Deck 27: Physiologic Maintenance and Monitoring of the Perioperative Patient

Question 1

What sign indicates the pulmonary artery catheter is in the correct location?

A)An audible beep heard on the invasive monitor screen
B)A narrow downstroke followed by a single notch on the upstroke
C)A steep upstroke followed by a dicrotic notch on the downstroke
D)A tachycardic QRS waveform (heart rate 100 bpm or greater)

Answer 1

C
When the catheter floats through the pulmonary semilunar valve into the pulmonary artery,a pulmonary artery tracing should appear on the monitor.This waveform has a steep upstroke at the beginning from right ventricular ejection and opening of the pulmonic valve,followed by a dicrotic notch on the downstroke at the closing of the pulmonic valve.

Question 2

Where can a core temperature probe be placed?

A)Bladder
B)Axilla
C)Index finger tip
D)Forehead

Answer 2

A
An esophageal probe is responsive to changes in body heat.A rectal probe is slow to detect changes in body temperatures.A bladder probe is placed in the tip of a Foley catheter.

Question 3

Which is a contraindication to proceeding with intracranial pressure (ICP)monitoring?

A)Diabetes mellitus
B)Hypertension
C)Anticoagulation therapy
D)Increased cerebral spinal fluid production

Answer 3

C
Contraindications to ICP monitoring include coagulopathies,anticoagulation therapy,cerebral edema with ventricular collapse or shift,and known scalp infection.

Question 4

When sending an arterial blood gas sample to the laboratory for analysis,never place the specimen on ice because that will cause the sample to coagulate and not be usable.

Question 5

Which is a condition that may occur during a surgical procedure,resulting in an altered physiology?

A)Tissue dystrophy
B)Bleeding
C)Surgical augmentation
D)Depression

Question 6

What is the normal hourly urinary output?

A)5 to 10 mL/hr
B)10 to 20 mL/hr
C)30 to 60 mL/hr
D)Greater than 30 to 60 mL/hr

Question 7

Which is a type of data that can be obtained from pulmonary artery monitoring?

A)Urine pH
B)Pulse oximetry
C)Urine output
D)Right atrial pressure

Question 8

What does an electrocardiogram (ECG)show?

A)Rate of respirations including inspirations
B)Cardiac output index
C)Blood pressure
D)Waveforms reflecting electrical forces

Question 9

Which is a result that may occur when using the bispectral index (BIS)monitor during a surgical procedure?

A)Increased core temperature
B)Decreased pain levels
C)Reduced drug use
D)Decreased infection rate

Question 10

Which is an example of an invasive monitoring device?

A)Intracardiac catheter
B)Blood pressure cuff
C)Pulse oximeter probe
D)Axillary thermometer

Question 11

Which is the most common complication during insertion of a pulmonary artery catheter?

A)Infection
B)Cardiac dysrhythmia
C)Coughing
D)Catheter dislocation

Question 12

Which device provides a two-dimensional color image of the beating heart?

A)Stethoscope
B)ECG
C)Echocardiogram
D)Sphygmomanometer

Question 13

Central venous pressure (CVP)

A)measures left atrial blood pressure.
B)measures total body blood volume.
C)reflects the pressure in the major veins as blood returns to the heart.
D)measures cardiac output.

Question 14

Which is an indication for using pulmonary artery monitoring?

A)Staph infection
B)Melanoma
C)Renal failure
D)Diabetes mellitus

Question 15

What could cause a sudden change in the configuration of a pulmonary artery pressure tracing?

A)Transducer is at the right atrial level.
B)Transducer needs to be calibrated.
C)Transducer connection is secure.
D)Pressure bag is present.

Question 16

Which is a benefit of indwelling arterial,venous,or intracardiac catheters?

A)Rapid, accurate assessment of physiologic alterations
B)Moderate yield of information with increased discomfort to the patient
C)Potential for bleeding or hemorrhage
D)Infection risk is increased with placement

Question 17

Which is a true statement about blood pressure (BP)measurement?

A)BP can be obtained by direct or indirect methods.
B)BP can be taken on an arm that has an IV.
C)Pressure is higher during diastole and lower in systole.
D)BP readings measure tissue perfusion.

Question 18

Which statement regarding pulse oximetry is false?

A)It measures arterial oxyhemoglobin saturation.
B)A reading of 90% or less is normal.
C)False high readings are found in cigarette smokers.
D)A probe should not be placed over a fingernail with polish.

Question 19

Which is a positioning consideration that must be ensured when assisting a physician in placing a subclavian or jugular vein catheter?

A)Turn the patient's head toward the insertion site.
B)Flex the patient's head toward the chest.
C)Elevate the scapular area.
D)Place the patient's head in a 0 degree Trendelenburg's position.

Question 20

Which statement about CVP is true?

A)A manometer is used and positioned level to the patient's right atrium.
B)Normal readings are 8 to 12 mm Hg.
C)CVP readings can be taken using a radial artery catheter.
D)Taking a breath can create positive pressure and alter the CVP.

Question 21

Match the correct pressure to the correct normal value.
a.15 to 25 mm Hg
b.6 to 12 mm Hg
c.15 to 25 mm Hg systolic, 8 to 15 diastolic
d.3 to 6 mm Hg
Pulmonary capillary wedge pressure

Question 22

Match the correct pressure to the correct normal value.
a.15 to 25 mm Hg
b.6 to 12 mm Hg
c.15 to 25 mm Hg systolic, 8 to 15 diastolic
d.3 to 6 mm Hg
Right ventricular pressure

Question 23

The stroke volume (SV)is measured to indicate ventricular function.

Question 24

Match the correct pressure to the correct normal value.
a.15 to 25 mm Hg
b.6 to 12 mm Hg
c.15 to 25 mm Hg systolic, 8 to 15 diastolic
d.3 to 6 mm Hg
Right atrial pressure

Question 25

Match the correct pressure to the correct normal value.
a.15 to 25 mm Hg
b.6 to 12 mm Hg
c.15 to 25 mm Hg systolic, 8 to 15 diastolic
d.3 to 6 mm Hg
Pulmonary artery pressure

Question 26

Cardiac output (CO)is measured to determine how many liters the right aorta pumps into the left ventricle.

Question 27

Capnometry measures end-tidal concentration of carbon dioxide.

Question 28

Establishing a patient's preoperative baseline is very important because it can alert the caregiver to any physiologic changes.

Question 29

Core body temperature refers to the entire body temperature including the interior and body surface.

Question 30

An EEG (electroencephalogram)measures muscular activity and messages sent from the core muscles to the brain.