Advancing a pulmonary artery catheter into a smaller artery may cause which of the following complications?
a. Pneumothorax
b. Air embolism
c. Pulmonary infarction
d. Ventricular fibrillation
Q. 2 During the inspiratory phase of spontaneous breathing, what happens to the pulmonary artery (PA) waveform?
a. There is no change in the waveform.
b. The PA waveform trend increases.
c. The PA waveform trend decreases.
d. The PA diastolic pressure increases.
Q. 3 An intubated patient with no known history of congestive heart failure is in the ICU.
The patient is comatose and currently receiving mechanical ventilation via volume-controlled continuous mandatory ventilation (VC-CMV), set rate 12 breaths/min, set tidal volume (VT) 400 mL, positive end-expiratory pressure (PEEP) 18 cm H2O, fractional inspired oxygen (FIO2) 0.35, and the patient is not assisting. Hemodynamic measurements show the following: central venous pressure (CVP) 5 mm Hg, pulmonary artery pressure (PAP) 33/20 mm Hg, and pulmonary artery occlusion pressure (PAOP) 16 mm Hg. Arterial blood gas (ABG) results are: pH 7.43, arterial partial pressure of carbon dioxide (PaCO2) 38 mm Hg, arterial partial pressure of oxygen (PaO2) 90 mm Hg. The physician asks for recommendations to improve this patient's hemodynamics. The most appropriate recommendation for this patient is which of the following?
a. Initiate pressure support ventilation (PSV) 10 cm H2O with CPAP 10 cm H2O, and check cardiac output.
b. Decrease the PEEP incrementally and re-check hemodynamic measurements.
c. Change to volume-controlled synchro-nized intermittent mandatory ventilation (VC-SIMV) with the same settings, and recheck hemodynamic measurements.
d. Change to pressure-controlled continuous mandatory ventilation (PC-CMV), peak inspiratory pressure (PIP) 25 cm H2O, PEEP 18 cm H2O, FIO2 0.35, and check PAP.
Q. 4 A high cardiac output can cause which of the following complications with a pulmonary artery catheter?
a. Pneumothorax
b. Catheter whip
c. Pulmonary infarction
d. Catheter knotting
Q. 5 A patient with a mitral valve stenosis is most likely to have which of the following pulmonary artery occlusion pressure (PAOP) values?
a. 4 mm Hg
b. 6 mm Hg
c. 12 mm Hg
d. 20 mm Hg
Q. 6 Which of the following is the hemodynamic measurement that is indicative of a patient with right heart failure?
a. Pulmonary artery occlusion pressure (PAOP) = 12 mm Hg
b. Central venous pressure (CVP) = 16 mm Hg
c. Pulmonary artery pressure (PAP) = 35/15 mm Hg
d. Mean arterial pressure (MAP) = 80 mm Hg
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