Cardiac Pac Website

Front 1

Which statement about therapeutic interventions to reduce afterload is most correct?

Back 1

Hypotension may occur

Front 2

Which one of the following is most effective in the treatment of increased afterload?

Back 2

Nitroprusside

Front 3

Which one of the following is most effective in the treatment of reduced contractility?

Back 3

Dobutamine

Front 4

Which one of the following statements is most correct?

Back 4

Volume expansion is often indicated in right ventricular failure despite elevation of central venous pressure

Front 5

Which one of the following statements is most correct?

Back 5

Stimulation of beta 2 receptors produces vascular smooth muscle relaxation

Front 6

Which one of the following drug-dosage pairs is most correct

Back 6

Norepinephrine 1-20 mcg/min

Front 7

Which one of the following statements about vasopressor drugs is most correct

Back 7

Use may be associated with a reduction of blood flow to some vascular beds

Front 8

Which of the following is a primary side effect of Dobutamine?

Back 8

Decreased SVR

Front 9

All of the following are expected/desirable hemodynamic responses to nitroprusside except:

Back 9

Increased SVR

Front 10

Which of the following statements regarding dopamine is most correct?

Back 10

Dopamine is indicated when low SV/SVI values are accompanied by adequate preload and normal or low afterload

Front 11

1) Which one of the following statements is false?

Back 11

C) Systemic vascular resistance is the same as afterload

Front 12

2) Which one of the following statements about preload is most correct?

Back 12

D) Preload decreases as mean intrathoracic pressure increases

Front 13

3) Which one of the following statements about ventricular contractility is false?

Back 13

B) Ventricular preload, afterload and contractility are independent variables

Front 14

4) Which one of the following statements about ventricular compliance is most correct?

Back 14

C) The less compliant the ventricle, the higher the filling pressure

Front 15

5) Which one of the following statements about ventricular compliance is most correct?

Back 15

D) Ventricular compliance decreases with increasing cardiac ischemia

Front 16

6) Which statement regarding changes in heart rate is false?

Back 16

C) Increases in heart rate cause decreases in contractility

Front 17

7) Which statement regarding changes in heart rate is false?

Back 17

D) Low heart rates (<50 bpm) may result in increased myocardial oxygen consumption

Front 18

8) Which of the following statements regarding preload is most correct?

Back 18

B) Increases in preload usually are associated with increased myocardial fiber length

Front 19

9) Which of the following statements regarding afterload is most correct?

Back 19

C) Decreases in afterload usually are associated with decreases in systemic vascular resistance

Front 20

10) Which of the following statements regarding ventricular filling is most correct?

Back 20

D) Loss of atrial contraction results in decreases in ventricular filling volume

Front 21

1) Which statement about therapeutic interventions to reduce afterload is most correct?

Back 21

A) Hypotension may occur

Front 22

2) Which one of the following is most effective in the treatment of increased afterload?

Back 22

D) Nitroprusside

Front 23

3) Which one of the following is most effective in the treatment of reduced contractility?

Back 23

D) Dobutamine

Front 24

4) Which one of the following statements is most correct?

Back 24

C) Volume expansion is often indicated in right ventricular failure despite elevation of central venous pressure

Front 25

5) Which one of the following statements is most correct?

Back 25

B) Stimulation of beta 2 receptors produces vascular smooth muscle relaxation

Front 26

6) Which one of the following drug-dosage pairs is most correct?

Back 26

B) Norepinephrine 1-20 mcg/min

Front 27

7) Which one of the following statements about vasopressor drugs is most correct?

Back 27

A) Use may be associated with a reduction of blood flow to some vascular beds

Front 28

8) Which of the following is a primary side effect of Dobutamine?

Back 28

B) Tachycardia

Front 29

9) All of the following are expected/desirable hemodynamic responses to epinephrine except:

Back 29

D) Decreased SVR

Front 30

10) All of the following are expected/desirable hemodynamic responses to nitroprusside except:

Back 30

D) Increased SVR

Front 31

11) Which of the following statements regarding dopamine is most correct?

Back 31

A) Dopamine is indicated when low SV/SVI values are accompanied by adequate preload and normal or low afterload

Front 32

1) The PAOP waveform depicted in Figure 5 is typically the result of:

Back 32

C) Excessive balloon inflation

Front 33

2) The a waves are consistently absent in the CVP/RA and PAOP waveforms in all the following conditions except:

Back 33

A) Third degree heart block

Front 34

3) The a waves become exaggerated in the CVP/RA and PAOP waveforms in which of the following conditions?

Back 34

A) A-V dissociation

Front 35

4) The v waves of the PAOP waveform may be abnormally exaggerated in which of the following conditions?

Back 35

D) Left ventricular ischemia

Front 36

5) Measurement of the CVP/RA or PAOP waveforms in a patient with a dysrhythmia causing a consistently enlarged a wave (cannon a wave) is best performed by:

Back 36

B) Measuring the pressure value at end-expiration just after the QRS complex.

