Question 1

What vessels conduct venous blood from the right ventricle to the lungs?&#10;A)The systemic arteries&#10;B)The systemic veins&#10;C)The pulmonary arteries&#10;D)The pulmonary veins

Accepted Answer

The pulmonary arteries conduct deoxygenated blood from the right ventricle to the lungs for oxygenation.

Question 2

Which of the following is not related to production of stroke volume?&#10;A)Circulating blood volume&#10;B)Vascular resistance&#10;C)Cardiac contractility&#10;D)Pulse pressure

Accepted Answer

Pulse pressure is the difference between the systolic and diastolic blood pressure, and while it is affected by stroke volume, it is not directly related to its production. The other options, circulating blood volume, vascular resistance, and cardiac contractility, are all factors that affect the production of stroke volume.

Question 3

Your patient has hypovolemic shock from severe diarrhea.Which of the following is least likely to be needed for care?&#10;A)Close CVP monitoring&#10;B)Mechanical ventilation with PEEP&#10;C)Fluid therapy&#10;D)Oxygen therapy

Accepted Answer

Mechanical ventilation with PEEP is generally not indicated in hypovolemic shock from severe diarrhea, as the primary treatment should focus on fluid resuscitation to restore intravascular volume. Close CVP monitoring, fluid therapy, and oxygen therapy may all be necessary in the care of this patient.

Question 4

What is the normal range for cardiac index? A)1.0-3.5 L/min/m² B)2.5-4.0 L/min/m² C)4.0-5.5 L/min/m² D)4.5-6.0 L/min/m²

Accepted Answer

The normal range for cardiac index is 2.5-4.0 L/min/m2.

Question 5

What type of shock is most likely to cause ARDS?&#10;A)Hypovolemic shock&#10;B)Septic shock&#10;C)Cardiogenic shock&#10;D)None of the above

Accepted Answer

Septic shock is the most common cause of ARDS. It initiates an inflammatory response that can damage the lungs and lead to the development of ARDS.

Question 6

What is the primary problem in patients with septic shock with regard to hemodynamics?&#10;A)Elevated filling pressures&#10;B)Reduced contractility&#10;C)High fever&#10;D)Low systemic vascular resistance

Accepted Answer

The primary problem in patients with septic shock is a drop in systemic vascular resistance resulting in inadequate tissue perfusion and oxygen delivery. This is not caused by elevated filling pressures or reduced contractility. High fever may be a symptom of septic shock but is not the primary problem with hemodynamics.

Question 7

What therapy is often needed for the patient with septic shock?&#10;A)Vasopressors&#10;B)Bronchodilators&#10;C)Positive inotropics&#10;D)Diuretics

Accepted Answer

Septic shock is a condition where there is a severe drop in blood pressure due to infection. Vasopressors are medications that increase blood pressure and are needed to manage septic shock. Bronchodilators are used to open up airways and are not indicated in septic shock. Positive inotropics are medications that increase the strength of the heart's contractions and are not always indicated in septic shock. Diuretics are used to remove excess fluid from the body and are not indicated in septic shock.

Question 8

Which of the following clinical signs suggests that the preload for the right side of the heart is elevated?&#10;A)Distended neck veins&#10;B)Central cyanosis&#10;C)Systemic hypotension&#10;D)Loud systolic murmur

Accepted Answer

Distended neck veins are a common sign of elevated preload in the right side of the heart. This occurs because blood is backing up into the veins due to the right atrium being unable to handle the increased volume. Central cyanosis, systemic hypotension, and loud systolic murmurs are not specific signs of elevated preload in the right side of the heart, and may be associated with other cardiovascular or respiratory conditions.

