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TEST BANK FOR CRITICAL EXAM 3 AND FINAL EXAM QUESTIONS AND ANSWERS UPDATE 2024ALL ANSWERS 100% CORRECT VERIFIED BEST EXAM SOLUTION RATED A+$12.99
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TEST BANK FOR CRITICAL EXAM 3 AND FINAL EXAM QUESTIONS AND ANSWERS UPDATE 2024ALL ANSWERS 100% CORRECT VERIFIED BEST EXAM SOLUTION RATED A+
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Course
CRITICAL 3
Institution
CRITICAL 3
TEST BANK FOR CRITICAL EXAM 3 AND FINAL EXAM QUESTIONS AND ANSWERS UPDATE 2024ALL ANSWERS 100% CORRECT VERIFIED BEST EXAM SOLUTION RATED A+..Both hemodynamic parameters and the reported hematocrit value indicate hypovolemia and
blood loss requiring volume resuscitation with blood products. Fur...
both hemodynamic parameters and the reported hemat
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TEST BANK QUESTIONS: CRITICAL EXAM 3 AND FINAL
EXAM QUESTIONS AND ANSWERS UPDATE 2024ALL
ANSWERS 100% CORRECT VERIFIED BEST EXAM
SOLUTION RATED A+ FOR SUCCESS
Both hemodynamic parameters and the reported hematocrit value indicate hypovolemia and
blood loss requiring volume resuscitation with blood products. Furosemide administration will
worsen fluid volume status. Inotropic agents will not correct the underlying fluid volume deficit
and anemia. Vasoconstrictors are contraindicated in a volume-depleted state. - CORRECT
ANSWERS A patient is admitted to the hospital with multiple trauma and extensive blood loss.
The nurse assesses vital signs to be BP 80/50 mm Hg, heart rate 135 beats/min, respirations 36
breaths/min, cardiac output (CO) of 2 L/min, systemic vascular resistance of 3000 dynes/sec/cm-
5, and a hematocrit of 20%. The nurse anticipates administration of which the following
therapies or medications?
a.
Blood transfusion
b.
Furosemide (Lasix)
c.
Dobutamine (Dobutrex) infusion
d.
Dopamine hydrochloride (Dopamine) infusion
ANS: C
The pulmonary pressures are higher than normal, indicating elevated preload, and the cardiac
index and output values are low. The priority order for the nurse to implement is to begin a
dobutamine (Dobutrex) infusion to improve cardiac output, possibly reducing pulmonary artery
occlusion pressures. The other treatments are important, but the dobutamine infusion is the most
important at this time. - CORRECT ANSWERS After pulmonary artery catheter insertion, the
nurse assesses a pulmonary artery pressure of 45/25 mm Hg, a pulmonary artery occlusion
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,Created By: A Solution
pressure (PAOP) of 20 mm Hg, a cardiac output of 2.6 L/min and a cardiac index of 1.9
L/min/m2. Which physician order is of the highest priority?
a.
Apply 50% oxygen via venture mask.
b.
Insert an indwelling urinary catheter.
c.
Begin a dobutamine (Dobutrex) infusion.
d.
Obtain stat cardiac enzymes and troponin.
ANS: B
Numbness and tingling in the left hand, which is the location of an arterial catheter, indicates
possible neurovascular compromise and requires immediate action. A dampened waveform can
indicate problems with arterial line patency but is not an emergent situation. Slight bloody
drainage at the subclavian insertion site is not an unusual finding. Slight redness at the insertion
site, while of concern, does not require immediate action. - CORRECT ANSWERS The nurse
is caring for a patient with a left subclavian central venous catheter (CVC) and a left radial
arterial line. Which assessment finding by the nurse requires immediate action?
a.
A dampened arterial line waveform
b.
Numbness and tingling in the left hand
c.
Slight bloody drainage at subclavian insertion site
d.
Slight redness at subclavian insertion site
ANS: B
Upon removal of an invasive arterial line, adequate pressure must be applied for at least 5
minutes to ensure adequate hemostasis. Application of an air occlusion dressing is not standard
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,Created By: A Solution
of care following removal of an arterial line. Elevation of the affected limb following removal of
an arterial line is not a necessary intervention. Neutral wrist position is optimum while the
catheter is in place and not necessary after catheter discontinuation. - CORRECT ANSWERS
The physician writes an order to discontinue a patient's left radial arterial line. When
discontinuing the patient's invasive line, what is the priority nursing action?
a.
Apply an air occlusion dressing to insertion site.
b.
Apply pressure to the insertion site for 5 minutes.
c.
Elevate the affected limb on pillows for 24 hours.
d.
Keep the patient's wrist in a neutral position.
ANS: C
X-ray results indicate proper position of the catheter. The tip of the central venous catheter
should rest just above the right atrium in the superior vena cava. The central venous catheter is
positioned correctly in the superior vena cava. Dysrhythmias occur if the catheter migrates to the
right ventricle. Central venous catheters are placed into great vessels of the venous system and
not advanced into the pulmonary artery. - CORRECT ANSWERS Following insertion of a
central venous catheter, the nurse obtains a stat chest x-ray film to verify proper catheter
placement. The radiologist reports to the nurse: "The tip of the catheter is located in the superior
vena cava." What is the best interpretation of these results by the nurse?
a.
The catheter is not positioned correctly and should be removed.
b.
The catheter position increases the risk of ventricular dysrhythmias.
c.
The distal tip of the catheter is in the appropriate position.
d.
The physician should be called to advance the catheter into the pulmonary artery.
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, Created By: A Solution
ANS: C
Balloon inflation should never be forced because the PAC may have migrated further into the
pulmonary artery, creating resistance to balloon inflation. Verification of proper line placement
is warranted to avoid pulmonary artery rupture. In addition, the PAC waveform should be
observed to assist in identifying location of the tip of the PAC. In this scenario, adding additional
air to the balloon will further risk pulmonary artery rupture.
Advancing a pulmonary artery catheter is not within the nurse's scope of practice.
Flushing the distal port with saline may be indicated to ensure patency; however, the balloon of
the PAC should never be locked in the inflated position as rupture of the pulmonary artery may
occur. - CORRECT ANSWERS 10. While inflating the balloon of a pulmonary artery catheter
(PAC) with 1.0 mL of air to obtain a pulmonary artery occlusion pressure (PAOP), the nurse
encounters resistance. What is the best nursing action?
a.
Add an additional 0.5 mL of air to the balloon and repeat the procedure.
b.
Advance the catheter with the balloon deflated and repeat the procedure.
c.
Deflate the balloon and obtain a chest x-ray study to determine line placement.
d.
Lock the balloon in the inflated position and flush the distal port of the PAC with normal saline.
ANS: A
Diminished breaths sounds over the lung field on the same side of the line insertion site may be
indicative of a pneumothorax. A pneumothorax, which can develop slowly, is a major
complication following insertion of central lines when the subclavian route is used. Localized
pain at catheter insertion site is not the immediate priority in this scenario. A measured central
venous pressure of 5 mm Hg is normal. Slight bloody drainage at the insertion site soon after the
procedure does not require immediate action. - CORRECT ANSWERS The nurse is caring for
a patient following insertion of a left subclavian central venous catheter (CVC). Which
assessment finding 2 hours after insertion by the nurse warrants immediate action?
A+ Page 4
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