Deck 29: Caring for Clients Under Going Cardiovascular Surgery

Question 1

The client is undergoing open heart surgery in the morning and will have to be placed on cardiopulmonary bypass. The client is very anxious and asks you why they have to be placed on "that machine." What would be your best response to this client?

A) "The machine takes the place of your heart during the surgery."
B) "To be able to repair your heart, it needs to be stopped. The machine will pump your blood to your body and through your lungs."
C) "Your body needs oxygen to survive, and the machine provides the oxygen while you have surgery."
D) "Your blood needs to circulate throughout your body, and the machine makes sure this happens."

Answer 1

"To be able to repair your heart, it needs to be stopped. The machine will pump your blood to your body and through your lungs."

Question 2

While teaching a pathophysiology class you are asked what vessels are used for alternative grafts if the saphenous vein is not used. What would be your answer? Select all that apply.

A) The popliteal vein
B) The internal mammary artery
C) The gastroepiploic artery
D) The internal jugular vein

Answer 2

The internal mammary artery
The gastroepiploic artery
The internal jugular vein

Question 3

The pathophysiology instructor is discussing heart disease with a class of pre-nursing 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.

Answer 3

Atheromas are calcified and noncompressible.
The heart cannot be repaired without compromising oxygenation of the body.

Question 4

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

Question 5

It is essential for a nurse to explain coughing, deep breathing, and leg exercises to a client who is scheduled to undergo cardiac surgery. What is the rationale for this?

A) To prevent hypothermia
B) To prevent impaired tissue perfusion
C) To prevent pneumonia and stasis of venous circulation
D) To prevent fluid imbalance

Question 6

A nurse caring for a client who has had cardiac surgery must know how to monitor pulmonary artery pressure. What is important about pulmonary artery pressure?

A) Aids in early treatment of right-sided congestive heart failure.
B) Aids in the early treatment of fluid imbalances.
C) Assesses right-sided heart pressures.
D) Assesses left atrial heart pressures.

Question 7

Hemodynamic monitoring is one of the essential areas of monitoring for the nurse caring for a post cardiac surgery client. What is hemodynamic monitoring used for?

A) Assess the pressure of blood in the heart and vascular system by manually assessing it.
B) Monitor the flow of blood through the heart.
C) Assess the volume and pressure of blood in the heart and vascular system by means of a surgically inserted catheter.
D) Monitor the flow of blood through the vascular system.

Question 8

To tighten an incompetent valve a client might have which of the following?

A) Commissurotomy
B) Valve adjustment
C) Annuloplasty
D) CABG

Question 9

A client present to the Emergency Department with complaints of pain in their left calf. The calf below the pain is cool and dusky and the pulse is weak. The client is diagnosed with a clot in their popliteal artery. What would be the treatment of choice for this client?

A) A popliteal revascularization
B) Hemodynamic restoration
C) An embolectomy
D) An endarterectomy

Question 10

Your client is having coronary artery bypass surgery. The client asks you how the surgeon is going to give their heart a better blood flow. What would be your best response?

A) "The surgeon takes pieces of other blood vessels to repair the vessels in the heart that aren't working right."
B) "The surgeon uses a blood vessel from another part of the body and makes a detour around the occluded vessel to restore the blood flow."
C) "Blood flow is improved by moving around other blood vessels."
D) "The big vein in your leg is removed and placed around your heart."

Question 11

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

Question 12

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

Question 13

A client has been admitted for a commissurotomy. You know that a commissurotomy repairs which of the following?

A) A ventricle
B) A valve
C) Part of the myocardium
D) An artery

Question 14

The organ donor nurse is talking with the family of a client who has been declared brain dead. A member of the family asks why it would be important to donate the heart of their family member. What would be the nurse's best response?

A) "One of the problems with heart transplants is that there are not enough donor hearts for the thousands of people who need them."
B) "It would save the life of someone else."
C) "The death of your family member might save some other family from feeling your pain."
D) "A child needs your loved one's heart."

Question 15

The nurse is caring for a client who has begun exhibiting symptoms of hemorrhage and significant blood loss. What would be the nurse's priority action for this client? Which of the following procedures must the nurse perform?

A) Place the client in supine position.
B) Elevate the extremities above the heart level.
C) Elevate the client's head as much as possible.
D) Notify the physician.

Question 16

A client has a tumor in his heart and is scheduled for surgery. The client asks the nurse if they will be a candidate for heart transplant if the entire tumor cannot be safely removed. What would be the nurse's best response?

A) "No, a heart tumor is not an indication for a heart transplant."
B) "Yes, if the surgeon cannot get all the tumor, you can be placed on the list for a heart transplant."
C) "That will be up to your cardiologist."
D) "That decision would be based entirely on how well you tolerate your first cardiac surgery."

Question 17

Bruising and bleeding of the heart may be caused by blunt trauma. What may be prescribed to stop the bleeding?

A) Embolectomy
B) Pericarditis
C) Thoracentesis
D) Inactivity and pressure from blood in the pericardium

Question 18

A client who has opted to undergo a surgery to repair one of his heart valves and replace it with an allograft heart valve needs to know the advantage of it. Which of the following would be your answer to such a client?

A) It lasts for 20 years.
B) It has better blood flow characteristics.
C) It is highly available.
D) It is less expensive.

Question 19

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 by the nursing instructor?

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

Question 20

You are caring for an 81-year-old client who is deciding whether to have cardiovascular surgery. The client asks you why the risks are greater for them than for a younger person, what would be your answer?

A) Many older adults have other things wrong with them besides their cardiac problems.
B) Older adults have the same risk factors as younger adults.
C) Older adults have hypersensitive renal systems and younger adults don't.
D) Older adults have different thought processes than younger adults do.

Question 21

You are caring for a client status post heart transplant. One of the family members asks you what the signs of organ rejection are. What would be your best response? (Mark all that apply.)

A) Fever over 101.5°F
B) Shortness of breath
C) Abdominal tenderness
D) Elevated blood pressure
E) Flu-like symptoms

Question 22

A client is diagnosed with an aneurysm of the descending aorta. What type of surgery would this client need?

A) Endarterectomy
B) Aortic revascularization
C) Coronary artery bypass graft
D) Vascular graft

Question 23

A client has developed a clot in their femoral artery. What type of surgery will this client need?

A) An embolectomy
B) An endarterectomy
C) A thrombectomy
D) A thorocotomy