cvp reading

apatin, ronick allan d.

Pre Test

1. the pressure within the right atrium and in

the great vein within the thorax
a. central venous pressure
b. bood pressure
c. right atrial pressure
d. both a and c

answer: d
rationale: CVP represents the filling
pressure of the right ventricle and it
indicates the ability of the right side of the
heart to manage a fluid load

2. it is the reference point where the zero

mark of the manometer must be placed
during cvp reading
a. phlebostatic axis
b. mcburney's point
c. both a and b
d. none of the above

answer: a
rationale: McBurney's point is the name given to the point over
the right side of the abdomen that is one-third of the distance from
the anterior superior iliac spine to the umbilicus (navel). This point
roughly corresponds to the most common location of the base of the
appendix where it is attached to the cecum
Phlebostatic axisthe approximate location of the right
atrium, found at the intersection of the midaxillary and a line drawn
from the fourth intercostal space at the right side of the sternum.
The phlebostatic axis is used extensively in hemodynamics

3. what is the normal range of central

venous pressure?
a. 5 - 12
b. 7 - 15
c. 8 - 20
d. 10 - 15

answer: a
rationale: the change in CVP is a more
useful indication of adequacy of venous
blood volume and alterations of
cardiovascular function. CVP is a dynamic
measurement. The normal values may
change from patient to patient. The
management of the patients not based on
one reading but on repeated serial
readings in correlation with patients
clinical status.

4. unit being used in cvp reading

a. cmH2O
b. mmH2O
c. mmHg
d. none of the above

answer: a

Post Test

5. common complication of cvp monitoring

a. infection
b. air embolism
c. both a and b

answer: c
rationale: break in the skin during incision
air may be introduced when
catheter is disconnected from iv line

6.

When a nurse is measuring central venous pressure (CVP) by manometer, which of

the following is the correct position for accurately obtaining a measurement? [Hint]
a. Client supine, head of bed elevated, measure at the 4th intercostal space on lateral
chest wall
b. Client supine, head of bed flat, measure at the site of the central venous catheter
c. Client supine, head of bed flat, measure at the 4th intercostal space on lateral
chest wall
d. Client supine, head of bed elevated, measure at the site of the central venous
catheter

answer: c
rationale: the appropriate positioning for
accurately measuring central venous
pressure is supine with head of bed flat.
Measure at the 4th intercostal space on
the lateral chest wall midway between the
anterior and posterior chest. The site
should be marked as a reference point for
future measurements

7. What jugular vein is most often preferred

for cannulation for central venous
pressure (CVP)?
a. right internal jugular
b. left internal jugular
c. subclavian
d. none of the above

answer: a
rationale: Left-sided catheterization via the
left jugular vein increases the risk of (1)
vascular erosion, (2) pleural effusions, and
(3) puncture of the thoracic duct, leading
to chylothorax

8. all but one cause decreased cvp reading

a. hypovolemia
b. hypervolemia
c. deep inhalation
d. none of the above

answer: b
rationale: hypovlolemia and deep inhalation
cause decreased cvp reading

9. which of the following causes increased

cvp reading?
a. distributive shock
b. Mechanical ventilation and the application
of positive end-expiratory pressure
(PEEP),Pulmonary
c. hypovolemia
d. deep inhalation

answer: b
rationale: choices a, c and d cause
decreased cvp reading

10. site where cvp catheter is inserted

a. anticubital site
b. femoral artery
c. subclavian artery

answer: anticubital site

rationale: front of elbow ( smaller vein, less
bleeding or uncontrollable bleeding in
cases of coagulopathy,thromoltic therapy,
anticoagulation therapy)

11. What are the indications for central

venous cannulation?
a. Administrationof fluid and electrolytes
b. Drug Therapy
c. Venous access for monitoring Central
Venous Pressure
d. Venous access for insertion of a
pulmonary artery catheter
e. all of the above

answer: e
rationale: all are possible indication for cvp
insertion

12. contraindications for cvp insertion

a. parenteral nutrition
b. thrombolytic therapy
c. both a and c
d. none of the above

answer: b
rationale: may cause uncontrolled bleeding

13. What is the nurse's primary concern

regarding fluid & electrolytes when caring for
an elderly pt. who is intermittently confused?
a. risk of dehydration
b. risk of kidney damage
c. risk of stroke
d. risk of bleeding

Answer: a
Rationale: As an adult ages, the thirst
mechanism declines. Adding this in a pt with
an altered level of consciousness, there is
an increased risk of dehydration & high
serum osmolality

14. When caring for a group of pts, the

nurse realizes that which of the following
health problems increases the risk for
metabolic alkalosis?
a. bulimia
b. dialysis
c. venous stasis ulcer
d. COPD

Answer: a
Rationale: Metabolic alkalosis is cause by
vomiting, diuretic therapy or nasogastric
suction, among others. A pt with bulimia may
engage in vomiting or indiscriminate use of
diuretics

15. The nurse assesses a pt's weight loss

as being 22 lbs. How many liters of fluid did
this pt. lose?
a.14
b.13
c.12
d.10

Answer: d
Rationale:Each liter of body fluid weighs 1
kg or 2.2 lbs. This pt has lost 10 liters of
fluid.

16. A postoperative pt is diagnosed with fluid

volume overload. Which of the following
should the nurse assess in this pt?
a. poor skin turgor
b. decreased urine output
c. distended neck veins
d. concentrated hemoglobin & hematocrit
levels

Answer: c
Rationale: Circulatory overload causes
manifestations such as a full, bounding pulse;
distended neck & peripheral veins; increased
central venous pressure; cough; dyspnea;
orthopnea; rales in the lungs; pulmonary edema;
polyuria; ascites; peripheral edema, or if severe,
anasarca, in which dilution of plasma by excess
fluid causes a decreased hematocrit & blood urea
nitrogen (BUN); & possible cerebral edema.

17. a nurse is to administer 10 meqs KCl,

how many cc should she aspirate?
a.5ml
b. 10ml
c. 2ml
d. 1ml

Answer: a
rationale: stock dose of KCl:
40meqs/20ml;2meqs/1ml

18. A pt is diagnosed with

hyperphosphatemia. The nurse realizes that
this pt might also have an imbalance of
which of the following electrolytes?
a. calcium
b. sodium
c. potassium
d. chloride

Answer: a
Rationale: Excessive serum phosphate
levels cause few specific symptoms. The
effects of high serum phosphate levels on
nerves & muscles are more likely the result
of hypocalcemia that develops secondary to
an elevated serum phosphorus level. The
phosphate in the serum combines with
ionized calcium, & the ionized serum
calcium level falls.

19. A pt is admitted for treatment of

hypercalcemia. The nurse realizes that this
pt's intravenous fluids will most likely be
which of the following?
a. dextrose 5% & water
b. dextrose 5% & ? normal saline
c. dextrose 5% & ? normal saline
d. normal saline

Answer: d
Rationale: Isotonic saline is used because
sodium excretion is accompanied by
calcium excretion through the kidneys

20. A 35-year-old female pt comes into the

clinic postoperative parathyroidectomy.
Which of the following should the nurse
instruct this pt?
a. Drink one glass of red wine per day.
b. Avoid the sun.
c. Milk & milk-based products will ensure an
adequate calcium intake.
d. Red meat is the protein source of choice.

Answer: c
Rationale: This pt is at risk for developing
hypocalcemia. This risk can be avoided if
instructed to ingest milk & milk-based
products