Management of the Cardiac Surgery patient



  1. Atherosclerosis impedes coronary blood flow by which of the following mechanisms?
    1. Plaques obstruct the vein
    2. Plaques obstruct the artery
    3. Blood clots form outside the vessel wall
    4. Hardened vessels dilate to allow blood to flow through
  1. A paradoxical pulse occurs in a client who had a coronary artery bypass graft (CABG) surgery 2 days ago. Which of the following surgical complications should the nurse suspect?
    1. Left-sided heart failure
    2. Aortic regurgitation
    3. Complete heart block
    4. Pericardial tamponade
  1. After cardiac surgery, a client’s blood pressure measures 126/80. The nurse determines that the mean arterial pressure (MAP) is which of the following?
    1. 46 mm Hg
    2. 80 mm Hg
    3. 95 mm Hg
    4. 90 mm Hg
  1. A woman with severe mitral stenosis and mitral regurgitation has a pulmonary artery catheter inserted. The physician orders pulmonary artery pressure monitoring, including pulmonary capillary wedge pressures. The purpose of this is to help assess the:
    1. Degree of coronary artery stenosis
    2. Peripheral arterial pressure
    3. Pressure from fluid within the left ventricle
    4. Oxygen and carbon dioxide concentration is the blood
  1. For a client who excretes excessive amounts of calcium during the postoperative period after open heart surgery, which of the following measures should the nurse institute to help prevent complications associated with excessive calcium excretion?
    1. Ensure a liberal fluid intake
    2. Provide an alkaline-ash diet
    3. Prevent constipation
    4. Enrich the client’s diet with dairy products
  1. A nurse is assessing the neurovascular of a client who has returned to the surgical nursing unit 4 hours ago after undergoing aortoiliac bypass graft. The affected leg is warm, and the nurse notes redness and edema. The pedal pulse is palpable and unchanged from admission. The nurse interprets that the neurovascular status is:
    1. Normal because of increased blood flow through the leg
    2. Slightly deteriorating and should be monitored for another hour
    3. Moderately impaired, and the surgeon should be called
    4. Adequate from an arterial approach, but venous complications are arising.
  1. After open-heart surgery a client develops a temperature of 102*F. The nurse notifies the physician, because elevated temperatures:
    1. Increase the cardiac output
    2. May indicate cerebral edema
    3. May be a forerunner of hemorrhage
    4. Are related to diaphoresis and possible chilling
  1. During a cardiac catherization blood samples from the right atrium, right ventricle, and pulmonary artery are analyzed for their oxygen content. Normally:
    1. All contain less CO2 than does pulmonary vein blood
    2. All contain more oxygen than does pulmonary vein blood
    3. The samples of blood all contain about the same amount of oxygen
    4. Pulmonary artery blood contains more oxygen than the other samples
  1. The nurse prepares the client for insertion of a pulmonary artery catheter (Swan-Ganz catheter). The nurse teaches the client that the catheter will be inserted to provide information about:
    1. Stroke volume
    2. Cardiac output
    3. Venous pressure
    4. Left ventricular functioning
  1. When preparing a client for discharge after surgery for a CABG, the nurse should teach the client that there will be:
    1. No further drainage from the incisions after hospitalizations
    2. A mild fever and extreme fatigue for several weeks after surgery
    3. Little incisional pain and tenderness after 3 to 4 weeks after surgery
    4. Some increase in edema in the leg used for the donor graft when activity increases
  1. What is the most important nursing action when measuring a pulmonary capillary wedge pressure (PCWP)?
    1. Have the client bear down when measuring the PCWP
    2. Deflate the balloon as soon as the PCWP is measured
    3. Place the client in a supine position before measuring the PCWP
    4. Flush the catheter with heparin solution after the PCWP is determined.
  1. The most important assessment for the nurse to make after a client has had a femeropopiteal bypass for peripheral vascular disease would be:
    1. Incisional pain
    2. Pedal pulse rate
    3. Capillary refill time
    4. Degree of hair growth
  1. Which signs cause the nurse to suspect cardiac tamponade after a client has cardiac surgery? Check all that apply.
    1. Tachycardia
    2. Hypertension
    3. Increased CVP
    4. Increased urine output
    5. Jugular vein distention
  1. A client has the diagnosis of left ventricular failure and a high pulmonary capillary wedge pressure (PCWP). The physician orders dopamine to improve ventricular function. The nurse will know the medication is working if the client’s:
    1. Blood pressure rises
    2. Blood pressure decreases
    3. Cardiac index falls
    4. PCWP rises
  1. A 35-year-old male was knifed in the street fight, admitted through the ER, and is now in the ICU. An assessment of his condition reveals the following symptoms: respirations shallow and rapid, CVP 15 cm H2O, BP 90 mm Hg systolic, skin cold and pale, urinary output 60-100 mL/hr for the last 2 hours. Analyzing these symptoms, the nurse will base a nursing diagnosis on the conclusion that the client has which of the following conditions?
    1. Hypovolemic shock
    2. Cardiac tamponade
    3. Wound dehiscence
    4. Atelectasis

Answers and Rationale


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