A patient who underwent coronary artery bypass surgery demonstrates effective understanding of discharge teaching by:

Correct Answer: B

Rationale: The correct answer is B) clarifying when cardiac rehabilitation will begin. This option demonstrates effective understanding of discharge teaching following coronary artery bypass surgery because cardiac rehabilitation is a crucial component of recovery. It helps patients improve cardiovascular health, increase physical activity, and learn about heart-healthy habits. By asking about the timing of cardiac rehabilitation, the patient shows awareness of the importance of structured exercise and education in their recovery process. Option A is incorrect because smoking, even one cigarette per day, is detrimental to cardiovascular health and can impede the healing process post-surgery. Option C is incorrect because relaxing in a hot tub can increase the heart rate and blood pressure, which may not be safe during the initial recovery period. Option D is incorrect because driving too soon after surgery can pose a risk to the patient's safety and hinder the healing process. In an educational context, it is important for patients post-coronary artery bypass surgery to be well-informed about their discharge instructions to ensure a successful recovery. Understanding the role of cardiac rehabilitation, following a heart-healthy lifestyle, and adhering to restrictions are vital for optimal outcomes. Patients should be encouraged to ask questions and seek clarification on any aspect of their care to promote their well-being.

Correct Answer: D

Rationale: In the management of a patient with hypertensive urgency, the nursing responsibility often includes instructing the patient to follow up with a healthcare professional within 24 hours after outpatient treatment (Option D). This is the correct answer because patients with hypertensive urgency require close monitoring and follow-up to ensure their condition is properly managed and any potential complications are addressed promptly. Option A is incorrect because hourly urine output monitoring is not typically a primary nursing responsibility in managing hypertensive urgency. Option B is also incorrect as titration of IV drug dosages every 2 to 3 minutes is too frequent and not standard practice in this scenario. Option C is not a primary nursing responsibility as continuous ECG monitoring is not typically required for the management of hypertensive urgency. Educationally, it is important for nurses to understand the appropriate interventions and follow-up care required for patients with hypertensive urgency to prevent complications. By instructing patients to follow up within 24 hours, nurses ensure continuity of care, medication adherence, and the early detection of any worsening symptoms, contributing to better patient outcomes.

Correct Answer: C

Rationale: In the context of cardiovascular health, identifying and rapidly treating unstable angina is crucial due to the potential risk of complete thrombus formation in the vessel lumen. Option C is correct because unstable angina results from the destabilization of atherosclerotic plaque, which can lead to the formation of a complete thrombus, causing reduced blood flow to the heart muscle. This can progress to a myocardial infarction (MI) if left untreated. Option A is incorrect because the severity of pain, although important, is not the primary reason for the urgency of identifying and treating unstable angina. Option B is incorrect as ECG changes and dysrhythmias are more commonly associated with myocardial infarction rather than unstable angina. Option D is incorrect as spasm of a major coronary artery typically leads to variant angina (Prinzmetal's angina) rather than unstable angina. Educationally, understanding the pathophysiology of unstable angina and its potential progression to MI is crucial for healthcare providers to provide timely and appropriate interventions to prevent adverse cardiac events. Rapid identification and treatment of unstable angina can help minimize the risk of serious complications and improve patient outcomes.

Correct Answer: B

Rationale: Rationale: Using docusate sodium (Colace) for a patient after an MI is aimed at relieving anxiety and reducing cardiac workload. Following a myocardial infarction (MI), patients often experience anxiety due to the traumatic event and the fear of potential complications. Anxiety can lead to increased sympathetic tone, elevating heart rate and blood pressure, which in turn can increase cardiac workload. By administering docusate sodium, a stool softener, the patient's discomfort from constipation is alleviated. This simple intervention can help reduce anxiety levels, indirectly decreasing sympathetic stimulation and cardiac workload. Option A: Controls ventricular dysrhythmias - This option is incorrect as docusate sodium does not have a direct effect on controlling ventricular dysrhythmias. These dysrhythmias are managed through medications like antiarrhythmics. Option C: Minimizes bradycardia from vagal stimulation - This option is incorrect because docusate sodium is not used to minimize bradycardia resulting from vagal stimulation. Bradycardia is usually addressed with medications like atropine. Option D: Prevents the binding of fibrinogen to platelets - This option is incorrect as docusate sodium does not play a role in preventing the binding of fibrinogen to platelets. This process is related to the coagulation cascade and is managed with anticoagulant medications. Educational Context: It is crucial for healthcare providers to understand the rationale behind using specific medications post-MI to optimize patient care. Addressing anxiety and reducing cardiac workload are essential components of holistic post-MI management. By providing appropriate explanations for medication choices, healthcare professionals can ensure safe and effective care for patients recovering from cardiovascular events.

Correct Answer: D

Rationale: In postoperative nursing management of a patient who has undergone a right pneumonectomy, selecting option D, "All of the above," is the correct choice. Monitoring respiratory status is crucial post-pneumonectomy as it helps to detect any signs of respiratory distress, such as decreased oxygen saturation or abnormal breath sounds. Managing pain is essential in promoting patient comfort and aiding in early mobilization, which is crucial for preventing complications like pneumonia or deep vein thrombosis. Preventing complications post-pneumonectomy involves a multifaceted approach, including early ambulation, deep breathing exercises, and vigilant monitoring for signs of infection or bleeding. Options A, B, and C all play critical roles in the comprehensive care of a patient following a pneumonectomy. Monitoring respiratory status ensures prompt detection of any respiratory compromise, managing pain improves patient comfort and promotes early mobilization, and preventing complications is essential in reducing the risk of postoperative issues. By selecting option D, nurses can address all these aspects of care holistically, promoting better outcomes for the patient. Educationally, understanding the importance of comprehensive postoperative care after a pneumonectomy is essential for nurses working in surgical or critical care settings. By mastering the principles of respiratory monitoring, pain management, and complication prevention, nurses can provide high-quality care and improve patient outcomes in the postoperative period. This question highlights the interconnectedness of these nursing interventions and emphasizes the importance of a well-rounded approach to patient care in the post-pneumonectomy setting.