The nurse is caring for a client experiencing dyspnea, dependent edema, hepatomegaly, crackles, and jugular vein distention. What condition should the nurse suspect?

Heart failure

Pulmonary embolism

Tension pneumothorax

Cardiac tamponade

Answer and Explanation

The Correct Answer is A

A. Heart failure often presents with dyspnea, crackles (from pulmonary congestion), jugular vein distention, dependent edema, and hepatomegaly due to fluid overload and impaired cardiac output—these are classic signs.
B. Pulmonary embolism typically causes sudden dyspnea, chest pain, and tachypnea but not hepatomegaly or dependent edema.
C. Tension pneumothorax presents with tracheal deviation, absent breath sounds on one side, and hypotension—different from the systemic fluid overload signs described.
D. Cardiac tamponade presents with muffled heart sounds, hypotension, and jugular vein distention (Beck's triad), but it does not cause crackles, hepatomegaly, or peripheral edema.

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Correct Answer is B

Explanation

A. Spinal cord perfusion is not monitored with a pulmonary artery catheter; it typically requires different neuromonitoring techniques.
B. Hemodynamic status is accurately monitored using a pulmonary artery catheter (also called a Swan-Ganz catheter), which provides information on cardiac output, pulmonary artery pressures, and other cardiovascular parameters.
C. Intracranial pressure is monitored using devices like an intraventricular catheter or subarachnoid bolt, not a pulmonary artery catheter.
D. Renal function is assessed through laboratory tests (e.g., BUN, creatinine) and urine output, not via a pulmonary artery catheter

A. Increased cardiac output and improved tissue perfusion B. Restored fluid balance and resolution of hypovolemia C. Worsening organ dysfunction and failure D. Decreased heart rate and improved blood pressure

Correct Answer is C

Explanation

A. In the refractory stage, cardiac output is decreased and tissue perfusion is severely impaired, not improved.
B. Fluid balance is not restored during the refractory stage; instead, hypovolemia worsens.
C. The refractory stage is characterized by irreversible damage with worsening organ dysfunction and failure despite interventions.
D. Heart rate usually increases initially, and blood pressure typically decreases; decreased heart rate and improved blood pressure are not features of this stage.

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The nurse is caring for a client experiencing dyspnea, dependent edema, hepatomegaly, crackles, and jugular vein distention. What condition should the nurse suspect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing a client for transfer to the ICU for placement of a pulmonary artery catheter. The nurse should explain to the client that this catheter is used to monitor which of the following conditions?

Correct Answer is B

Explanation

During the refractory stage of shock in hypovolemia, which of the following responses accurately describes the physiological changes that occur?

Correct Answer is C

Explanation

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