Nokea
A client is scheduled for a coronary artery bypass graft (CABG) in the morning using a saphenous vein. The physician does not use the internal mammary artery for the bypass graft, because the internal mammary artery:
- A. takes more time to remove.
- B. has a greater risk of becoming reoccluded.
- C. is smaller in diameter.
- D. has too many valves.
Correct Answer: A
Rationale: Many physicians do not use the internal mammary artery because it is time consuming. Removing the internal mammary artery does not pose a greater risk of reocclusion. In fact, it may stay patent longer. The internal mammary artery is larger in diameter than the saphenous vein. The internal mammary artery does not have too many valves.
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Which type of anesthesia describes a state in which the client is free of pain, fear, and anxiety and can tolerate unpleasant procedures while maintaining independent cardiorespiratory function and the ability to respond to verbal commands and tactile stimulation?
- A. General
- B. Regional
- C. Epidural
- D. Procedural sedation
Correct Answer: D
Rationale: The correct answer is D because procedural sedation allows the client to remain responsive while being sedated.
Which technique facilitates interactions between the nurse and client?
- A. Ask questions that can be answered with yes or no.
- B. Sit within the client’s comfort zone.
- C. Avoid making eye contact.
- D. Address clients by their first names.
Correct Answer: B
Rationale: Respecting personal space enhances trust and comfort during interactions.
Which chief complaint is NOT desirable for recording on the client’s chart?
- A. CC: “cough and temperature elevation,” 2 days duration
- B. CC: “passing black stools,” 1 day duration
- C. CC: “substernal pain,” 2 hours duration
- D. Reason for contact: “physical examination for college”
Correct Answer: D
Rationale: Correct Answer: D
Rationale:
1. Chief complaints should be symptoms or concerns related to the client's health issues.
2. "Physical examination for college" is not a specific symptom or health concern.
3. Chief complaints guide healthcare providers in assessing and treating the client.
4. Recording irrelevant chief complaints can lead to confusion in diagnosis and treatment.
Summary of Incorrect Choices:
A: Describes specific symptoms, suitable for recording.
B: Describes a specific symptom (black stools), suitable for recording.
C: Describes a specific symptom (substernal pain), suitable for recording.
What are these sensory phenomena called when a client hears voices or sees images that do not objectively exist?
- A. Mania
- B. Delusions
- C. Seasonal affective disorder
- D. Hallucinations
Correct Answer: D
Rationale: Hallucinations involve perceiving things that are not present, such as hearing voices or seeing images.
While recovering from the anesthetic, what is the best position for Mrs. West?
- A. Supine with legs fully extended
- B. Prone with head turned to the side
- C. Lateral Sims with legs flexed
- D. Trendelenburg with head to the side
Correct Answer: D
Rationale: The correct answer is D: Trendelenburg with head to the side. This position helps prevent aspiration by promoting drainage of secretions from the mouth and reducing the risk of airway obstruction. Placing the patient in Trendelenburg position with the head to the side also helps facilitate proper blood flow and ventilation. Supine with legs fully extended (A) may increase the risk of airway obstruction and aspiration. Prone with head turned to the side (B) may obstruct the airway and hinder breathing. Lateral Sims with legs flexed (C) is not suitable for a patient recovering from anesthesia as it may not provide optimal airway clearance and respiratory support.