What is the nurse's priority action?
A) Initiate CPR and ventilate with bag-mask
B) Deliver an unsynchronized shock immediately
C) Administer epinephrine 1 mg IV
D) Check for a carotid pulse for 10 seconds
Correct Answer: Deliver an unsynchronized shock immediately
