Chapter 19--Critical Care

Chapter 19–Critical Care

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. The nurse determines that a client’s cardiac output is normal. Which of the following values would be considered normal?

ANS:  3

Normal cardiac output is 4 to 8 L/min. This variation is due to the differences in body sizes of individuals. The values less than 4 L/min are low and the value of 15 L/min is extremely high.

PTS:   1                    DIF:    Analyze         REF:   Cardiac Output

2. A client’s cardiac index is calculated to be 3.1 L/minute/m². Which of the following could explain this client’s cardiac index value?

ANS:  3

The normal cardiac index range is 2.5 to 4.2 L/min/m². An index of 3.1 L/min/m²  is considered a normal value. Cardiac index is low with the diagnosis of acute myocardial infarction or cardiogenic shock. Cardiac index is elevated with a fever.

PTS:   1                    DIF:    Analyze         REF:   Cardiac Output

3. A client with an elevated cardiac index has received diuretic medication as prescribed. The nurse realizes that this medication will affect which cardiac parameter?

ANS:  3

Preload is characterized by the amount of cardiac muscle fiber stretch preceding each contraction. Preload will decrease with the use of diuretics. Contractility is the force of ventricular contraction. Afterload is the pressure and forces opposing ventricular contraction. The stroke volume is the amount of blood pumped by the left ventricle in one contraction. Diuretics do not specifically impact contractility, afterload, or stroke volume.

PTS:   1                    DIF:    Analyze         REF:   Hemodynamic Monitoring: Preload

4. The nurse is caring for a client who is experiencing an increase in cardiac contractility. Which of the following will decrease contractility and reduce myocardial oxygen demand for this client?

ANS:  3

Medications such as beta-blockers and calcium channel blockers will reduce myocardial oxygen demand, decreasing cardiac contractility. Medications such as Primacor, Digoxin, and potassium chloride will increase cardiac contractility.

PTS:   1                    DIF:    Analyze         REF:   Contractility

5. Which of the following interventions would ensure the accuracy of hemodynamic parameters and ensure an air-free system?

ANS:  3

Interventions to ensure the accuracy of hemodynamic parameters and an air-free system include fast-flushing the system after taking a blood sample, keeping connections tight, keeping the pressure bag inflated to 300 mmHg, not adding extensions to the line, and periodically performing flick and flush to the tubing system.

PTS:   1                    DIF:    Apply            REF:   Measurement of Hemodynamic Parameters