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An OR nurse is preparing to assist with a coronary artery bypass graft (CABG). The OR nurse knows that the vessel most commonly used as source for a CABG is what?
- A. Brachial artery
- B. Brachial vein
- C. Femoral artery
- D. Greater saphenous vein
Correct Answer: D
Rationale: The greater saphenous vein is the most commonly used graft site for CABG. The right and left internal mammary arteries, radial arteries, and gastroepiploic artery are other graft sites used, though not as frequently. The femoral artery, brachial artery, and brachial vein are never harvested.
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A patient with angina has been prescribed nitroglycerin. Before administering the drug, the nurse should inform the patient about what potential adverse effects?
- A. Nervousness or paresthesia
- B. Throbbing headache or dizziness
- C. Drowsiness or blurred vision
- D. Tinnitus or diplopia
Correct Answer: B
Rationale: Headache and dizziness commonly occur when nitroglycerin is taken at the beginning of therapy. Nervousness, paresthesia, drowsiness, blurred vision, tinnitus, and diplopia do not typically occur as a result of nitroglycerin therapy.
The nurse is creating a plan of care for a patient with acute coronary syndrome. What nursing action should be included in the patients care plan?
- A. Facilitate daily arterial blood gas (ABG) sampling
- B. Administer supplementary oxygen, as needed
- C. Have patient maintain supine positioning when in bed
- D. Perform chest physiotherapy, as indicated
Correct Answer: B
Rationale: Oxygen should be administered along with medication therapy to assist with symptom relief. Administration of oxygen raises the circulating level of oxygen to reduce pain associated with low levels of myocardial oxygen. Physical rest in bed with the head of the bed elevated or in a supportive chair helps decrease chest discomfort and dyspnea. ABGs are diagnostic, not therapeutic, and they are rarely needed on a daily basis. Chest physiotherapy is not used in the treatment of ACS.
An ED nurse is assessing an adult woman for a suspected MI. When planning the assessment, the nurse should be cognizant of what signs and symptoms of MI that are particularly common in female patients? Select all that apply.
- A. Shortness of breath
- B. Chest pain
- C. Anxiety
- D. Numbness
- E. Weakness
Correct Answer: D,E
Rationale: Although these symptoms are not wholly absent in men, many women have been found to have atypical symptoms of MI, including indigestion, nausea, palpitations, and numbness. Shortness of breath, chest pain, and anxiety are common symptoms of MI among patients of all ages and genders.
When assessing a patient diagnosed with angina pectoris it is most important for the nurse to gather what information?
- A. The patients activities limitations and level of consciousness after the attacks
- B. The patients symptoms and the activities that precipitate attacks
- C. The patients understanding of the pathology of angina
- D. The patients coping strategies surrounding the attacks
Correct Answer: B
Rationale: The nurse must gather information about the patients symptoms and activities, especially those that precede and precipitate attacks of angina pectoris. The patients coping, understanding of the disease, and status following attacks are all important to know, but causative factors are a primary focus of the assessment interview.
The ED nurse is caring for a patient with a suspected MI. What drug should the nurse anticipate administering to this patient?
- A. Oxycodone
- B. Warfarin
- C. Morphine
- D. Acetaminophen
Correct Answer: C
Rationale: The patient with suspected MI is given aspirin, nitroglycerin, morphine, an IV beta-blocker, and other medications, as indicated, while the diagnosis is being confirmed. Tylenol, warfarin, and oxycodone are not typically used.