PCU Hemodynamic Monitoring & Vascular Access 3

Question 1

The nurse is caring for a PCU patient on a norepinephrine infusion. The patient's blood pressure drops suddenly. Which assessment should the nurse perform first?

Accepted Answer

Check the IV site for infiltration and verify the infusion is patent and correctly dosed

Answer

Before changing the dose, the nurse must verify the infusion is running correctly, as a disconnected or infiltrated line would explain the drop in blood pressure.

Question 2

Which type of vascular access device is MOST appropriate for long-term IV therapy exceeding 6 months, such as chemotherapy or TPN?

Accepted Answer

Implanted port (port-a-cath)

Answer

An implanted port is designed for long-term intermittent access, has the lowest infection risk of central devices, and is appropriate for therapy extending beyond 6 months.

Question 3

A patient's cardiac output (CO) is 3.8 L/min and body surface area (BSA) is 1.9 m². What is the cardiac index (CI) and how should the nurse interpret it?

Accepted Answer

CI = 2.0 L/min/m²; indicates low cardiac output state

Answer

CI = CO / BSA = 3.8 / 1.9 = 2.0 L/min/m²; the normal CI is 2.5–4.0, so 2.0 indicates a borderline low cardiac output state requiring close monitoring.

Question 4

When assessing a central venous catheter insertion site, which finding requires immediate removal of the catheter?

Accepted Answer

Purulent drainage, erythema, and tenderness at the site

Answer

Purulent drainage with erythema and tenderness are signs of catheter-site infection, which mandates immediate catheter removal and physician notification to prevent bloodstream infection.

Question 5

A nurse is preparing to draw blood cultures from a patient's central venous catheter. Which practice is correct?

Accepted Answer

Wipe the hub with a 70% alcohol or chlorhexidine swab and allow it to dry before accessing

Answer

Scrubbing the hub with antiseptic (scrub the hub technique) and allowing it to dry before access reduces the risk of contaminating the culture specimen and causing CLABSI.

PCU - Progressive Care Unit Certification Practice Test

PCU - Progressive Care Unit Certification Practice Test

PCU Hemodynamic Monitoring & Vascular Access 3