When evaluating the effectiveness of preoperative teaching with a patient scheduled for coronary artery bypass graft (CABG) surgery using the internal mammary artery, the nurse determines that additional teaching is needed when the patient says which of the following?

Correct Answer: B

Rationale: The correct answer is B because incisions in the leg are not made for harvesting the internal mammary artery in CABG surgery; instead, the internal mammary artery is typically accessed through a small incision in the chest. This shows a misunderstanding of the surgical procedure. A, C, and D are incorrect: A: Correct, as it shows understanding that a heart-lung machine will circulate blood during surgery. C: Correct, as it demonstrates knowledge of using an artery near the heart for bypass. D: Correct, as it indicates awareness of postoperative medication regimen.

Correct Answer: B

Rationale: The correct answer is B: Assess the client. When a cardiac monitor alarm sounds for ventricular tachycardia, the nurse's initial action should be to assess the client to determine the client's level of consciousness, pulse quality, and overall condition. This assessment helps the nurse gather crucial information to determine the appropriate next steps and interventions. Performing immediate defibrillation (A) is not the first action as the client's status needs to be assessed first. Calling the physician (C) can cause a delay in providing immediate care, and administering a precordial thump (D) is not recommended as it may not be effective and could delay appropriate interventions.

Correct Answer: A

Rationale: The correct focus of nursing care is A: Improving myocardial oxygenation and reducing cardiac workload. Substernal chest pain with electrocardiographic changes and elevated troponin indicates a myocardial infarction. By improving oxygenation, we can help reduce myocardial damage. Reducing workload can prevent further strain on the heart. Choice B is incorrect as diagnosis is already established. Choice C is not the priority compared to addressing the physiological issue. Choice D is not directly addressing the cardiovascular problem.

Correct Answer: A

Rationale: The correct answer is A: Withhold the digoxin and notify the physician. A pulse rate of 90 beats/minute in an infant is considered abnormal and may indicate potential digoxin toxicity. By withholding the medication and informing the physician, the nurse ensures patient safety and allows for further evaluation and adjustment of the treatment plan. Administering the digoxin without addressing the high pulse rate could worsen the condition. Option B is incorrect because administering the medication without addressing the abnormal pulse rate is not safe. Option C is incorrect as it neglects the need for further assessment and intervention. Option D is incorrect as it fails to prioritize patient safety by withholding the medication.

Correct Answer: C

Rationale: The correct answer is C. The client receiving antibiotics for bacterial endocarditis reporting anxiety and chest pain should be seen first. This client is at risk for complications like infective endocarditis, which can lead to serious cardiac issues. Addressing the anxiety and chest pain promptly is essential to prevent further deterioration. A client with hypertrophic cardiomyopathy reporting dyspnea may need attention next, but it's not as urgent as addressing a potential complication like infective endocarditis. The client post-cardiac catheterization ambulating for the first time and the client recovering from CABG with a fever of 101 F can be seen after the client with bacterial endocarditis due to the acuity of their presenting symptoms.