NR 341/ NR341 COMPLEX ADULT HEALTH
EXAM 2 LATEST 2023-2024 REAL EXAM
QUESTIONS AND CORRECT
ANSWERS|AGRADE
While caring for a patient with a small bowel obstruction, the nurse assesses a pulmonary artery occlusion pressure (PAOP) of 1 mm Hg and hourly urine output of 5 mL. The nurse anticipates which therapeutic intervention?
- Diuretics
- Intravenous fluids
- Negative inotropic agents
- Vasopressors
ANS: B
- The nursing is caring for a patient who has had an arterial line inserted. To reduce the risk of
complications, what is the priority nursing intervention?
- Apply a pressure dressing to the insertion site.
- Ensure all tubing connections are tightened.
- Obtain a portable x-ray to confirm placement.
- Restrain the affected extremity for 24 hours.
- / 3
ANS: B
While caring for a patient with a pulmonary artery catheter, the nurse notes the pulmonary artery occlusion pressure (PAOP) to be significantly higher than previously recorded values. The nurse assesses respirations to be unlabored at 16 breaths/min, oxygen saturation of 98% on 3 L of 2 / 3
oxygen via nasal cannula, and lungs clear to auscultation bilaterally. What is the priority nursing action?
- Increase supplemental oxygen and notify respiratory therapy.
- Notify the physician immediately of the assessment findings.
- Obtain a stat chest x-ray film to verify proper catheter placement.
- Zero reference and level the catheter at the phlebostatic axis.
ANS: D
The nurse is caring for a patient with a left subclavian central venous catheter (CVC) and a left radial arterial line. Which assessment finding by the nurse requires immediate action?
- A dampened arterial line waveform
- Numbness and tingling in the left hand
- Slight bloody drainage at subclavian insertion site
- Slight redness at subclavian insertion site
ANS: B
Following insertion of a central venous catheter, the nurse obtains a stat chest x-ray film to verify proper catheter placement. The radiologist reports to the nurse: “The tip of the catheter is located in the superior vena cava.” What is the best interpretation of these results by the nurse?
- / 3