Front 37

6) Measurement of the mean value of the CVP/RA or PAOP waveform in a patient with atrial fibrillation is best performed by:

Back 37

C) Measuring the pressure value at end-expiration just after the QRS complex.

Front 38

7) Measurement of the value of the PAOP in a patient with mitral regurgitation is best performed by:

Back 38

C) Measuring the mean of the a wave at end-expiration.

Front 39

1) Which one of the following statements is true concerning ventricular diastole?

Back 39

D) Blood leaves the atria and fills the ventricles

Front 40

2) Which one of the following statements is most correct about timing of ventricular diastole?

Back 40

A) It begins after the ECG T wave

Front 41

3) Which one of the following statements is most correct regarding ventricular end-diastole?

Back 41

C) Right atrial pressure equalizes with right ventricular end-diastolic pressure

Front 42

4) At peak ventricular systole which one of the following statements is most correct?

Back 42

D) Pulmonary artery systolic pressure and right ventricular systolic pressure equalize

Front 43

5) Which one of the following statements about preload is most correct?

Back 43

D) It refers to the force or load on the ventricle in its relaxed state

Front 44

6) Which one of the following statements about the pulmonary artery occlusion pressure is most correct?

Back 44

A) It is an estimate of left ventricular preload

Front 45

7) Which one of the following statements about afterload is most correct?

Back 45

B) It is the force or load on the ventricle during the ejection phase

Front 46

8) Which one of the following statements about contractility is most correct?

Back 46

A) It refers to the force or strength of ventricular systole

Front 47

9) Which of the following has the most direct impact on the arterial oxygen content?

Back 47

C) Hemoglobin

Front 48

10) Which statement about oxygen supply and demand is most correct?

Back 48

C) May be altered by the metabolic demands of the tissues

Front 49

1) Which one of the following statements about SvO2 is most correct?

Back 49

A) SvO2 values <0.60 indicate threatened tissue oxygenation

Front 50

2) Which one of the following statements is most correct?

Back 50

B) A CVP >6 mmHg usually reflects RV failure if the SVI is <25 mL/beat/M2

Front 51

3) Which of the following statements is most correct?

Back 51

A) SV/SVI assesses cardiac pump performance

Front 52

4) Which one of the pair of stroke volume and stroke volume index values is abnormal?

Back 52

D) SV = 49 ml/beat; SVI = 17 mL/beat/M2

Front 53

Identify the condition most consistent with the following hemodynamic profile:
SvO2 ... 0.50 ... PAOP ... 21 mmHg
CI ... 2.2 L/min/M2 ...CVP/RA ... 4 mmHg
SVI ... 23 ml/beat M2 ... HR ... 98

Back 53

C) LV dysfunction/failure

Front 54

Identify the condition most consistent with the following hemodynamic profile:
SvO2 ... 0.53 ... PAOP ... 21 mm Hg
CI ... 2.8 L/min/M2 ... CVP/RA ... 14 mm Hg
SVI ... 20 ml/beat/M2 ... HR ... 140

Back 54

B) Hypervolemia

Front 55

7) Identify the condition most consistent with the following hemodynamic profile: SvO2 ... 0.47 ... PAOP ... 4 mm Hg
CI ... 2.0 L/min/M2 ... CVP/RA ... 2 mm Hg
SVI ... 19 ml/beat/M2 ... HR ... 111

Back 55

A) Hypovolemia

Front 56

8) Which of the combined set of hemodynamic values is of greatest concern?

Back 56

A) CO = 6.9 L/min; ....... CI = 3.8 L/min/M2 SV = 63 mL/beat; ....... SVI = 34 mL/beat/M2 BP = 102/52 mm Hg ....... SvO2 = 0.83

Front 57

9) Which one of the following hemodynamic variables is paired with an incorrect normal value?

Back 57

C) Cardiac output (4-8 mm Hg)

Front 58

10) Which one of the following equations is most correct?

Back 58

C) SVI = CI/HR

Front 59

11) Which one of the following is most likely to be associated with hypovolemia?

Back 59

B) Decreased ventricular end-diastolic volume

Front 60

1) Which statement about therapeutic interventions to reduce afterload is most correct?

Back 60

A) Hypotension may occur

Front 61

2) Which one of the following statements about heart rate is false?

Back 61

A) Heart rates > 180 beat/min are usually associated with augmented diastolic filling

Front 62

3) Which one of the following is most likely to benefit a hypovolemic patient?

Back 62

D) Lactated Ringers

Front 63

4) Which one of the following is most characteristic of decreased afterload?

Back 63

Decreased systemic vascular resistance

Front 64

5) Which one of the following conditions is most likely to be associated with a decreased afterload?

Back 64

A) Septic shock

Front 65

6) Which one of the following is most likely to occur during treatment of increased afterload?

Back 65

A) Increased stroke volume

Front 66

7) Which one of the following is most effective in the treatment of increased afterload?

