The client with a chest tube after a coronary artery bypass graft has significantly slowed drainage. What action is most important for the nurse to take?

Correct Answer: B

Rationale: The correct answer is B: Notify the provider immediately. This is the most important action because significantly slowed drainage in a client with a chest tube after surgery can indicate a potential complication like a blocked tube or bleeding. Notifying the provider allows for prompt assessment and intervention to prevent further complications. Increasing the suction setting (choice A) without knowing the reason for slowed drainage can potentially worsen the situation. Re-positioning the chest tube (choice C) may not address the underlying issue causing the slowed drainage. Taking the tubing apart to assess for clots (choice D) should not be done by the nurse as it can introduce the risk of infection and requires sterile technique.

Correct Answer: C

Rationale: The correct answer is C: 1630 (4:30 PM). The rationale is as follows: 1. The standard guideline for performing percutaneous coronary intervention (PCI) in acute MI is within 90 minutes of arrival at the hospital. 2. The client arrived at 1500 (3:00 PM), so adding 90 minutes to this time gives us 1630 (4:30 PM). 3. This timing aligns with The Joint Commission's Core Measures for timely PCI in acute MI cases. 4. Therefore, the correct time for the client to have PCI performed is 1630 (4:30 PM). In summary, choices A, B, and D are incorrect because they do not align with the 90-minute guideline for performing PCI in acute MI cases, as mandated by The Joint Commission's Core Measures.

Correct Answer: C

Rationale: The correct answer is C: It increases the force of the heart's contractions. Inotropic agents are medications that enhance the strength of the heart's contractions, improving cardiac output. This explanation is accurate because inotropic agents work by increasing the contractility of the heart muscle, leading to stronger contractions and improved pumping ability. Explanation for why the other choices are incorrect: A: It constricts vessels, improving blood flow - This is incorrect because inotropic agents primarily affect the heart's contractility, not vascular constriction. B: It dilates vessels, which lessens the work of the heart - This is incorrect because inotropic agents do not primarily dilate vessels; their main action is on the heart's contractility. D: It slows the heart rate down for better filling - This is incorrect because inotropic agents do not slow down the heart rate; they increase the force of contractions. In summary, choice C is correct as inotropic agents increase the force of

Correct Answer: A

Rationale: The correct answer is A: Assess the client's lung sounds. This is important because after a myocardial infarction, there is a risk of pulmonary edema, which can present as crackles or wheezes in the lungs. By assessing the lung sounds, the healthcare provider can identify any signs of respiratory distress and promptly intervene if necessary. Choice B is incorrect because calling the Rapid Response Team is not warranted based solely on abnormal heart sounds. Choice C is incorrect as having the client sit upright is not directly related to addressing abnormal heart sounds. Choice D is also incorrect as it focuses solely on assessing lung sounds without considering the potential implications of the abnormal heart sounds.

Correct Answer: A

Rationale: The correct action is to assess the client's blood pressure and level of consciousness. This is crucial in a client with an inferior wall MI to monitor for potential complications like cardiogenic shock. Assessing these vital signs can provide immediate information on the client's hemodynamic stability. Calling the health care provider or Rapid Response Team may be necessary based on assessment findings. Obtaining a permit for a temporary pacemaker insertion and preparing to administer antidysrhythmic medication are not the most immediate priorities and may not address the client's current needs.