Critical Care Nursing

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Author:
plbernal
ID:
186608
Filename:
Critical Care Nursing
Updated:
2012-12-12 12:58:04
Tags:
Hemodynamics Neuro
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Description:
Chapter 8, 13
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  1. A 45-year-old male is visiting the wellness clinic and has been newly diagnosed as a stage I hypertensive patient. His blood pressure assessment over the past 6 months has consistently been 145/92 mm Hg. The patient asks, “What is blood pressure?” What is the best response by the nurse?

    A) “A complex measurement that should be discussed only with your physician.”
    B) “A measurement that takes into consideration the amount of blood your heart is pumping and the size of the vessel diameter the heart must pump against.”
    C) “The amount of pressure exerted on the veins by the blood.”
    D) “A measurement that should be 120/80 mm Hg unless complications are present.”
    B) “A measurement that takes into consideration the amount of blood your heart is pumping and the size of the vessel diameter the heart must pump against.”
    (this multiple choice question has been scrambled)
  2. What is the best position for the nurse to place the patient in to obtain a right atrial pressure measurement?

    A) Left side-lying with the head of the bed elevated 30 degrees
    B) Prone, lying on the abdomen with slight head elevation
    C) Right side-lying with the head of the bed elevated 30 degrees
    D) Supine, either flat or with the head of the bed no more than 60 degrees
    D) Supine, either flat or with the head of the bed no more than 60 degrees
    (this multiple choice question has been scrambled)
  3. What is the best action by the nurse to accurately record a thermodilution cardiac output (CO)?

    A) Position the patient supine, obtain three values within 10% of each other, and calculate the average cardiac output.
    B) Place the patient supine, enter the computation constant, and obtain one value with the head of the bed elevation at 45 degrees.
    C) Place the patient prone, enter the computation constant, and obtain four successive measurements.
    D) Place the patient prone, elevate the backrest 30 degrees, and obtain three successive measurements.
    A) Position the patient supine, obtain three values within 10% of each other, and calculate the average cardiac output.
    (this multiple choice question has been scrambled)
  4. What is the best understanding of mixed venous oxygen saturation by the nurse?

    A) An overall picture of oxygen delivery and oxygen consumption
    B) The amount of oxygen attached to each hemoglobin molecule
    C) The amount of oxygen perfusion taking place within the myocardium
    D) The amount of oxygen the lungs are able to mix with the blood
    A) An overall picture of oxygen delivery and oxygen consumption
    (this multiple choice question has been scrambled)
  5. What is the best action by the nurse to level and zero a hemodynamic monitoring system transducer?

    A) Position the air-fluid interface of the zeroing transducer at the phlebostatic axis; fourth intercostal space, midaxillary line.
    B) Level the air-fluid interface of the zeroing transducer at the height of the patient’s mattress.
    C) Position the air-fluid interface of the zeroing transducer at the fifth intercostal space; midclavicular line.
    D) Level the air-fluid interface of the zeroing transducer at the second intercostal space; anterior-axillary line.
    A) Position the air-fluid interface of the zeroing transducer at the phlebostatic axis; fourth intercostal space, midaxillary line.
    (this multiple choice question has been scrambled)
  6. When checking a patient’s pulmonary artery occlusion pressure, the nurse inflates the balloon as ordered, not inflating the balloon for more than 8 to 10 seconds. What is the best understanding of this action by the nurse?

    A) Prolonged inflation increases the risk of catheter balloon rupture.
    B) Prolonged inflation will reduce tension on the pulmonary artery wall.
    C) Prolonged inflation can obstruct blood flow, resulting in ischemia.
    D) Prolonged inflation increases the likelihood of thermistor damage.
    C) Prolonged inflation can obstruct blood flow, resulting in ischemia.
    (this multiple choice question has been scrambled)
  7. The nurse begins to review orders recently entered by the cardiologist. Medication orders include dobutamine (Dobutrex) 400 mg in 250 mL 5% dextrose in water titrated to keep cardiac index > 2 L/min/m2. What is the best understanding of cardiac index by the nurse?

    A) The pressure created by the volume of blood in the left heart
    B) The amount of blood pumped out by a ventricle per minute
    C) The amount of blood ejected with each ventricular contraction
    D) The measurement specific to the patient’s size or body area
    D) The measurement specific to the patient’s size or body area
    (this multiple choice question has been scrambled)
  8. The nurse is caring for a patient being monitored with a central venous catheter. In preparing to record a right atrial pressure reading, what is most important for the nurse to understand in recording an accurate value?

    A) Zero referencing is not needed before every recording.
    B) High pressures are likely to indicate hypovolemia.
    C) Record the pressure at the end of expiration.
    D) Low pressures indicate ventricular dysfunction.
    C) Record the pressure at the end of expiration.
    (this multiple choice question has been scrambled)
  9. The nurse is preparing a patient for assessment of cardiac output using an esophageal monitor. What is the best understanding of this procedure by the nurse?

    A) Patients require deep sedation provided by an anesthesia provider.
    B) The procedure involves a thin probe inserted into the esophagus.
    C) There are no absolute contraindications for the procedure.
    D) The procedure immediately assesses right ventricular performance.
    B) The procedure involves a thin probe inserted into the esophagus.
    (this multiple choice question has been scrambled)
  10. The physician orders cardiac output monitoring for a mechanically ventilated, hemodynamically unstable patient. The nurse prepares to set up a Vigileo pulse contour monitoring system. What is the best understanding of this technology by the nurse?

    A) The device can be used in patients with intraaortic counterpulsation (IABP).
    B) The device requires extensive calibration that includes blood sampling.
    C) Pulse contour analysis is accurate in patients with peripheral vascular disease.
    D) The device provides better predictors of fluid responsiveness than RAP.
    D) The device provides better predictors of fluid responsiveness than RAP.
    (this multiple choice question has been scrambled)
  11. The physician orders continuous cardiac output (CCO) monitoring for a patient admitted in cardiogenic shock. Which statement(s) best describes advantages associated with the continuous monitoring of cardiac output? (Select all that apply.)

    A) No extra fluid is administered to the patient.
    B) The device senses CCO in hypothermic patients.
    C) Data are continuously available for trending.
    D) There is no need to change the computation constant.
    E) The device detects acute changes in cardiac output.
    • A) No extra fluid is administered to the patient.
    • C) Data are continuously available for trending.
    • D) There is no need to change the computation constant.
  12. The nurse needs to obtain a cardiac output measurement from a patient who has just had a pulmonary artery catheter inserted. What are important interventions for ensuring accurate pressure and cardiac output measurements? (Select all that apply.)

    A) Inflate the pulmonary artery catheter balloon with 5 mL air.
    B) Use lactated Ringer’s solution for the injectate.
    C) Ensure rapid injection of fluid through the injectate port.
    D) Zero reference the transducer system at the phlebostatic axis.
    C) Ensure rapid injection of fluid through the injectate port.B) Zero reference the transducer system at the phlebostatic axis.
    (this multiple choice question has been scrambled)

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