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 nurse is caring for a client who is having a mitral valve replacement with a mechanical valve. What instructions should the nurse be sure the client understands prior to being discharged?
Correct Answer: B
Rationale: A mechanical valve should last at least 20 years. The disadvantages are the risk for thrombi and emboli, so anticoagulation is necessary. There is a risk of bleeding, and there can be a sudden malfunction in the valve. An allograft will last 10 to 15 years. A bioprosthetic valve does not require anticoagulation but is prone to deterioration and calcification.
Question 2 of 5
A client is at the clinic for follow-up after cardiothoracic surgery and tells the nurse, 'I don't know what is wrong with me. I don't want to eat, and I feel depressed.' What is the best response by the nurse to this statement?
Correct Answer: C
Rationale: Discharge instruction should be given prior to the client leaving the hospital about it taking several weeks for a normal appetite to return and that depression is normal and temporary. The client does not need psychiatric help at this point but may benefit from a support group with other clients that have had cardiothoracic surgery. Telling a client there is no reason for being depressed is nontherapeutic and demeans the client's feelings. Telling the client to inform the physician because the depression could be serious could cause alarm.
Question 3 of 5
A client has just had cardiothoracic surgery and tells the nurse about having a 6-month-old grandchild. The client states, 'I can't wait to hold my grandchild!' What is the best response by the nurse?
Correct Answer: B
Rationale: The client must refrain from lifting, pushing, or pulling anything that weighs more than 10 lb. until the physician relieves the restriction in approximately 6 to 12 weeks. Telling the client 'I know you are glad you made it through the surgery' is not an informative or therapeutic response. Six months for lifting is an excessive time frame for activity to resume. There are several restrictions that the client should be made aware of during the postoperative time period.
Question 4 of 5
After being discharged from the hospital after undergoing cardiothoracic surgery, the client asks the nurse when it will be possible to resume sexual activity. What is the best response by the nurse?
Correct Answer: C
Rationale: Sexual relations usually can be resumed in 2 to 4 weeks after cardiothoracic surgery depending on one's comfort level and tolerance for activity; climbing two flights of stairs without dyspnea or chest pain is a common guideline. The other options are nontherapeutic responses to the client's concern. Six months is an excessively long time period to wait if the client has been able to resume activities without shortness of breath or chest pain.
Question 5 of 5
The nurse is preparing a client for coronary artery bypass surgery. What vessel does the nurse know is most commonly used for grafting?
Correct Answer: A
Rationale: The saphenous vein in the leg is the vessel most often used for grafting in coronary artery bypass. The basilic vein in the arm, radial artery in the arm, and gastroepiploic artery from the stomach are alternative graft vessels.