Question 1

A patient with a newly inserted pulmonary catheter begins to cough up blood-tinged sputum.The most likely cause for this is:

Accepted Answer

A) pneumothorax. 
B) pulmonary embolus. 
C) pulmonary infarction. 
D) perforation of the heart muscle. 
A) pneumothorax. 
B) pulmonary embolus. 
C) pulmonary infarction. 
D) perforation of the heart muscle. C

Question 2

An increase in pulmonary artery systolic pressure is seen in patients with all of the following conditions except:

Accepted Answer

A) pulmonary embolus. 
B) mitral valve stenosis. 
C) right ventricular failure. 
D) hypoxia and hypoxemia. 
A) pulmonary embolus. 
B) mitral valve stenosis. 
C) right ventricular failure. 
D) hypoxia and hypoxemia. C

Question 3

When the water manometer is used to measure the CVP, the reading usually is taken at:

Accepted Answer

A) peak inspiration with the patient in the semi-Fowler position. 
B) the end of expiration with the patient in the supine position. 
C) the end of inspiration with the head of the bed elevated 45 degrees. 
D) any time during inspiration or expiration with the head of the bed elevated 45 degrees. 
A) peak inspiration with the patient in the semi-Fowler position. 
B) the end of expiration with the patient in the supine position. 
C) the end of inspiration with the head of the bed elevated 45 degrees. 
D) any time during inspiration or expiration with the head of the bed elevated 45 degrees. B

Question 4

During systole, the CVP v waveform is exaggerated and the CVP increases.This most likely is due to:

Accepted Answer

A) a kink in the tubing. 
B) air bubbles in the catheter. 
C) an incompetent tricuspid valve. 
D) incorrect positioning of the measuring instrument with respect to the right atrium. 
A) a kink in the tubing. 
B) air bubbles in the catheter. 
C) an incompetent tricuspid valve. 
D) incorrect positioning of the measuring instrument with respect to the right atrium.

Question 5

Pulmonary artery catheter monitoring is likely to be considered for patients with any of the following conditions except:

Accepted Answer

A) ARDS. 
B) pulmonary embolus. 
C) cardiogenic pulmonary edema. 
D) septic shock. 
A) ARDS. 
B) pulmonary embolus. 
C) cardiogenic pulmonary edema. 
D) septic shock.

Question 6

Which of the following is not an advantage of using the internal jugular vein as the insertion site for the central venous catheter?

Accepted Answer

A) The risk of pneumothorax from pleural puncture is low. 
B) Visibility is good if hematomas form around the neck. 
C) Tubing is more stable and is less likely to kink in a patient who is awake. 
D) It is nearly a straight line from the right internal jugular vein to the right atrium. 
A) The risk of pneumothorax from pleural puncture is low. 
B) Visibility is good if hematomas form around the neck. 
C) Tubing is more stable and is less likely to kink in a patient who is awake. 
D) It is nearly a straight line from the right internal jugular vein to the right atrium.

Question 7

An exaggerated v wave would be found in which of the following conditions?

Accepted Answer

A) Atrial fibrillation 
B) Tricuspid regurgitation 
C) Ventricular diastole 
D) All of the above 
A) Atrial fibrillation 
B) Tricuspid regurgitation 
C) Ventricular diastole 
D) All of the above

Question 8

Arterial cannulation is indicated for all of the following except:

Accepted Answer

A) determining cardiac output. 
B) severe hypotension. 
C) unstable respiratory failure. 
D) avoiding arterial injury from multiple arterial punctures. 
A) determining cardiac output. 
B) severe hypotension. 
C) unstable respiratory failure. 
D) avoiding arterial injury from multiple arterial punctures.

Question 9

For the pulmonary capillary wedge pressure to reflect pulmonary venous and left atrial pressures, blood flow must be uninterrupted between the catheter tip and the left heart.This condition exists only in West zone:

Accepted Answer

A) I. 
B) II. 
C) III. 
D) IV. 
A) I. 
B) II. 
C) III. 
D) IV.

Question 10

The purpose of the balloon at the tip of the pulmonary artery catheter is to:

Accepted Answer

A) obtain wedge pressure measurements. 
B) sense temperature changes in the blood. 
C) make the catheter more visible on a chest x-ray. 
D) provide a place for slow-release medication to be stored before it is released. 
A) obtain wedge pressure measurements. 
B) sense temperature changes in the blood. 
C) make the catheter more visible on a chest x-ray. 
D) provide a place for slow-release medication to be stored before it is released.

Question 11

The normal range for pulmonary artery systolic pressure is _____ mm Hg.

Accepted Answer

A) 0 to 10 
B) 10 to 20 
C) 20 to 30 
D) 30 to 40 
A) 0 to 10 
B) 10 to 20 
C) 20 to 30 
D) 30 to 40

Question 12

A difference between the pulmonary artery diastolic pressure and the pulmonary capillary wedge pressure greater than 5 mm Hg is seen in which of the following conditions?

Accepted Answer

A) ARDS 
B) Sepsis 
C) Excessive positive end-expiratory pressure (PEEP) 
D) All of the above 
A) ARDS 
B) Sepsis 
C) Excessive positive end-expiratory pressure (PEEP) 
D) All of the above

Question 13

With a properly inserted and positioned pulmonary artery catheter, a systolic pressure reading in the pulmonary artery of 50 mm Hg could be due to:

Accepted Answer

A) pulmonary vasodilation. 
B) tricuspid valve stenosis. 
C) pulmonic valve stenosis. 
D) chronic obstructive pulmonary disease (COP
D) . 
A) pulmonary vasodilation. 
B) tricuspid valve stenosis. 
C) pulmonic valve stenosis. 
D) chronic obstructive pulmonary disease (COP
D) .

