ATI LPN
Timby's Introductory Medical-Surgical Nursing Thirteenth, North American Edition
Chapter 29 : Caring for Clients Undergoing Cardiovascular Surgery Questions
Question 1 of 5
The client will be having a surgical procedure that does not use cardiopulmonary bypass, and the surgeon keeps the heart at a rate of 40 beats/minute. What surgical procedure does the nurse anticipate preparing the client for?
Correct Answer: D
Rationale: OPCAB is very similar to conventional CABG except that it does not involve the use of a cardiopulmonary bypass machine. Instead, the surgeon keeps the heart beating at a slow rate (about 40 beats/minute) with drugs such as adenosine and esmolol. The other answers require cardiopulmonary bypass.
Question 2 of 5
A client was driving a car without wearing a seat belt and slid off the road and hit a tree. The client's chest was crushed against a steering wheel. What type of lethal injury does the nurse anticipate the client may have suffered?
Correct Answer: A
Rationale: A nonpenetrating injury of the chest, such as being crushed against a steering wheel, may cause bruising and bleeding of the heart. Because the pericardium encloses the heart, blood accumulates in the pericardial space, resulting in cardiac tamponade. Although a fractured pelvis and bladder trauma may be sustained, they are generally not lethal. A pleural effusion would not result from this traumatic injury.
Question 3 of 5
A client has been waiting for a donor heart for several months. Upon receiving the call that a heart has become available, the client asks the transplant nurse, 'How much time do I have to get to the hospital?' What answer should the nurse give the client?
Correct Answer: C
Rationale: When a donor heart becomes available, it must be removed from the donor and transplanted within 6 hours of being harvested. It is unreasonable to expect a client to be in the hospital within 15 minutes and would be an incorrect time frame.
Question 4 of 5
The pathophysiology instructor is discussing heart disease with a class of prenursing students. One of the students asks what indications there are for coronary artery bypass surgery. What would be an acceptable answer(s) from the instructor? Select all that apply.
Correct Answer: A,B,E
Rationale: A coronary artery bypass is performed when (1) the client has multiple coronary artery occlusions, (2) the atheromas are calcified and noncompressible, or (3) the anatomic location of the occlusion(s) interferes with the safe insertion of a coronary artery catheter. This makes the other options incorrect.
Question 5 of 5
The nurse reinforces teaching for a client who is scheduled for coronary artery bypass surgery. The client asks, 'What vessels can be used if my saphenous vein doesn't meet the requirements?' Which vessel(s) should the nurse include in the response to the client? Select all that apply.
Correct Answer: A,D,E
Rationale: Alternative graft vessels include the following: the internal mammary and internal thoracic arteries in the chest; the basilic and cephalic veins in the arm, the radial artery in the arm, and the gastroepiploic artery from the stomach, in some cases. The axillary and popliteal veins are not alternative graft vessels; therefore, the nurse should not include them in the response to the client.