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. This statement indicates a misunderstanding about the procedure for CABG surgery using the internal mammary artery. The internal mammary artery is typically used for the bypass graft, not a vein from the leg. The other choices (A, C, D) are all accurate statements related to CABG surgery. Choice A correctly describes the use of a heart-lung machine during surgery. Choice C accurately explains the purpose of using an artery near the heart for the bypass. Choice D is true as aspirin is often prescribed post-surgery to prevent graft occlusion. Therefore, B is the incorrect choice as it does not align with the procedure being discussed.

Correct Answer: B

Rationale: Certainly! The correct answer is B: Assess the client. Ventricular tachycardia may or may not require immediate intervention like defibrillation. Assessing the client's condition first allows the nurse to gather vital information such as the client's level of consciousness, vital signs, and overall stability. This assessment will guide the nurse in determining the appropriate next steps, which may include interventions like defibrillation, calling the physician, or administering treatment. Performing immediate defibrillation (choice A) without assessing the client's condition can be harmful if the client does not actually require it. Calling the physician (choice C) can be done after assessing the client to provide a comprehensive report. Administering a precordial thump (choice D) is not recommended in current guidelines and should not be the initial response to ventricular tachycardia.

Correct Answer: A

Rationale: The correct answer is A because in a client presenting with substernal chest pain, electrocardiographic changes, and elevated cardiac troponin level, the priority is to improve myocardial oxygenation and reduce cardiac workload. This is crucial to prevent further damage to the heart muscle and potential complications like myocardial infarction. By focusing on improving oxygen supply and reducing workload, the nurse can help stabilize the client's condition and prevent further cardiac events. Choice B is incorrect because while confirming the diagnosis and preventing complications are essential, the immediate focus should be on addressing the physiological needs of the heart. Choice C is incorrect as reducing anxiety and relieving pain are important but secondary to addressing the underlying cardiac issue. Choice D is incorrect as eliminating stressors and providing a nondemanding environment may be beneficial but not the immediate priority in this situation.

Correct Answer: A

Rationale: The correct answer is A: Withhold the digoxin and notify the physician. The infant's pulse rate of 90 beats/minute is below the normal range for an infant, indicating bradycardia. Digoxin can further lower heart rate, leading to serious complications. By withholding the medication and notifying the physician, the nurse ensures the infant's safety and allows the physician to make an informed decision about adjusting the dosage or prescribing an alternative treatment. Administering the medication (B, C) could worsen bradycardia. Withholding without notifying (D) delays necessary intervention.

Correct Answer: C

Rationale: The correct answer is C because a client receiving antibiotics for bacterial endocarditis who is reporting anxiety and chest pain is showing signs of a potential cardiac emergency that requires immediate attention to prevent further complications. Chest pain and anxiety are red flags for cardiac issues such as myocardial infarction that could lead to life-threatening situations. Therefore, the nurse should prioritize this client to assess and intervene promptly. Choice A is incorrect because dyspnea in a client with hypertrophic cardiomyopathy, while concerning, does not indicate an acute cardiac emergency that requires immediate attention. Choice B is incorrect because a client who had a cardiac catheterization and will be ambulating for the first time does not exhibit urgent signs that necessitate immediate intervention compared to a client with chest pain and anxiety. Choice D is incorrect because a temperature of 101 F in a client recovering from CABG surgery is not as concerning as chest pain and anxiety, which could indicate a cardiac complication.