Acute Care Nurse Practitioner Hemodynamic Monitoring and Management 3

Question 1

Which inotrope is MOST appropriate for a patient in cardiogenic shock with severe hypotension (MAP 55 mmHg)?

Accepted Answer

Norepinephrine + dobutamine

Answer

Milrinone

Answer

Dobutamine

Answer

Dopamine at 5 mcg/kg/min

Question 2

A patient with right heart failure has which expected hemodynamic pattern?

Accepted Answer

High CVP, low PAOP, low CO

Answer

High PAOP, low CVP, high CO

Answer

Low CVP, high PAOP, low CO

Answer

High CVP, high PAOP, high CO

Question 3

An ACNP is titrating vasopressors for a patient with refractory septic shock. Which adjunctive agent has been shown to reduce vasopressor requirements?

Accepted Answer

Hydrocortisone 200 mg/day

Answer

Methylprednisolone 1 g IV daily

Answer

Fludrocortisone alone

Answer

Dexamethasone 10 mg IV

Question 4

Which device provides direct measurement of cardiac output via thermodilution?

Accepted Answer

Pulmonary artery catheter

Answer

Arterial line

Answer

Central venous catheter

Answer

Peripheral IV

Question 5

A patient on vasopressors has digital ischemia developing in multiple extremities. Which intervention is MOST appropriate?

Accepted Answer

Wean vasopressors to the lowest effective dose and consider phentolamine

Answer

Increase vasopressor dose to maintain MAP

Answer

Transition to milrinone monotherapy

Answer

Apply warm compresses to affected extremities

Question 6

Which condition is characterized by high cardiac output, low SVR, and low-to-normal CVP?

Accepted Answer

Distributive shock

Answer

Cardiogenic shock

Answer

Obstructive shock

Answer

Hypovolemic shock