Cardiac Vascular Nursing Exam Technology & Digital Applications 4 — Questions and Answers
Question 1: A nurse is troubleshooting a pulmonary artery catheter connected to a digital hemodynamic monitoring system. The displayed pulmonary artery occlusion pressure (PAOP) is consistently 0 mmHg. What is the most likely cause?
- The patient has pulmonary hypertension
- The balloon is ruptured or the catheter has migrated back to the right ventricle (Correct answer)
- The monitor's scale is set too high
- The patient is volume overloaded
Correct answer: The balloon is ruptured or the catheter has migrated back to the right ventricle
A PAOP of 0 mmHg suggests balloon rupture preventing occlusion or catheter migration, both of which render the measurement invalid and require immediate assessment.
Question 2: Which digital documentation practice is most important when a cardiac nurse administers thrombolytic therapy for acute MI?
- Document only the drug name
- Record time of administration, dose, patient response, and any contraindications assessed (Correct answer)
- Wait until end of shift to document to ensure accuracy
- Document only if the patient has an adverse reaction
Correct answer: Record time of administration, dose, patient response, and any contraindications assessed
Time-sensitive thrombolytic therapy requires complete real-time documentation of administration details and patient response to support safe ongoing care and legal accountability.
Question 3: A hospital implements a digital early warning system (EWS) that automatically calculates a Modified Early Warning Score (MEWS). Which cardiovascular parameter contributes most to triggering a high MEWS alert?
- Blood type
- Heart rate and systolic blood pressure deviations from baseline (Correct answer)
- Patient's reported pain score
- Serum cholesterol level
Correct answer: Heart rate and systolic blood pressure deviations from baseline
Heart rate and systolic blood pressure are key vital sign components of MEWS calculations that, when significantly deranged, trigger escalation alerts for deteriorating cardiac patients.
Question 4: Which of the following best describes the function of a cardiac resynchronization therapy (CRT) device's remote optimization feature?
- It automatically recharges the device battery
- It allows non-invasive adjustment of AV and VV intervals based on transmitted device data (Correct answer)
- It controls the patient's pacing rate via smartphone
- It sends medication reminders to the patient's phone
Correct answer: It allows non-invasive adjustment of AV and VV intervals based on transmitted device data
Remote CRT optimization allows clinicians to adjust atrioventricular and interventricular timing intervals using transmitted device data to maximize cardiac mechanical synchrony without an office visit.
Question 5: A nurse reviews a patient's continuous glucose monitoring (CGM) data integrated into the cardiac ICU's central monitoring system. Why is tight glycemic control particularly important for this population?
- Hyperglycemia has no effect on cardiac outcomes
- Hyperglycemia increases inflammation, impairs wound healing, and worsens outcomes post-cardiac surgery (Correct answer)
- CGM is used primarily for insulin dosing convenience, not clinical outcomes
- Glucose monitoring is only relevant for diabetic patients in the ICU
Correct answer: Hyperglycemia increases inflammation, impairs wound healing, and worsens outcomes post-cardiac surgery
Hyperglycemia in cardiac patients increases oxidative stress, promotes inflammation, and is independently associated with increased mortality and wound complications after cardiac surgery.
Question 6: A nurse is preparing a patient for a cardiac MRI and must verify implanted device compatibility. Which digital resource is the most authoritative and up-to-date reference?
- The nurse's personal memory from previous experience
- The manufacturer's MRI Conditional labeling and the MRIsafety.com database (Correct answer)
- The patient's verbal statement about their device
- A general internet search engine
Correct answer: The manufacturer's MRI Conditional labeling and the MRIsafety.com database
Manufacturer MRI Conditional labeling combined with validated databases like MRIsafety.com provide the most current, device-specific safety parameters required before MRI exposure.
Question 7: During tele-ICU monitoring, a remote intensivist observes worsening ST-segment changes on a cardiac patient's EHR-integrated waveform. What is the tele-ICU nurse's first action?
- Wait for the morning team to address the finding
- Immediately alert the bedside nurse and initiate the site's STEMI protocol (Correct answer)
- Document the finding and continue monitoring
- Turn off the alarm to reduce noise
Correct answer: Immediately alert the bedside nurse and initiate the site's STEMI protocol
ST-segment changes indicating ischemia require immediate activation of the bedside care team and STEMI protocol; delay risks myocardial injury progression.
Cardiac Vascular Nursing Exam Technology & Digital Applications 4
A nurse is troubleshooting a pulmonary artery catheter connected to a digital hemodynamic monitoring system.
The displayed pulmonary artery occlusion pressure (PAOP) is consistently 0 mmHg.
What is the most likely cause?