Question 1

A client is scheduled to have CABG surgery next week. To best meet the client's need for psychosocial support, which intervention by the nurse would be best?
A) Ask the client and family to relay fears and questions.
B) Discuss the possible need for blood products during or after the operation.
C) Provide written and oral instructions along with contact phone numbers.
D) Refer the client to the preoperative educational classes at the hospital.

Accepted Answer

All options are appropriate. However, since the psychological preparation of the client before surgery is so important, many hospitals have instituted preoperative educational classes. These classes greatly reduce client and family fear and apprehension.

Question 2

A client is scheduled to have a PTCA. The nurse brings the consent forms and the client questions why he/she has to sign a consent form for possible coronary artery bypass grafting too. The nurse's response should be based on understanding that (Select all that apply)
A) a separate consent must be signed for each procedure.
B) education will only have to be done one time if the client signs both now.
C) in case of a complication, there may not be time to have a consent signed.
D) the client will be sedated during the PTCA and cannot sign another consent form.

Accepted Answer

Complications of PTCA can include perforation of the artery or acute occlusion. In that case, CABG would be required. The client or family would need to sign a separate consent form for that procedure. In case of emergency, there might not be time to do so. The client who is sedated for the PTCA cannot sign another consent. It is standard procedure to have clients sign consents for both PTCA and CABG.

Question 3

A client had a PTCA with stent placement. Nursing care that can be delegated to the unlicensed assistive personnel (UAP) after the procedure includes (Select all that apply)
A) assessing the distal pulses every 15-30 minutes.
B) calling for an ECG immediately if the client has angina.
C) monitoring vital signs every 15-30 minutes.
D) providing the client with plenty of fluids to drink.
E) reminding the client to remain flat in bed.

Accepted Answer

All options are appropriate care for the client after a PTCA and stent placement. However, the registered nurse must assess pulses. If the client complains of angina to the UAP, that person should let the nurse know. The nurse must assess the client before anyone calls for an ECG.

Question 4

A nurse is preparing to administer IV digoxin to an elderly client in heart failure. Which nursing action takes priority?
A) Ask the client if he/she has ever had digoxin before.
B) Assess the client's pulse rate and hold the medication if it is less than 60 beats/min.
C) Prepare the client for any side effects of the medication.
D) Provide instruction to the client on the medication's expected effects.

Accepted Answer

Digoxin's actions include slowing the heart rate to allow more effective filling. However, with its narrow therapeutic range, toxicity is common. One manifestation of toxicity is bradycardia. Nearly all health care institutions have policies that require nurses to check the client's pulse rate before administering digoxin and to hold the dose and notify the physician if the pulse rate is less than 60 beats/min. While all options are appropriate nursing interventions, option b takes priority.

Question 5

A nurse is conducting worksite health education classes. The nurse informs the participants that in order to prevent heart disease, the American Heart Association recommends which amount of exercise?
A) 10-20 minutes every day.
B) 20-30 minutes three to five times a week.
C) 30-60 minutes every day.
D) 30-60 minutes on most days of the week.

Accepted Answer

25% of Americans report no leisure time physical activity. The AHA recommends that to prevent heart and blood vessel diseases, individuals get 30-60 minutes of exercise on most days of the week.

Question 6

A client who is grossly overweight tells the nurse "I just can't lose a bunch of weight to prevent a disease I might not get." The best response by the nurse takes into consideration that
A) even a small weight loss is beneficial.
B) even overweight, women do not get coronary heart disease at high rates.
C) obesity is not one of the major risk factors for coronary heart disease.
D) the client really does need to lose substantial weight.

Accepted Answer

Coronary heart disease is the number one killer of both men and women. Obesity is a major risk factor not only because the heart has to work harder in an obese person but also because obesity is often associated with other risk factors. However, even losing 10-20 pounds significantly reduces one's risk.

Question 7

A nurse is caring for a client in the intensive care unit who underwent a CABG earlier this morning. Which nursing diagnosis takes priority?
A) Decreased Cardiac Output
B) Impaired Gas Exchange
C) Pain
D) Risk for Hemorrhage

Accepted Answer

Using the ABCs (airway, breathing, circulation), Impaired Gas Exchange would be the priority followed by Decreased Cardiac Output. Pain would be third because it is an actual, not a "risk for," diagnosis.

Question 8

A client is being discharge after successful CABG surgery. Despite the positive prognosis, the nurse cautions the client and family that
A) a heart attack could happen at any time.
B) heart disease can always return.
C) postoperative depression is common.
D) the real results of the operation are not yet known.

Accepted Answer

Postoperative depression, fatigue, incisional discomfort, dyspnea, and anorexia are common. By the fourth or fifth week, clients are feeling much better, and by 1 year after the operation, 93% report improved quality of life.

Quiz 56: Management of Clients with Functional Cardiac Disorders

A client is scheduled to have CABG surgery next week. To best meet the client's need for psychosocial support, which intervention by the nurse would be best?

A client is scheduled to have a PTCA. The nurse brings the consent forms and the client questions why he/she has to sign a consent form for possible coronary artery bypass grafting too. The nurse's response should be based on understanding that (Select all that apply)

A client had a PTCA with stent placement. Nursing care that can be delegated to the unlicensed assistive personnel (UAP) after the procedure includes (Select all that apply)

A nurse is preparing to administer IV digoxin to an elderly client in heart failure. Which nursing action takes priority?

A nurse is conducting worksite health education classes. The nurse informs the participants that in order to prevent heart disease, the American Heart Association recommends which amount of exercise?

A client who is grossly overweight tells the nurse "I just can't lose a bunch of weight to prevent a disease I might not get." The best response by the nurse takes into consideration that

A nurse is caring for a client in the intensive care unit who underwent a CABG earlier this morning. Which nursing diagnosis takes priority?

A client is being discharge after successful CABG surgery. Despite the positive prognosis, the nurse cautions the client and family that