Question 1

Which of the following cause an increase in the CVP?
1) Volume overload
2) Tension pneumothorax
3) Spontaneous inspiration
4) Increased intrathoracic pressure

Accepted Answer

Volume overload increases blood volume, raising CVP. Tension pneumothorax compresses the heart and great vessels, increasing CVP. Increased intrathoracic pressure, such as from mechanical ventilation, also raises CVP. Spontaneous inspiration decreases intrathoracic pressure, lowering CVP.

Question 2

According to West, which zone is dominant in the supine position?

Accepted Answer

The answer of According to West, which zone is dominant...

Question 3

If, when the pulmonary artery catheter is inserted, there is a rapid increase in the height of the pressure waveforms with the downstroke dropping near zero, the respiratory therapist should:

Accepted Answer

The rapid increase in the height of the pressure waveforms with the downstroke dropping near zero indicates that the catheter has entered the right ventricle.

Question 4

When the pulmonary artery catheter is inserted, the balloon is inflated in the right atrium before it is inserted further. This is done to:

Accepted Answer

Inflating the balloon allows the catheter to float with the blood flow, facilitating its passage through the heart chambers.

Question 5

The CVP can be used to estimate left ventricular filling pressures if there is no left ventricular dysrhythmia and the ejection fraction is greater than:

Accepted Answer

The CVP (central venous pressure) can be used to estimate left ventricular filling pressures when the ejection fraction is greater than 0.50, as this indicates normal or near-normal left ventricular function without significant dysrhythmia.

Question 6

For the pulmonary capillary wedge pressure to reflect pulmonary venous and left atrial pressures, blood flow must be uninterrupted between the catheter tip and the left heart. This condition exists only in West zone:

Accepted Answer

In West zone III, the pulmonary arterial pressure is greater than the pulmonary venous pressure, which is greater than the alveolar pressure, allowing for continuous blood flow and accurate reflection of left atrial pressure.

Question 7

In left ventricular failure, the pulmonary capillary wedge pressure is expected to:

Accepted Answer

In left ventricular failure, the heart's ability to pump blood effectively is compromised, leading to increased pressure in the left atrium and pulmonary veins. This results in an elevated pulmonary capillary wedge pressure.

Question 8

Large fluctuations in the net distending pressure within the left ventricle, also known as the transmural pressure, are seen in which of the following situations?
1) Coughing
2) Valsalva maneuver
3) Positive-pressure ventilation
4) Hemorrhage

Accepted Answer

Coughing, Valsalva maneuver, and positive-pressure ventilation all involve changes in intrathoracic pressure, which can lead to large fluctuations in the transmural pressure of the left ventricle.

Question 9

With a properly inserted and positioned pulmonary artery catheter, a systolic pressure reading in the pulmonary artery of 50 mm Hg could be due to:

Accepted Answer

The answer of With a properly inserted and positioned pulmonary...

Question 10

A shift to zone I or II may occur if which of the following conditions is present?
1) Hypovolemia
2) Increased PEEP
3) Hemorrhage
4) Decrease in PEEP

Accepted Answer

A shift to zone I or II in the lung can occur due to conditions that decrease pulmonary blood flow or increase alveolar pressure. Hypovolemia and hemorrhage decrease blood flow, while increased PEEP raises alveolar pressure, both contributing to such a shift.

Question 11

Pulmonary artery catheter monitoring is likely to be considered for patients with which of the following conditions?
1) ARDS
2) Pulmonary embolus
3) Cardiogenic pulmonary edema
4) Septic shock

Accepted Answer

Pulmonary artery catheter monitoring is often used in ARDS, cardiogenic pulmonary edema, and septic shock to assess hemodynamic status and guide treatment.

Question 12

A difference between the pulmonary artery diastolic pressure and the pulmonary capillary wedge pressure greater than 5 mm Hg is seen in which of the following conditions?

Accepted Answer

A difference greater than 5 mm Hg between pulmonary artery diastolic pressure and pulmonary capillary wedge pressure can be seen in ARDS, sepsis, and excessive PEEP due to increased pulmonary vascular resistance or other factors affecting the pulmonary circulation.

Question 13

Complications involving the use of CVP catheters include which of the following?
1) Bleeding
2) Pneumothorax
3) Infection
4) Atrial septal puncture

Accepted Answer

Complications of CVP catheters can include bleeding, pneumothorax, and infection. Atrial septal puncture is not a common complication associated with CVP catheters.

Question 14

The normal range for pulmonary artery systolic pressure is _____ mm Hg.

Accepted Answer

The normal range for pulmonary artery systolic pressure is typically between 20 to 30 mm Hg.

Question 15

The normal range for pulmonary artery diastolic pressure is _____ mm Hg.

Accepted Answer

The normal range for pulmonary artery diastolic pressure is typically between 8 to 15 mm Hg.

Question 16

The CVP is most likely to correlate well with left ventricular filling pressure in which of the following patients?

Accepted Answer

Central venous pressure (CVP) is more likely to correlate with left ventricular filling pressure in a patient without significant cardiac or pulmonary pathology, such as the female recovering well after abdominal surgery.

Question 17

The normal pulmonary capillary wedge pressure is _____ mm Hg.

Accepted Answer

The normal pulmonary capillary wedge pressure (PCWP) ranges from 4 to 12 mm Hg, reflecting the pressure in the left atrium and is used to assess left ventricular function and fluid status.

Question 18

Which of the following cause a decrease in the CVP?

Accepted Answer

Peripheral vasodilation decreases venous return to the heart, leading to a decrease in central venous pressure (CVP).

Question 19

An increase in pulmonary artery systolic pressure is seen in patients with which of the following conditions?
1) Pulmonary embolus
2) Mitral valve stenosis
3) Right ventricular failure
4) Hypoxia and hypoxemia

Accepted Answer

Pulmonary embolus, mitral valve stenosis, and hypoxia/hypoxemia can all lead to increased pulmonary artery systolic pressure due to obstruction, increased left atrial pressure, and vasoconstriction, respectively.

Question 20

The purpose of the balloon at the tip of the pulmonary artery catheter is to:

Accepted Answer

The balloon at the tip of the pulmonary artery catheter is inflated to occlude a branch of the pulmonary artery, allowing for the measurement of pulmonary capillary wedge pressure, which reflects left atrial pressure.

Quiz 15: Assessment of Cardiac Output

Which of the following cause an increase in the CVP? 1) Volume overload 2) Tension pneumothorax 3) Spontaneous inspiration 4) Increased intrathoracic pressure