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

Norepinephrine provides vasopressor support to raise MAP while dobutamine adds inotropic effect in cardiogenic shock with hypotension.

Question 2

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

Accepted Answer

High CVP, low PAOP, low CO

Answer

Right heart failure causes elevated CVP from backward congestion but low PAOP and low CO from inadequate left-sided filling.

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

Hydrocortisone 200 mg/day is recommended for vasopressor-refractory septic shock as it reduces vasopressor requirements.

Question 4

Which device provides direct measurement of cardiac output via thermodilution?

Accepted Answer

Pulmonary artery catheter

Answer

The pulmonary artery catheter (Swan-Ganz) measures cardiac output via thermodilution using cold saline injection.

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

Vasopressor-induced ischemia requires weaning to the lowest effective dose; phentolamine (alpha blocker) can be used for severe digital ischemia.

Acute Care Nurse Practitioner Practice Test

Acute Care Nurse Practitioner Practice Test

Acute Care Nurse Practitioner Hemodynamic Monitoring and Management 3