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Essentials of Critical Care Nursing Hemodynamics Monitoring Exam
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Essentials of Critical CareNursing Hemodynamics
Monitoring Exam
A patient has a blood pressure of 134/70 per blood pressure cuff and a blood
pressure of 90/50 per arterial line. The nurse should:
1. Discontinue the arterial line immediately.
2. Check the level of the transducer and relevel and re-zero the system.
3. Do nothing because this is a normal variation between the two methods of
measurement.
4. Begin the infusion of a dopamine drip. - ANSWER Correct Answer: 2
Rationale 1: The system needs to be assessed first.
Rationale 2: The placement of the transducer is essential for accurate measurement.
It must be level with the phlebostatic axis for the monitoring system to be accurate.
Rationale 3: This is not a normal variation between the two methods of
measurement.
Rationale 4: More information and data are needed before administering
medication therapy.
The nurse is monitoring a patient's pulmonary vascular resistance. Which value is
the normal value?
1. 100-250 mm Hg
2. 10-250 dynes/sec/cm2
3. 400-800 mm Hg
,4. 800-1,400 dynes/sec/cm2 - ANSWER Correct Answer: 2
Rationale 1: A measurement in mm Hg is used to measure pressure only.
Rationale 2: The pulmonary system is a low-pressure system. The pressure of the
vascular system is measured in dynes/sec/cm2 due to factors of flow, resistance,
and time. This is the normal value for pulmonary vascular resistance.
Rationale 3: A measurement in mm Hg is used to measure pressure only.
Rationale 4: This is the value for SVR.
A patient's systemic vascular resistance (SVR) has dangerously decreased. The
nurse would expect to administer which medications?
1. Furosemide (Lasix) and dopamine
2. Nitroprusside and furosemide (Lasix)
3. Dopamine and norepinephrine (Levophed)
4. Nitroglycerin and digoxin (Lanoxin) - ANSWER Correct Answer: 3
Rationale 1: Furosemide (Lasix) is a diuretic that reduces fluid volume and is a
mild vasodilator. The systemic vascular resistance will be further decreased.
Rationale 2: Furosemide (Lasix) is a diuretic that reduces fluid volume and is a
mild vasodilator. The systemic vascular resistance will be further decreased.
Rationale 3: If the SVR is low, there is massive peripheral vasodilation. These
meds will increase vasomotor tone as well as increase blood pressure.
Rationale 4: Nitroglycerin is a potent vasodilator. The systemic vascular resistance
will be further decreased.
A patient has mixed venous oxygen saturation (SVO2) of 52% with the following
hemodynamic findings: CO of 4.8 L/min, SaO2 of 95%, and an unchanged
hemoglobin level. The nurse should assess the patient for:
, 1. Excessive sedation
2. Position of the PA catheter
3. Hypothermia
4. Pain - ANSWER Correct Answer: 4
Rationale 1: Excessive sedation contributes to a higher than normal SVO2 level
due to a lower level of oxygen extracted by the tissues.
Rationale 2: This would not influence the patient's blood levels of oxygen and
carbon dioxide.
Rationale 3: Hypothermia contributes to a higher than normal SVO2 level due to a
lower level of oxygen extracted by the tissues.
Rationale 4: Pain causes an increased consumption of oxygen; therefore, the SVO2
level will decrease.
Which of the following actions has the highest priority for maintaining safety when
caring for a patient with a PA catheter?
1. Obtain pressures per protocol.
2. Administer fluids and medications via pump.
3. Maintain asepsis when providing line care.
4. Obtain lab values as ordered. - ANSWER Correct Answer: 3
Rationale 3: The presence of all invasive lines can lead to infection and sepsis.
Preventing infection is the highest priority in maintaining patient safety.
A patient with a right subclavian triple lumen catheter has a CVP reading of 18 mm
Hg. The nurse would further assess the patient for symptoms of:
1. Peripheral edema and jugular vein distention
2. Decreased peripheral pulses and cool extremities
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