Back 66

D) Nitroprusside

Front 67

8) Which one of the following is most closely associated with reduced contractility?

Back 67

B) Increased heart rate

Front 68

1) Which one of the following statements is most correct regarding hemodynamic waveform measurement?

Back 68

B) It is best done from a paper recording with a simultaneous ECG and pressure waveform

Front 69

2) Which one of the following statements is most correct regarding the PAOP waveform?

Back 69

C) The v-wave is due to blood filling the atrium

Front 70

3) Which one of the following statements is most correct regarding timing of the CVP/right atrial pressure waves with the ECG tracing?

Back 70

B) The a wave occurs just after the P wave

Front 71

6) Which one of the following is the most characteristic difference between the right ventricular (RV) waveform and the pulmonary artery (PA) waveform?

Back 71

C) The RV diastolic pressure is lower than the PA diastolic pressure

Front 72

8) Which one of the following statements is most correct regarding the pulmonary artery waveform and simultaneous ECG tracing?

Back 72

B) End-diastole is measured after the QRS complex

Front 73

9) Which one of the following statements about the pulmonary artery occlusion pressure (PAOP) is most correct?

Back 73

) The PAOP waveform often contains 3 positive waves (a, c, v)

Front 74

10) Which one of the following statements about the pulmonary artery occlusion pressure (PAOP) waveform is most correct?

Back 74

A) To measure the pulmonary artery occlusion pressure the value of the a wave is averaged

Front 75

Which one of the following statements about measurement of the pulmonary artery occlusion pressure is most correct?

Back 75

D) The pulmonary artery occlusion pressure is lower than the mean pulmonary artery pressure

Front 76

13) Which one of the following statements about hemodynamic waveforms is most correct?

Back 76

C) Hemodynamic pressures should be read at end-expiration in a patient breathing spontaneously

Front 77

1) Which statement regarding the set-up of hemodynamic monitoring equipment is most correct?

Back 77

C) All vented caps on stopcock ports must be replaced with closed (dead-ender) caps.

Front 78

2) Which statement regarding zeroing/leveling is most correct?

Back 78

D) Any stopcock within the monitoring line can be used to zero/level the system if it is positioned at the patient’s mid-chest or phlebostatic axis

Front 79

3) Which of the following statements about bolus thermodilution is most correct?

Back 79

B) The presence of a PA waveform from the distal lumen of the catheter must be confirmed prior to bolus injection.

Front 80

5) Which one of the following statements about the technical aspects of hemodynamic pressure monitoring equipment is most correct?

Back 80

D) The air-reference stopcock must be at the level of the phlebostatic axis

Front 81

4) Which of the following statements about bolus thermodilution is most correct?

Back 81

C) The accuracy of injection technique and cardiac output values should be evaluated by the appearance of serial cardiac output curves.

Front 82

6) Which one of the following statements regarding bolus thermodilution cardiac outputs is false?

Back 82

B) A cardiac output curve with a slow decline best insures proper injection technique

Front 83

7. Which of the following statements regarding zeroing/leveling is most correct?

Back 83

B) If the air-reference stopcock is attached to an IV pole, zeroing/leveling must be performed every time there is a change in the patient’s position.

Front 84

Which one of the following conditions is a cause of inaccurate thermodilution cardiac output measurements?

Back 84

) Failure to connect the temperature sensing probe to the injectate system

Front 85

9) Which one of the following statements regarding bolus thermodilution cardiac outputs is most correct?

Back 85

B) A PA waveform must be observed via the distal lumen of the catheter prior to injection

Front 86

1) Which of the following statements regarding PA catheter insertion is most correct?

Back 86

A) Following vessel puncture, SaO2 analysis of a withdrawn blood sample should be <.85.

Front 87

2) Which of the following statements regarding PA catheter insertion is most correct?

Back 87

D) A PA waveform should be observed from the tip of the PA catheter after the catheter has been inserted approximately 15 cm from the subclavian vein.

Front 88

3) Which of the following statements regarding pulmonary artery rupture is most correct?

Back 88

D) Minimize or avoid PAOP measurements; monitor the PAedp instead of PAOP if pressure values are close.

Front 89

4) Immediate treatment of pulmonary artery rupture may include all of the following:

Back 89

A) Discontinuation of anticoagulation,C) Selective bronchial intubation,D) PEEP

Front 90

6) Which statement regarding thrombus formation is most correct?

Back 90

A) All intravascular monitoring catheters are thrombogenic.

Front 91

7) Which one of the following statements about prevention of pulmonary artery rupture is most correct?

Back 91

B) Withdraw PAC slightly if a PAOP waveform is obtained with inflation of <1.25 ml air

Front 92

8) Which one of the following statements about the occurrence of dysrhythmias during PA catheterization is most correct?

Back 92

) It is best prevented by rapid passage of PAC with balloon inflated with 1.5 ml air