Question 9

What hemodynamic monitoring result is most consistent with cardiogenic shock?&#10;A)CVP = 2 mmHg&#10;B)Cardiac output = 5 L/min&#10;C)PCWP = 20 mmHg&#10;D)Mean blood pressure = 85 mmHg

Accepted Answer

Cardiogenic shock is characterized by decreased cardiac output and increased pulmonary capillary wedge pressure (PCWP). A low CVP (choice A) is more consistent with hypovolemic shock. A cardiac output of 5 L/min (choice B) is normal but may be decreased in cardiogenic shock. A mean blood pressure of 85 mmHg (choice D) is within the normal range, but in cardiogenic shock, the blood pressure may be decreased due to the decreased cardiac output. The elevated PCWP of 20 mmHg (choice C) suggests an increased left atrial pressure, which is a hallmark of cardiogenic shock.

Question 10

Which of the following clinical findings is least consistent with left heart failure?&#10;A)Inspiratory crackles&#10;B)Distended neck veins&#10;C)Cool extremities&#10;D)Elevated pulse pressure

Accepted Answer

Elevated pulse pressure is least consistent with left heart failure because it is a finding typically associated with conditions such as hyperthyroidism, anemia, and aortic regurgitation. Inspiratory crackles, distended neck veins, and cool extremities are all findings commonly associated with left heart failure.

Question 11

What parameter is used to assess preload for the left ventricle?&#10;A)CVP&#10;B)PCWP&#10;C)Systemic blood pressure&#10;D)Pulmonary vascular resistance

Accepted Answer

The answer of What parameter is used to assess preload...

Question 12

Which of the following clinical findings is most consistent with the diagnosis of shock?&#10;A)Peripheral cyanosis&#10;B)Abnormal sensorium&#10;C)Chest pain&#10;D)Dyspnea

Accepted Answer

The answer of Which of the following clinical findings is...

Question 13

Your patient has a history of heart failure and now has a CVP of 10 mmHg and a PCWP of 21 mmHg.Which of the following therapies is most likely needed?&#10;A)Inderal&#10;B)Lasix&#10;C)CPAP&#10;D)Intubation

Accepted Answer

The answer of Your patient has a history of heart...

Question 14

Which of the following medications is likely to increase cardiac contractility?&#10;A)Atropine&#10;B)Lasix&#10;C)Inderal&#10;D)Levophed

Accepted Answer

The answer of Which of the following medications is likely...

Question 15

Your patient is a large male with a body surface area of 2.2 m².His cardiac output is 4.0 L/min and his body temperature is 38.5°C.What interpretation is most appropriate for his cardiac output? A)It is probably adequate B)It is probably more than adequate C)It is probably less than adequate D)It indicates hypovolemia

Accepted Answer

The answer of Your patient is a large male with...

Question 16

What is the most common cause of distributive shock?&#10;A)Toxic ingestion&#10;B)Head trauma&#10;C)Sepsis&#10;D)Chest trauma

Accepted Answer

The answer of What is the most common cause of...

Question 17

What percent of patients who have a myocardial infarction develop cardiogenic shock?&#10;A)Less than 10%&#10;B)About 25%&#10;C)About 50%&#10;D)About 75%

Accepted Answer

The answer of What percent of patients who have a...

Question 18

Your patient has a history of heart disease and is now complaining of chest pain.What finding on the ECG would suggest coronary hypoperfusion?&#10;A)Elevated ST segment&#10;B)Depressed ST segment&#10;C)Inverted T waves&#10;D)All the above

Accepted Answer

The answer of Your patient has a history of heart...

Question 19

What is the normal range for cardiac output?&#10;A)2-4 L/min&#10;B)3-5 L/min&#10;C)4-8 L/min&#10;D)5-10 L/min

Accepted Answer

The answer of What is the normal range for cardiac...

Question 20

What therapy is often needed for patients with cardiogenic shock?&#10;A)Vasopressors&#10;B)Bronchodilators&#10;C)Positive inotropics&#10;D)Fluids

Accepted Answer

The answer of What therapy is often needed for patients...

Deck 6: Hemodynamic Monitoring and Shock