INTRODUCTION TO CRITICAL CARE NURSING 7TH EDITION SOLE TEST BANK
Chapter 08: Hemodynamic Monitoring Sole: Introduction to Critical Care Nursing, 7th Edition MULTIPLE CHOICE 1. The nurse is caring for a 100-kg patient being monitored with a pulmonary artery catheter.
The nurse assesses a blood pressure of 90/60 mm Hg, heart rate 110 beats/min, respirations 36/min, oxygen saturation of 89% on 3 L of oxygen via nasal cannula. Bilateral crackles are audible upon auscultation. Which hemodynamic value requires immediate action by the nurse? a. Cardiac index (CI) of 1.2 L/min/m3 b. Cardiac output (CO) of 4 L/min c. Pulmonary vascular resistance (PVR) of 80 dynes/sec/cm–5 d. Systemic vascular resistance (SVR) of 1400 dynes/sec/cm–5 ANS: A
A cardiac index of 1.2 L/min/m3 combined with the identified clinical assessment findings indicate a low cardiac output with fluid overload (bilateral crackles), requiring intervention. The remaining hemodynamic values are within normal limits: cardiac output of 4 L/min; pulmonary vascular resistance of 80 dynes/sec/cm–5; and the systemic vascular resistance of 1400 dynes/sec/cm–5. DIF: Cognitive Level: Analyze/Analysis OBJ: Identify normal hemodynamic values. TOP: Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity NURSINGTB.COM
REF: p. 137 | Table 8-1 | Box 8-8
2. While caring for a patient with a small bowel obstruction, the nurse assesses a pulmonary
artery occlusion pressure (PAOP) of 1 mm Hg and hourly urine output of 5 mL. The nurse anticipates which therapeutic intervention? a. Diuretics b. Intravenous fluids c. Negative inotropic agents d. Vasopressors ANS: B
Low pulmonary artery occlusion pressures usually indicate volume depletion, so intravenous fluids would be indicated. A normal hourly urine output is 1 mL/kg or at least 30 mL/hour, so this is another indication that the patient is volume depleted. Administration of diuretics would worsen the patient’s volume status. Negative inotropes would not improve the patient’s volume status. Vasopressors will increase blood pressure but are contraindicated in a low volume state. DIF: Cognitive Level: Analyze/Analysis REF: p. 149 | Box 8-1 OBJ: Articulate appropriate nursing actions for patients with altered hemodynamic values. TOP: Nursing Process Step: Planning MSC: NCLEX Client Needs Category: Physiological Integrity
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