NUR 3112 Exam 5 FREQUENTLY TESTED ACTUAL
QUESTIONS WITH CORRECT ANSWERS
Question 1.
How do we verify endotracheal placement? (4)
ANSWER
•Look: symmetrical chest expansion
•Listen: equal breath sounds
•End tidal CO2/CO2 Detector
•STAT chest x-ray
Question 2.
Extubation criteria: SAT and SBT (7;7)
ANSWER
SAT - Spontaneous awakening trial
Sedation vacation / awaken patients daily
•No:
-ETOH
-Agitation
-Paralytics
-Active seizures
-MI
•Normal ICP
SBT - Spontaneous breathing trial
Assess pt's readiness to extubate daily
•No agitation
•O2 > 88%
•FiO2 < 50%
•PEEP < 7.5 cm H2O
•No MI
•No vasopressor
•Inspiratory efforts
,Question 3.
_____ is a hemodynamic parameter representing cardiac output divided by body surface area.
ANSWER
cardiac index
**Normal CI: 2.7-3.2 L/min/m2
***Commonly measured via pulmonary artery catheterization.
Low CI (Low Output): Heart dysfunction (myocardial infarction), severe fluid loss, or
obstructions like tamponade.
High CI (High Output): Early distributive shock, fever, or anemia.
Question 4.
_____ is the pressure in thoracic vena cava near R atrium
ANSWER
CVP
Question 5.
Factors decreasing preload (4)
ANSWER
-Vasodilation (ex. nitrates)
-Diuresis (ex. 40 mg furosemide IVP)
-Hemorrhage (ex. 1000 mL blood loss)
-Dehydration (ex. excess vomiting, diarrhea)
,Question 6.
Forces influencing afterload: (3)
ANSWER
-Systemic arterial pressure
-Aortic valve resistance
-Mass and density of blood
*Left heart afterload = systemic vascular resistance (SVR)
*Right heart afterload = pulmonary vascular resistance (PVR)
Question 7.
Positive and negative inotropes:
ANSWER
•Positive: contractility
-Ex: dobutamine, digoxin, dopamine
•Negative: contractility
-Ex: beta blockers, calcium channel blockers
Question 8.
Intra-Arterial Blood Pressure Monitoring
ANSWER
•Continuous monitoring of BP and blood sampling
•Insertion Site
-Most common is radial artery
-Other sites: femoral and brachial
Question 9.
Potential Complications: Arterial Line (6)
ANSWER
•Massive ecchymosis
•Hemorrhage
•Infection
•Thrombus formation
•Neurovascular impairment distal ischemia
•Loss of limb
, Question 10.
Central Venous Pressure (CVP)
ANSWER
•Measurement of pressure in vena cava or right atrium
•Direct measurement of right ventricular preload
•Normal is 2 - 6 mmHg
•Can be measured with a central venous access device
**Low CVP: hypovolemia (dehydration, bleeding) or decreased venous tone **High CVP: fluid
overload, right ventricular failure, or mechanical obstruction
Question 11.
Pressure Monitoring Systems (3)
ANSWER
•Catheter (arterial and CVP)
-Attached to fluid-filled system
•Transducer
-Converts mechanical pressure into electrical signal
•Monitor
-Converts electrical signal to waveform and digital number
Question 12.
Leveling of CVP and Arterial Lines
ANSWER
•Phlebostatic Axis
-4th intercostal space and midchest
-Level pressure monitoring system to this point
QUESTIONS WITH CORRECT ANSWERS
Question 1.
How do we verify endotracheal placement? (4)
ANSWER
•Look: symmetrical chest expansion
•Listen: equal breath sounds
•End tidal CO2/CO2 Detector
•STAT chest x-ray
Question 2.
Extubation criteria: SAT and SBT (7;7)
ANSWER
SAT - Spontaneous awakening trial
Sedation vacation / awaken patients daily
•No:
-ETOH
-Agitation
-Paralytics
-Active seizures
-MI
•Normal ICP
SBT - Spontaneous breathing trial
Assess pt's readiness to extubate daily
•No agitation
•O2 > 88%
•FiO2 < 50%
•PEEP < 7.5 cm H2O
•No MI
•No vasopressor
•Inspiratory efforts
,Question 3.
_____ is a hemodynamic parameter representing cardiac output divided by body surface area.
ANSWER
cardiac index
**Normal CI: 2.7-3.2 L/min/m2
***Commonly measured via pulmonary artery catheterization.
Low CI (Low Output): Heart dysfunction (myocardial infarction), severe fluid loss, or
obstructions like tamponade.
High CI (High Output): Early distributive shock, fever, or anemia.
Question 4.
_____ is the pressure in thoracic vena cava near R atrium
ANSWER
CVP
Question 5.
Factors decreasing preload (4)
ANSWER
-Vasodilation (ex. nitrates)
-Diuresis (ex. 40 mg furosemide IVP)
-Hemorrhage (ex. 1000 mL blood loss)
-Dehydration (ex. excess vomiting, diarrhea)
,Question 6.
Forces influencing afterload: (3)
ANSWER
-Systemic arterial pressure
-Aortic valve resistance
-Mass and density of blood
*Left heart afterload = systemic vascular resistance (SVR)
*Right heart afterload = pulmonary vascular resistance (PVR)
Question 7.
Positive and negative inotropes:
ANSWER
•Positive: contractility
-Ex: dobutamine, digoxin, dopamine
•Negative: contractility
-Ex: beta blockers, calcium channel blockers
Question 8.
Intra-Arterial Blood Pressure Monitoring
ANSWER
•Continuous monitoring of BP and blood sampling
•Insertion Site
-Most common is radial artery
-Other sites: femoral and brachial
Question 9.
Potential Complications: Arterial Line (6)
ANSWER
•Massive ecchymosis
•Hemorrhage
•Infection
•Thrombus formation
•Neurovascular impairment distal ischemia
•Loss of limb
, Question 10.
Central Venous Pressure (CVP)
ANSWER
•Measurement of pressure in vena cava or right atrium
•Direct measurement of right ventricular preload
•Normal is 2 - 6 mmHg
•Can be measured with a central venous access device
**Low CVP: hypovolemia (dehydration, bleeding) or decreased venous tone **High CVP: fluid
overload, right ventricular failure, or mechanical obstruction
Question 11.
Pressure Monitoring Systems (3)
ANSWER
•Catheter (arterial and CVP)
-Attached to fluid-filled system
•Transducer
-Converts mechanical pressure into electrical signal
•Monitor
-Converts electrical signal to waveform and digital number
Question 12.
Leveling of CVP and Arterial Lines
ANSWER
•Phlebostatic Axis
-4th intercostal space and midchest
-Level pressure monitoring system to this point
