Acute Care Nurse Practitioner Hemodynamic Monitoring and Management

Question 1

A patient in the ICU has a pulmonary artery occlusion pressure (PAOP) of 22 mmHg and a cardiac index of 1.8 L/min/m². Which condition does this most likely indicate?

Accepted Answer

Cardiogenic shock

Answer

Distributive shock

Answer

Hypovolemic shock

Answer

Obstructive shock

Question 2

Which hemodynamic parameter best reflects left ventricular preload?

Accepted Answer

Pulmonary artery occlusion pressure

Answer

Central venous pressure

Answer

Systemic vascular resistance

Answer

Mean arterial pressure

Question 3

A patient's arterial line waveform shows pulsus paradoxus. Which condition should the ACNP suspect first?

Accepted Answer

Cardiac tamponade

Answer

Aortic stenosis

Answer

Mitral regurgitation

Answer

Pulmonary hypertension

Question 4

Which ScvO₂ value indicates adequate oxygen delivery relative to consumption in a critically ill patient?

Accepted Answer

70%

Answer

45%

Answer

55%

Answer

85%

Question 5

A patient receiving norepinephrine has an SVR of 1,800 dynes/s/cm⁻⁵ and MAP of 92 mmHg, but urine output is 15 mL/hr. What is the MOST appropriate next step?

Accepted Answer

Start dobutamine

Answer

Increase norepinephrine dose

Answer

Add vasopressin

Answer

Give a fluid bolus

Question 6

When interpreting a CVP waveform, prominent 'v' waves are associated with which condition?

Accepted Answer

Tricuspid regurgitation

Answer

Aortic stenosis

Answer

Cardiac tamponade

Answer

Heart block