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92 Cards in this Set

  • Front
  • Back
Which statement about therapeutic interventions to reduce afterload is most correct?
Hypotension may occur
Which one of the following is most effective in the treatment of increased afterload?
Nitroprusside
Which one of the following is most effective in the treatment of reduced contractility?
Dobutamine
Which one of the following statements is most correct?
Volume expansion is often indicated in right ventricular failure despite elevation of central venous pressure
Which one of the following statements is most correct?
Stimulation of beta 2 receptors produces vascular smooth muscle relaxation
Which one of the following drug-dosage pairs is most correct
Norepinephrine 1-20 mcg/min
Which one of the following statements about vasopressor drugs is most correct
Use may be associated with a reduction of blood flow to some vascular beds
Which of the following is a primary side effect of Dobutamine?
Decreased SVR
All of the following are expected/desirable hemodynamic responses to nitroprusside except:
Increased SVR
Which of the following statements regarding dopamine is most correct?
Dopamine is indicated when low SV/SVI values are accompanied by adequate preload and normal or low afterload
1) Which one of the following statements is false?
C) Systemic vascular resistance is the same as afterload
2) Which one of the following statements about preload is most correct?
D) Preload decreases as mean intrathoracic pressure increases
3) Which one of the following statements about ventricular contractility is false?
B) Ventricular preload, afterload and contractility are independent variables
4) Which one of the following statements about ventricular compliance is most correct?
C) The less compliant the ventricle, the higher the filling pressure
5) Which one of the following statements about ventricular compliance is most correct?
D) Ventricular compliance decreases with increasing cardiac ischemia
6) Which statement regarding changes in heart rate is false?
C) Increases in heart rate cause decreases in contractility
7) Which statement regarding changes in heart rate is false?
D) Low heart rates (<50 bpm) may result in increased myocardial oxygen consumption
8) Which of the following statements regarding preload is most correct?
B) Increases in preload usually are associated with increased myocardial fiber length
9) Which of the following statements regarding afterload is most correct?
C) Decreases in afterload usually are associated with decreases in systemic vascular resistance
10) Which of the following statements regarding ventricular filling is most correct?
D) Loss of atrial contraction results in decreases in ventricular filling volume
1) Which statement about therapeutic interventions to reduce afterload is most correct?
A) Hypotension may occur
2) Which one of the following is most effective in the treatment of increased afterload?
D) Nitroprusside
3) Which one of the following is most effective in the treatment of reduced contractility?
D) Dobutamine
4) Which one of the following statements is most correct?
C) Volume expansion is often indicated in right ventricular failure despite elevation of central venous pressure
5) Which one of the following statements is most correct?
B) Stimulation of beta 2 receptors produces vascular smooth muscle relaxation
6) Which one of the following drug-dosage pairs is most correct?
B) Norepinephrine 1-20 mcg/min
7) Which one of the following statements about vasopressor drugs is most correct?
A) Use may be associated with a reduction of blood flow to some vascular beds
8) Which of the following is a primary side effect of Dobutamine?
B) Tachycardia
9) All of the following are expected/desirable hemodynamic responses to epinephrine except:
D) Decreased SVR
10) All of the following are expected/desirable hemodynamic responses to nitroprusside except:
D) Increased SVR
11) Which of the following statements regarding dopamine is most correct?
A) Dopamine is indicated when low SV/SVI values are accompanied by adequate preload and normal or low afterload
1) The PAOP waveform depicted in Figure 5 is typically the result of:
C) Excessive balloon inflation
2) The a waves are consistently absent in the CVP/RA and PAOP waveforms in all the following conditions except:
A) Third degree heart block
3) The a waves become exaggerated in the CVP/RA and PAOP waveforms in which of the following conditions?
A) A-V dissociation
4) The v waves of the PAOP waveform may be abnormally exaggerated in which of the following conditions?
D) Left ventricular ischemia
5) Measurement of the CVP/RA or PAOP waveforms in a patient with a dysrhythmia causing a consistently enlarged a wave (cannon a wave) is best performed by:
B) Measuring the pressure value at end-expiration just after the QRS complex.