Question 14

Monitoring of the CVP is indicated when there is a need to assess:

Accepted Answer

A) the circulating blood volume. 
B) the degree of venous return. 
C) the right ventricular function. 
D) all of the above. 
A) the circulating blood volume. 
B) the degree of venous return. 
C) the right ventricular function. 
D) all of the above.

Question 15

Large fluctuations in the net distending pressure within the left ventricle, also known as the transmural pressure, are seen in which of the following situations?

Accepted Answer

A) Coughing 
B) Valsalva maneuver 
C) Positive-pressure ventilation 
D) All of the above 
A) Coughing 
B) Valsalva maneuver 
C) Positive-pressure ventilation 
D) All of the above

Question 16

The most common site for arterial catheterization is the _____ artery.

Accepted Answer

A) radial 
B) axillary 
C) femoral 
D) brachial 
A) radial 
B) axillary 
C) femoral 
D) brachial

Question 17

What change is seen on the CVP waveform when the patient takes a spontaneous deep breath?

Accepted Answer

A) The waveform falls to baseline. 
B) The waveform falls to below baseline. 
C) The waveform increases to above baseline. 
D) There is no change in the waveform. 
A) The waveform falls to baseline. 
B) The waveform falls to below baseline. 
C) The waveform increases to above baseline. 
D) There is no change in the waveform.

Question 18

The normal range for pulmonary artery diastolic pressure is _____ mm Hg.

Accepted Answer

A) 0 to 8 
B) 8 to 15 
C) 15 to 28 
D) 28 to 35 
A) 0 to 8 
B) 8 to 15 
C) 15 to 28 
D) 28 to 35

Question 19

The CVP represents:

Accepted Answer

A) the right ventricular preload. 
B) the pressure of blood in the right atrium. 
C) the right ventricular end-diastolic pressure. 
D) all of the above. 
A) the right ventricular preload. 
B) the pressure of blood in the right atrium. 
C) the right ventricular end-diastolic pressure. 
D) all of the above.

Question 20

The CVP is most likely to correlate well with left ventricular filling pressure in which of the following patients?

Accepted Answer

A) Male, age 20 years, scheduled for surgery for mitral valve stenosis repair 
B) Female, age 52 years, scheduled for coronary artery bypass grafting in four arteries 
C) Male, age 37 years, receiving care in the intensive care unit (ICU) for acute respiratory distress syndrome (ARDS) 
D) Female, age 25 years, recovering well after abdominal surgery 
A) Male, age 20 years, scheduled for surgery for mitral valve stenosis repair 
B) Female, age 52 years, scheduled for coronary artery bypass grafting in four arteries 
C) Male, age 37 years, receiving care in the intensive care unit (ICU) for acute respiratory distress syndrome (ARDS) 
D) Female, age 25 years, recovering well after abdominal surgery

Exam 15: Vascular Pressure Monitoring

A patient with a newly inserted pulmonary catheter begins to cough up blood-tinged sputum.The most likely cause for this is:

An increase in pulmonary artery systolic pressure is seen in patients with all of the following conditions except:

When the water manometer is used to measure the CVP, the reading usually is taken at:

During systole, the CVP v waveform is exaggerated and the CVP increases.This most likely is due to:

Pulmonary artery catheter monitoring is likely to be considered for patients with any of the following conditions except:

Which of the following is not an advantage of using the internal jugular vein as the insertion site for the central venous catheter?

An exaggerated v wave would be found in which of the following conditions?

Arterial cannulation is indicated for all of the following except:

For the pulmonary capillary wedge pressure to reflect pulmonary venous and left atrial pressures, blood flow must be uninterrupted between the catheter tip and the left heart.This condition exists only in West zone:

The purpose of the balloon at the tip of the pulmonary artery catheter is to:

The normal range for pulmonary artery systolic pressure is _____ mm Hg.

A difference between the pulmonary artery diastolic pressure and the pulmonary capillary wedge pressure greater than 5 mm Hg is seen in which of the following conditions?

With a properly inserted and positioned pulmonary artery catheter, a systolic pressure reading in the pulmonary artery of 50 mm Hg could be due to:

Monitoring of the CVP is indicated when there is a need to assess:

Large fluctuations in the net distending pressure within the left ventricle, also known as the transmural pressure, are seen in which of the following situations?

The most common site for arterial catheterization is the _____ artery.

What change is seen on the CVP waveform when the patient takes a spontaneous deep breath?

The normal range for pulmonary artery diastolic pressure is _____ mm Hg.

The CVP represents:

The CVP is most likely to correlate well with left ventricular filling pressure in which of the following patients?

Preparing for the Patient Encounter

The Medical History and the Interview

Cardiopulmonary Symptoms

Vital Signs

Fundamentals of Physical Examination

Neurologic Assessment

Clinical Laboratory Studies

Interpretation of Blood Gases

Pulmonary Function Testing

Chest Imaging

Interpretation of Electrocardiogram Tracings

Neonatal and Pediatric Assessment

Older Patient Assessment

Respiratory Monitoring in Critical Care

Cardiac Output Measurement

Bronchoscopy

Nutrition Assessment

Sleep and Breathing Assessment

Home Care Patient Assessment

Documentation

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