EXAM 2 Reading (N.Ch17)

Question 1

2 associated with a loss of “a wave” on a CVP waveform?

Answer 1

atrial fibrillation

Ventricular pacing

Question 2

Which of the following in an overestimation of the actual BP?

Answer 2

Placing a BP cuff on an extremity below the level of the heart.

Question 3

You are inserting a pulmonary artery catheter via the right internal jugular vein. At what distance would you expect to reach the right atrium?

Answer 3

15-25cm

Question 4

The distances from the right internal jugular vein to the cardiac and pulmonary structures are as follows: pulmonary artery:

Answer 4

35-45 cm,

Question 5

distances from the right internal jugular vein to the right ventricle:

Answer 5

25-35cm

Question 6

Distance to pulmonary artery wedge position:

Answer 6

40-50 cm

Question 7

When the balloon of a PA catheter is not inflated, what pressures are reflected during diastole?

Answer 7

pulmonary artery diastolic pressure

Question 8

Transduced during systole

Answer 8

Right ventricular systolic pressure

Question 9

Transduced during diastole.

Answer 9

PA diastolic pressure

Question 10

The PA diastolic pressure is also a representation of

Answer 10

left atrial (LA) pressure

Question 11

What does the y descent on a central venous pressure waveform represent?

Answer 11

Opening of the tricuspid valve

Question 12

The x descent follows the a wave and represents the

Answer 12

relaxation of the atria.

Question 13

The x1 descent occurs as a result of the

Answer 13

downward pull of the ventricular septum during systole.

Question 14

The y descent represents the

Answer 14

opening of the tricuspid valve.

Question 15

Which of the following are associated with an increased central venous pressure reading? (select two)

Answer 15

Pulmonary hypertension

Heart failure

Question 16

Mechanical ventilation, PEEP on CVP

Answer 16

Increase

Question 17

Tension pneumothorax, and pulmonary embolism on CVP

Answer 17

Increase

Question 18

Chronic LV failure on CVP

Answer 18

Increase

Question 19

Tricuspid stenosis and TR on CVP

Answer 19

increase

Question 20

How will an arterial pressure transducer that is placed below the level of the heart affect the estimate of the actual blood pressure?

Answer 20

Overestimates

Question 21

What factors result in decreased mixed venous oxygen (SVO2) measurements? (select three)

Answer 21

Shivering
Decreased CO
Hemorrhage

Question 22

Factors that result in an increased SVO2 include:

Answer 22

Cyanide toxicity, 
Hypothermia.  
A wedged pulmonary artery 
    catheter
Left-to-right shunts,
Sepsis

Question 23

Factors that result in a decreased SVO2 include:

Answer 23

hyperthermia
shivering,
hemorrhage,
decreased cardiac output, and a decrease in the pulmonary transport of oxygen.

Question 24

Which of the following would you expect to produce a large V wave on a CVP waveform?

Answer 24

Tricuspid regurgitation, mitral regurgitation, or a sudden, dramatic increase in intravascular volume

Question 25

Which of the following are associated with cannon ‘a’ waves on the central venous pressure waveform? (select two)

Answer 25

Diatolic dysfunction

Compleve AV block

Question 26

Tricuspid and mitral stenosis will show on CVP

Answer 26

Cannon a waves.

Question 27

When calculating the mean arterial pressure, the diastolic pressure is doubled

Answer 27

because diastole accounts for two-thirds of the cardiac cycle duration

Question 28

TEE: Complete absence of wall motion is

Answer 28

Akinesia

Question 29

TEE; Decreased wall motion is

Answer 29

HYPOKINESIA

Question 30

TEE: Paradoxical wall motion

Answer 30

Dyskinesia

Question 31

What is the hallmark of myocardial infarction with ventricular aneurysm?

Answer 31

Dyskinesia (paradoxical motion)

Question 32

When the balloon of a pulmonary artery catheter is inflated, what pressure can be obtained indirectly during ventricular systole?

Answer 32

left atrial filling pressure

Question 33

The most significant expected alteration from a cracked stopcock in an arterial pressure monitoring system would be

Answer 33

acute blood loss

Question 34

Potential complications due to intra-arterial monitoring include:

Answer 34

acute blood loss from a leak or crack in the transducer system, thrombosis, vasospasm, infection, hematoma, nerve damage, and loss of digits.

Question 35

Which of the following would result in an underestimation of the aortic pressure? (select two)

Answer 35

Radial artery monitoring during hypothermic cardiopulmonary bypass
Air in the transducer tubin g

Question 36

Hypothermic conditions reduce the vascular resistance in the hand compared to the aorta, and the radial arterial line will

Answer 36

underestimate the aortic pressure.

Question 37

Placing a blood pressure cuff that is too loose, too small, or positioned below the level of the heart will result in a blood pressure that

Answer 37

overestimates the actual blood pressure.

Question 38

The presence of air in the transducer tubing and the addition of stopcocks and longer tubing can

Answer 38

decrease the frequency of the monitoring system and lead to overdamping which will tend to underestimate the systolic blood pressure.

Question 39

The degree of ST elevation or depression on an ECG is measured between the isoelectric line and the

Answer 39

J point

Question 40

ATrial repolarization occur at

Answer 40

S

Question 41

Isoelectric line after t wave is

Answer 41

Ventricular repolarization complete.

Question 42

T wave is the

Answer 42

Ventricular repolarization is beginning

Question 43

QT interval indicates

Answer 43

Ventricular depolarization is complete.

Question 44

End of QRS complex at the last downward deflection is

Answer 44

Ventricular depolarization begins

Atria are repolarizing

Question 45

PR interval is

Answer 45

Atrial depolarization is complete.

Question 46

P wave is

Answer 46

Atrial depolarization begins