Introductory Medical Surgical Nursing 11th Edition by Barbara K. Tim
Introductory Medical Surgical Nursing 11th Edition by Barbara K. Tim
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Chapter 29, Caring for Clients Undergoing Cardiovascular Surgery
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
| 1. | 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? | |
| A) | Pulmonary artery pressure | |
| B) | Temperature | |
| C) | Skin and mentation | |
| D) | Blood pressure | |
| Ans: | D | |
| Feedback: | ||
| 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. | ||
| 2. | 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? | |
| A) | To acknowledge the client’s emotion | |
| B) | To encourage verbal conversation | |
| C) | To relieve the client’s insecurity and anxiety | |
| D) | To encourage the client to communicate | |
| Ans: | C | |
| Feedback: | ||
| When the nurse is knowledgeable and competent, it relieves the client’s insecurity and anxiety regarding the surgery. | ||
| 3. | A nurse caring for a client who has had cardiac or vascular surgery knows to do hourly assessments on which of the following? | |
| A) | Blood sugar level | |
| B) | Fluid intake and urine output | |
| C) | Mentation | |
| D) | Blood pressure and pulse rate in both arms | |
| Ans: | B | |
| Feedback: | ||
| While accessing a client undergoing cardiac or vascular surgery, the nurse assesses the client’s fluid intake and urine output on hourly basis. The nurse may assess the blood sugar level during the initial assessment process but not hourly. For a client undergoing a cardiac or vascular surgery, the nurse does not assess for mentation. The nurse assesses the client’s blood pressure and pulse rate in both arms after thoracic surgery. | ||
| 4. | 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 with cardiopulmonary bypass. What would be the instructor’s answer? Select all that apply. | |
| A) | Atheromas are calcified and noncompressible. | |
| B) | The heart cannot be repaired without compromising oxygenation of the body. | |
| C) | The client has multiple coronary artery occlusions. | |
| D) | Transluminal coronary angioplasty is necessary. | |
| E) | The anatomic location of the occlusion(s) interferes with the safe insertion of a coronary artery catheter. | |
| Ans: | A, B, E | |
| Feedback: | ||
| 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 options B and D incorrect. | ||
| 5. | One of the nursing students asks the nursing instructor why someone would need cardiac surgery. What would be an appropriate response by the nursing instructor? | |
| A) | A ventricular aneurysm | |
| B) | Mitral valve sufficiency | |
| C) | An atrial aneurysm | |
| D) | Endocarditis | |
| Ans: | A | |
| Feedback: | ||
| A ventricular aneurysm is the most lethal complication among clients who survive the acute stage of a myocardial infarction (MI). Because the motion of the myocardium may rupture the aneurysm, an emergency procedure may be performed to suture the weakened area. If waiting is possible, the stretched tissue is excised 4 to 8 weeks after the MI when scar tissue has formed. If surgery is performed too early, it is difficult to differentiate healthy from necrotic tissue, and sutures placed in necrotic tissue usually are not retained. Mitral valve insufficiency produces a “backup” of blood within the left atrium but is not necessarily a cause for surgery. Atrial aneurysm is rare. Endocarditis is an infection and does not require surgery. | ||
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