CMC-AACN Exam with Practice Questions and Answers

CMC-AACN Exam with Practice Questions and Answers While caring for a patient with an IABP at 3:1, the nurse notes: A. decreasing urine output as well as increasing BUN and CR levels; the nurse should increase timing to 2:1 B. absent pulses in the proximal extremity; the nurse should apply pressure at the insertion site. C. blood in the IABP tubing; the nurse should disconnect the balloon catheter from the IABP. D. blood oozing from the insertion site; the nurse should anticipate the need for an emergency fasciotomy. ANSWER A. incorrect. decreasing urine output with increasing BUN and CR levels with an IABP in place indicates obstruction of the renal arteries. The nurse should plan for removal. B. incorrect. absent pulses distal to the insertion site indicates complete occlusion of the femoral artery. application of pressure to the insertion site will worsen the obstruction. C. correct. blood in the IABP tubing indicates a rupture of the balloon. Continuing to allow the IABP to inflate and deflate will increase the size of the rupture, causing more bleeding. the nurse should plan for removal or exchange of the IABP catheter. D. incorrect. a fasciotomy would be indicated if the patient had an increase in fluid accumulation in the extremities causing significant injury to the limb. An IABP is currently at 3:1 when the patient suddenly goes into ventricular fibrillation. In addition to resuscitative measures, the nurse should: A. change the trigger to internal or pressure support resuscitative measures. B. increase timing back to 1:1 to increase coronary artery perfusion pressure. C. put the pump on standby until the return of spontaneous circulation. D. assess the IABP timing to chest compressions at 1:2. ANSWER A. correct. the IABP will not be able to time correctly when a patient is in V-Fib. by placing the system to