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 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 2 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.
Question 3 of 5
A client is 2 days postoperative from mitral valve replacement and is in pain at an 8 on a 0 to 10 scale. What intervention(s) can the nurse provide to control the pain before it gets to this level? Select all that apply.
Correct Answer: A,B,C
Rationale: Small, frequent self-administration of an opioid drug controls acute pain within consistently tolerable levels. Administer non-narcotic analgesics between prescribed doses of narcotic analgesics. Non-narcotics have a different mechanism of action and are not likely to cause respiratory depression or depressed level of consciousness if given concurrently with narcotics. Pain is more easily controlled by giving analgesic medication before the pain becomes severe, so the nurse would not wait until the client to ask for the pain medication. The nurse cannot administer more of the narcotic than the physician prescriptions.
Question 4 of 5
The nursing instructor is giving a class on assessing cardiac clients after thoracic surgery. What assessment is most important for the nurse to perform when caring for this client?
Correct Answer: D
Rationale: The nurse assesses the blood pressure (BP) and pulse rate in both arms after thoracic surgery. Although it is necessary for the nurse to also assess pulmonary artery pressure, temperature, skin, and mentation after thoracic surgery, blood pressure and pulse rate are the most essential assessments.
Question 5 of 5
When discussing the nursing process, the instructor stresses that for clients undergoing cardiac surgery, it is important for the nurse to demonstrate competence. What is the rationale for this statement?
Correct Answer: C
Rationale: When the nurse is knowledgeable and competent, it relieves the client's insecurity and anxiety regarding the surgery.