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Chapter 7 Question 1 The nurse is preparing to use a patient’s pulmonary artery catheter to obtain hemodynamic measurements. Which nursing action is indicated? 1. Zero the transducer at the phlebostatic axis. 2. Place the patient in Trendelenburg position. 3. Warm cardiac output injectate fluid to body temperature. 4. Prepare 20 mL of injectate. Question 2 The preceptor nurse is assisting a newly hired nurse with completion of hemodynamic assessment using a pulmonary artery catheter. Which action would require the preceptor to intervene? 1. Inflating the pressure bag to 300 mm Hg 2. Infusing a vasoactive drug through the proximal injectate port 3. Obtaining a pulmonary artery wedge pressure reading through the distal port 4. Using iced normal saline to obtain a cardiac output Question 3 While caring for a patient being hemodynamically monitored the nurse notices that the systemic vascular resistance has risen to 1,800 dynes/sec/cm5, whereas the patient’s cardiac output remains at 6.0 liters per minute. What would the nurse expect the patient’s blood pressure to be? 1. Increased 2. Unchanged 3. Decreased 4. Initially decreased, and then increased Question 4 The nurse is reviewing the results of a patient’s cardiac output curve and notes that the size of the curve is small. Which of the following does this finding indicate? 1. A low cardiac output 2. Poor injection technique 3. Incorrect placement of the catheter 4. A high cardiac output Question 5 The nurse is performing an assessment on a patient whose right atrial pressure is 12 mm Hg. Which findings would the nurse anticipate? 1. Jugular vein distention 2. Weak, thready pulse 3. Presence of rales and rhonchi 4. Poor skin turgor 5. Hepatomegaly Question 6 A patient who was stabbed multiple times in the chest and abdomen has just returned from emergency surgery. Hemodynamic monitoring was initiated during surgery and now reveals that the patient’s right atrial pressure has dropped to 2 mmHg. The nurse would assess for findings of which conditions? 1. Internal hemorrhage 2. Fluid loss during surgery 3. Vasodilation from drugs administered during surgery 4. Left heart failure 5. Cardiac tamponade Question 7 While evaluating a patient’s pulmonary artery waveforms, the nurse notes a sudden onset of right ventricular waves. Which nursing intervention is indicated? 1. Assist the patient to a left side-lying position. 2. Notify the physician for repositioning. 3. Increase intravenous fluids. 4. Nothing, since this is an expected occurrence. Question 8 A patient with congestive heart failure is receiving scheduled doses of an intravenous diuretic. After administering the drug, which finding would indicate to the nurse that the drug was effective? 1. A pulmonary artery wedge pressure of 16 mm Hg 2. Pulmonary artery pressure of 34/16 mm Hg 3. Systemic vascular resistance of 1,400 dynes/sec/cm-5 4. A right atrial pressure of 5 mm Hg Question 9 The nurse is caring for a patient who is being monitored with a pulmonary artery catheter. Which change requires immediate intervention? 1. Systemic vascular resistance of 900 dynes/sec/cm5 2. Appearance of an “a” wave on the pulmonary artery waveform 3. Pulmonary artery wedge pressure of 10 mm Hg 4. Spontaneous development of a pulmonary artery wedge pressure waveform Question 10 A patient is admitted for evaluation of hypotension. Which assessment by the nurse would require immediate attention? 1. Pulmonary artery wedge pressure of 2 mm Hg 2. Heart rate of 112 3. Urine output of 25 mL/hr 4. Presence of rales at both lung bases