SOLVED

 Question 11 Which nursing interventions are indicated when measuring pulmonary artery wedge pressure (PAWP)? 1. Use no more than 1.25 mL of air to inflate the balloon. 2. Pull back on the syringe to deflate the balloon. 3. Leave the balloon slightly inflated to maintain integrity. 4. Maintain balloon inflation for 3 to 5 minutes to obtain a stable reading. 5. If there is any resistance during inflation do not continue. Question 12 The nurse is caring for a patient whose pulmonary artery wedge pressure is 16 mm Hg. The patient’s neck veins are flat, lungs are clear, and the pulse pressure is low. Which intervention would the nurse anticipate? 1. Administer a 500 mL normal saline fluid bolus. 2. Repeat the reading after recalibrating the system. 3. Repeat the reading after repositioning the patient. 4. Administer a diuretic and a vasodilator. Question 13 A patient who has a radial artery catheter in place is complaining of numbness and tingling in the fingers. What is the nurse’s priority assessment? 1. Is there a palpable pulse? 2. Is blood is easily obtained from the catheter? 3. Does the patient have a fever? 4. Does the waveform have a characteristic appearance? Question 14 The nurse is assessing a patient’s arterial waveform and notes a notch on the descending portion of the waveform. The nurse associates this notch with which physiological events? 1. Closure of the aortic valve 2. The highest systolic pressure 3. Systolic ejection of blood 4. The diastolic pressure 5. Beginning of ventricular diastole Question 15 A patient who has a pulmonary artery catheter in place is to receive the drug nitroprusside. The nurse would assess for which indicator of the drug’s effectiveness? 1. Decreased systemic vascular resistance 2. Decreased cardiac output 3. Increased right atrial pressure 4. Increased pulmonary artery wedge pressure Question 16 The nurse is caring for a patient with sepsis. On completing the hemodynamic assessment the nurse notes that the patient’s afterload, measured by the systemic vascular resistance, is 400 dynes/sec/cm-5. The nurse evaluates this finding to be primarily the result of which change associated with sepsis? 1. Decreased circulating volume 2. Reaction to antibiotics used to treat sepsis 3. Marked vasodilation 4. Decreased ventricular contractility Question 17 A patient is being prepared for impedance cardiography. Which information will the nurse provide? 1. “This technology will use ultrasound to measure your heart rate and blood flow.” 2. “We are preparing to measure the oxygenation of your peripheral tissues.” 3. “A catheter will be inserted into a vein in your neck.” 4. “Electrodes will be placed on your neck and your lateral chest.” Question 18 A patient is admitted to the emergency department after fainting. Vital signs are blood pressure 86/60, heart rate 160 bpm, and respirations 20. The patient’s skin is cool to the touch. Which nursing diagnosis (NDX) is priority? 1. Risk for Falls 2. Fluid Volume Deficient 3. Decreased Cardiac Output 4. Impaired Gas Exchange Question 19 Which nursing actions are necessary to collect information needed to figure the patient’s cardiac index? 1. Weigh the patient. 2. Take the patient’s temperature. 3. Measure the patient’s blood pressure. 4. Measure the patient’s height. 5. Determine the patient’s age. Question 20 A patient requires insertion of a pulmonary artery catheter. Which nursing action is indicated? 1. Instill air in all stopcocks. 2. Prime the pressure monitoring system. 3. Call for the rapid response team. 4. Obtain sterile gowns, gloves, caps, and masks for all persons who will be present during the insertion.