ABPANC Cardiovascular Assessment & Monitoring 1 — Questions and Answers
Question 1: Which of the following represents the normal range for mean arterial pressure (MAP) in adult patients?
- 50–60 mmHg
- 70–100 mmHg (Correct answer)
- 110–130 mmHg
- 40–50 mmHg
Correct answer: 70–100 mmHg
Normal MAP in adults is 70–100 mmHg, reflecting the average perfusion pressure throughout the cardiac cycle needed to maintain adequate organ perfusion.
Question 2: A post-operative patient develops symptomatic bradycardia (HR 38 bpm) with hypotension. Which medication should the perianesthesia nurse anticipate administering FIRST?
- Metoprolol 5 mg IV
- Atropine 0.5 mg IV (Correct answer)
- Adenosine 6 mg IV
- Amiodarone 150 mg IV
Correct answer: Atropine 0.5 mg IV
Atropine is the first-line pharmacological treatment for symptomatic bradycardia, as it blocks vagal tone and increases sinus node firing rate to restore adequate heart rate.
Question 3: On cardiac monitoring, the perianesthesia nurse observes a rate of 160 bpm, regular rhythm, narrow QRS complexes, and no visible P waves. This pattern is MOST consistent with:
- Ventricular tachycardia
- Atrial flutter with 2:1 block
- Supraventricular tachycardia (SVT) (Correct answer)
- Sinus tachycardia
Correct answer: Supraventricular tachycardia (SVT)
SVT presents with rates typically 150–250 bpm, regular narrow QRS complexes, and absent or hidden P waves due to rapid electrical firing originating above the ventricles.
Question 4: Which post-operative finding requires the MOST IMMEDIATE intervention by the perianesthesia nurse?
- Heart rate of 90 bpm
- Blood pressure of 138/88 mmHg
- ST segment elevation on the cardiac monitor (Correct answer)
- SpO2 of 96%
Correct answer: ST segment elevation on the cardiac monitor
ST segment elevation signals acute myocardial injury or infarction, requiring immediate physician notification, 12-lead ECG acquisition, and emergency intervention.
Question 5: The perianesthesia nurse calculates cardiac output using which formula?
- CO = HR × SVR
- CO = HR × SV (Correct answer)
- CO = MAP / CVP
- CO = SV / HR
Correct answer: CO = HR × SV
Cardiac output equals heart rate multiplied by stroke volume (CO = HR × SV), representing the total volume of blood pumped by the heart per minute.
Question 6: A patient in the PACU has BP 86/52 mmHg, HR 126 bpm, and cold clammy skin after major abdominal surgery. The PRIORITY nursing intervention is:
- Administer oral fluids and monitor closely
- Notify the physician immediately and prepare to administer an IV fluid bolus (Correct answer)
- Apply a warming blanket and recheck vitals in 15 minutes
- Administer IV morphine to rule out pain as the cause
Correct answer: Notify the physician immediately and prepare to administer an IV fluid bolus
Signs of hypovolemic shock require immediate physician notification and fluid resuscitation to restore intravascular volume and hemodynamic stability before the patient deteriorates further.
Question 7: A central venous pressure (CVP) reading of 1 mmHg in a post-operative patient MOST likely indicates:
- Fluid overload
- Hypovolemia or markedly decreased venous return (Correct answer)
- Cardiac tamponade
- Right ventricular failure
Correct answer: Hypovolemia or markedly decreased venous return
A very low CVP (normal 2–8 mmHg) reflects reduced venous return to the right heart, most commonly from hypovolemia due to blood loss or inadequate fluid replacement post-operatively.
ABPANC Cardiovascular Assessment & Monitoring 1
Which of the following represents the normal range for mean arterial pressure (MAP) in adult patients?