6) Measurement of the mean value of the CVP/RA or PAOP waveform in a patient with atrial fibrillation is best performed by:
C) Measuring the pressure value at end-expiration just after the QRS complex.
7) Measurement of the value of the PAOP in a patient with mitral regurgitation is best performed by:
C) Measuring the mean of the a wave at end-expiration.
1) Which one of the following statements is true concerning ventricular diastole?
D) Blood leaves the atria and fills the ventricles
2) Which one of the following statements is most correct about timing of ventricular diastole?
A) It begins after the ECG T wave
3) Which one of the following statements is most correct regarding ventricular end-diastole?
C) Right atrial pressure equalizes with right ventricular end-diastolic pressure
4) At peak ventricular systole which one of the following statements is most correct?
D) Pulmonary artery systolic pressure and right ventricular systolic pressure equalize
5) Which one of the following statements about preload is most correct?
D) It refers to the force or load on the ventricle in its relaxed state
6) Which one of the following statements about the pulmonary artery occlusion pressure is most correct?
A) It is an estimate of left ventricular preload
7) Which one of the following statements about afterload is most correct?
B) It is the force or load on the ventricle during the ejection phase
8) Which one of the following statements about contractility is most correct?
A) It refers to the force or strength of ventricular systole
9) Which of the following has the most direct impact on the arterial oxygen content?
C) Hemoglobin
10) Which statement about oxygen supply and demand is most correct?
C) May be altered by the metabolic demands of the tissues
1) Which one of the following statements about SvO2 is most correct?
A) SvO2 values <0.60 indicate threatened tissue oxygenation
2) Which one of the following statements is most correct?
B) A CVP >6 mmHg usually reflects RV failure if the SVI is <25 mL/beat/M2
3) Which of the following statements is most correct?
A) SV/SVI assesses cardiac pump performance
4) Which one of the pair of stroke volume and stroke volume index values is abnormal?
D) SV = 49 ml/beat; SVI = 17 mL/beat/M2
Identify the condition most consistent with the following hemodynamic profile:
SvO2 ... 0.50 ... PAOP ... 21 mmHg
CI ... 2.2 L/min/M2 ...CVP/RA ... 4 mmHg
SVI ... 23 ml/beat M2 ... HR ... 98
C) LV dysfunction/failure
Identify the condition most consistent with the following hemodynamic profile:
SvO2 ... 0.53 ... PAOP ... 21 mm Hg
CI ... 2.8 L/min/M2 ... CVP/RA ... 14 mm Hg
SVI ... 20 ml/beat/M2 ... HR ... 140
B) Hypervolemia
7) Identify the condition most consistent with the following hemodynamic profile: SvO2 ... 0.47 ... PAOP ... 4 mm Hg
CI ... 2.0 L/min/M2 ... CVP/RA ... 2 mm Hg
SVI ... 19 ml/beat/M2 ... HR ... 111
A) Hypovolemia
8) Which of the combined set of hemodynamic values is of greatest concern?
A) CO = 6.9 L/min; ....... CI = 3.8 L/min/M2 SV = 63 mL/beat; ....... SVI = 34 mL/beat/M2 BP = 102/52 mm Hg ....... SvO2 = 0.83
9) Which one of the following hemodynamic variables is paired with an incorrect normal value?
C) Cardiac output (4-8 mm Hg)
10) Which one of the following equations is most correct?
C) SVI = CI/HR
11) Which one of the following is most likely to be associated with hypovolemia?
B) Decreased ventricular end-diastolic volume
1) Which statement about therapeutic interventions to reduce afterload is most correct?
A) Hypotension may occur
2) Which one of the following statements about heart rate is false?
A) Heart rates > 180 beat/min are usually associated with augmented diastolic filling
3) Which one of the following is most likely to benefit a hypovolemic patient?
D) Lactated Ringers
4) Which one of the following is most characteristic of decreased afterload?
Decreased systemic vascular resistance
5) Which one of the following conditions is most likely to be associated with a decreased afterload?
A) Septic shock
6) Which one of the following is most likely to occur during treatment of increased afterload?
A) Increased stroke volume
7) Which one of the following is most effective in the treatment of increased afterload?
