NUR417 NUR 417 EXAM 1

NUR417 / NUR 417 EXAM 1

Care of Adult II Concordia, St. Paul Actual Questions and Answers

This Exam contains:

➢ 100% Guarantee Pass.➢ Expert Verified Explanation ➢ Multiple choice (single best answer) ➢ Select All That Apply (SATA) ➢ Fill-in-the-blank ➢ Case Studies/Scenario-Based Questions

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The nurse is caring for a patient who has an intraaortic balloon pump in place. Which action should be included in the plan of care?

• Avoid the use of anticoagulant medications.
• Measure the patient's urinary output every hour.
• Provide passive range of motion for all extremities.
• Position the patient supine with head flat at all times.

Answer B

Monitoring urine output will help determine whether the patient's cardiac output has improved and also help monitor for balloon displacement blocking the renal arteries. The head of the bed can be elevated up to 30 degrees. Heparin is used to prevent thrombus formation. Limited movement is allowed for the extremity with the balloon insertion site to prevent displacement of the balloon.

Which hemodynamic parameter best reflects the effectiveness of drugs that the nurse gives to reduce a patient's left ventricular afterload?

• Mean arterial pressure (MAP)
• Systemic vascular resistance (SVR)
• Pulmonary vascular resistance (PVR)
• Pulmonary artery wedge pressure (PAWP)

Answer B

SVR reflects the resistance to ventricular ejection, or afterload. The other parameters may be monitored but do not reflect afterload as directly.

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After surgery for an abdominal aortic aneurysm, a patient's central venous pressure (CVP) monitor indicates low pressures. Which action should the nurse take?

• Administer IV diuretic medications.
• Increase the IV fluid infusion per protocol.
• Increase the infusion rate of IV vasodilators.
• Elevate the head of the patient's bed to 45 degrees.

ANSWER

B

A low CVP indicates hypovolemia and a need for an increase in the infusion rate. Diuretic administration will contribute to hypovolemia and elevation of the head or increasing vasodilators may decrease cerebral perfusion.

The nurse is caring for a patient receiving a continuous norepinephrine IV infusion. Which patient assessment finding indicates that the infusion rate may need to be adjusted?

• Heart rate is slow at 58 beats/min.
• Mean arterial pressure (MAP) is 56 mm Hg.
• Systemic vascular resistance (SVR) is elevated.
• Pulmonary artery wedge pressure (PAWP) is low.

ANSWER

C

Vasoconstrictors such as norepinephrine will increase SVR, and this will increase the work of the heart and decrease peripheral perfusion. The infusion rate may need to be decreased. Bradycardia, hypotension (MAP of 56 mm Hg), and low PAWP are not associated with norepinephrine infusion. 3 / 4

When evaluating a patient with a central venous catheter, the nurse observes that the insertion site is red and tender to touch and the patient's temperature is 101.8° F. What should the nurse plan to do?

• Discontinue the catheter and culture the tip.
• Use the catheter only for fluid administration.
• Change the flush system and monitor the site.
• Check the site more frequently for any swelling.

ANSWER

A

The information indicates that the patient has a local and systemic infection caused by the catheter, and the catheter should be discontinued to avoid further complications such as endocarditis. Changing the flush system, continued monitoring, or using the line for fluids will not help prevent or treat the infection.

stroke volume

A patient's vital signs are pulse 90, respirations 24, and BP 128/64 mm Hg, and cardiac output is 4.7 L/min. The patient's stroke volume is _____ mL. (Round to the nearest whole number.)

ANSWER

52

Stroke volume = Cardiac output/heart rate52 mL = (4.7 L x 1000 mL/L)/90

An intraaortic balloon pump (IABP) is being used for a patient who is in cardiogenic shock. Which assessment data indicate to the nurse that the goals of treatment with the IABP are being met?

• Urine output of 25 mL/hr
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