D) Nitroprusside
8) Which one of the following is most closely associated with reduced contractility?
B) Increased heart rate
1) Which one of the following statements is most correct regarding hemodynamic waveform measurement?
B) It is best done from a paper recording with a simultaneous ECG and pressure waveform
2) Which one of the following statements is most correct regarding the PAOP waveform?
C) The v-wave is due to blood filling the atrium
3) Which one of the following statements is most correct regarding timing of the CVP/right atrial pressure waves with the ECG tracing?
B) The a wave occurs just after the P wave
6) Which one of the following is the most characteristic difference between the right ventricular (RV) waveform and the pulmonary artery (PA) waveform?
C) The RV diastolic pressure is lower than the PA diastolic pressure
8) Which one of the following statements is most correct regarding the pulmonary artery waveform and simultaneous ECG tracing?
B) End-diastole is measured after the QRS complex
9) Which one of the following statements about the pulmonary artery occlusion pressure (PAOP) is most correct?
) The PAOP waveform often contains 3 positive waves (a, c, v)
10) Which one of the following statements about the pulmonary artery occlusion pressure (PAOP) waveform is most correct?
A) To measure the pulmonary artery occlusion pressure the value of the a wave is averaged
Which one of the following statements about measurement of the pulmonary artery occlusion pressure is most correct?
D) The pulmonary artery occlusion pressure is lower than the mean pulmonary artery pressure
13) Which one of the following statements about hemodynamic waveforms is most correct?
C) Hemodynamic pressures should be read at end-expiration in a patient breathing spontaneously
1) Which statement regarding the set-up of hemodynamic monitoring equipment is most correct?
C) All vented caps on stopcock ports must be replaced with closed (dead-ender) caps.
2) Which statement regarding zeroing/leveling is most correct?
D) Any stopcock within the monitoring line can be used to zero/level the system if it is positioned at the patient’s mid-chest or phlebostatic axis
3) Which of the following statements about bolus thermodilution is most correct?
B) The presence of a PA waveform from the distal lumen of the catheter must be confirmed prior to bolus injection.
5) Which one of the following statements about the technical aspects of hemodynamic pressure monitoring equipment is most correct?
D) The air-reference stopcock must be at the level of the phlebostatic axis
4) Which of the following statements about bolus thermodilution is most correct?
C) The accuracy of injection technique and cardiac output values should be evaluated by the appearance of serial cardiac output curves.
6) Which one of the following statements regarding bolus thermodilution cardiac outputs is false?
B) A cardiac output curve with a slow decline best insures proper injection technique
7. Which of the following statements regarding zeroing/leveling is most correct?
B) If the air-reference stopcock is attached to an IV pole, zeroing/leveling must be performed every time there is a change in the patient’s position.
Which one of the following conditions is a cause of inaccurate thermodilution cardiac output measurements?
) Failure to connect the temperature sensing probe to the injectate system
9) Which one of the following statements regarding bolus thermodilution cardiac outputs is most correct?
B) A PA waveform must be observed via the distal lumen of the catheter prior to injection
1) Which of the following statements regarding PA catheter insertion is most correct?
A) Following vessel puncture, SaO2 analysis of a withdrawn blood sample should be <.85.
2) Which of the following statements regarding PA catheter insertion is most correct?
D) A PA waveform should be observed from the tip of the PA catheter after the catheter has been inserted approximately 15 cm from the subclavian vein.
3) Which of the following statements regarding pulmonary artery rupture is most correct?
D) Minimize or avoid PAOP measurements; monitor the PAedp instead of PAOP if pressure values are close.
4) Immediate treatment of pulmonary artery rupture may include all of the following:
A) Discontinuation of anticoagulation,C) Selective bronchial intubation,D) PEEP
6) Which statement regarding thrombus formation is most correct?
A) All intravascular monitoring catheters are thrombogenic.
7) Which one of the following statements about prevention of pulmonary artery rupture is most correct?
B) Withdraw PAC slightly if a PAOP waveform is obtained with inflation of <1.25 ml air
8) Which one of the following statements about the occurrence of dysrhythmias during PA catheterization is most correct?
) It is best prevented by rapid passage of PAC with balloon inflated with 1.5 ml air