Question 1 of 6
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Which concern will be the focus of care for a patient who will be undergoing a heart transplant?
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- Transplant rejectionTransplant rejection is a concern after heart transplantation.
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- Transplant pericarditisPericarditis is a concern related to coronary artery bypass grafting.
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- Edema in the donor legEdema in the donor leg is a concern related to coronary artery bypass grafting.
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- Transplant Dressler syndromeTransplant Dressler syndrome is a concern related to coronary artery bypass grafting.
Question 2 of 6
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Which assessment must be performed frequently for a patient who has just returned to the hospital room after a percutaneous transluminal coronary angioplasty (PTCA)? Select all that apply. One, some, or all responses may be correct.
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- Vital signs and patient statusThe nurse would thoroughly assess the status of the patient after cardiac catheterization.
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- Pulses distal to the catheterization siteDistal pulses on the affected leg must be assessed frequently.
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- Assurance of bedbound status for 6 hours after the procedureThe patient may be up and about within 2 to 4 hours when an arterial closure device is used to seal the procedure site. The patient would have no ambulation restrictions immediately post procedure except possibly needing help because of grogginess from procedural sedation.
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- Checking placement of oxygen nasal cannula tubing in the nosePatients do not generally require supplemental oxygen post catheterization.
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- Assessment of groin area for the presence of hemorrhage or a hematomaThe groin area must be assessed for the presence of hemorrhage or a hematoma.
Question 3 of 6
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Who is in control of patient rehabilitation and prognosis for a patient post myocardial infarction, according to sound patient education?
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- Patient’s familyThe patient’s family is instrumental as a support system throughout the patient’s rehabilitation process. The family plays a key role in encouraging the patient. However, the patient’s family cannot ensure patient compliance.
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- PatientIt is important to stress to the patient that they have control over their rehabilitation and prognosis. They alone have full control over lifestyle changes and the treatment program. When the patient feels that they, rather than the health care provider, are in control, they are much more likely to remain on the treatment program.
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- Health care providerThe health care provider orders treatment and rehabilitation but cannot ensure patient compliance. When the patient feels that they, rather than the health care provider, are in control, they are much more likely to remain on the treatment program.
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- NurseThe nurse develops a plan of care based on the health care provider’s treatment and rehabilitation orders. The nurse educates the patient, but the nurse cannot ensure patient compliance.
Question 4 of 6
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Which nursing action would be taken by the nurse caring for a patient who has just undergone cardiac catheterization in the cardiac care unit (CCU)?
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- Frequently assess the groin and distal pulses on affected leg.Postoperatively, the nurse should frequently assess distal pulses on the affected leg and the groin area for presence of hemorrhage or hematoma.
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- Monitor liver function closely.Monitoring renal function closely is merited because of the potential adverse effects of contrast dyes used during the procedure. Liver function is unaffected by this procedure.
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- Administer loading dose of antiplatelet medication.A loading dose of antiplatelet medication is usually administered before the patient leaves the catheterization laboratory and prior to the patient’s arrival to the CCU.
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- Immediately remove the pressure device placed at procedure site.The pressure device will gradually be released until it can be removed. It is not to be immediately removed.
Question 5 of 6
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Which type of medical equipment will the patient who has undergone open heart surgery expect to have in the immediate postoperative period? Select all that apply. One, some, or all responses may be correct.
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- Indwelling urinary catheterUrine output is initially monitored hourly for 8 hours and thereafter every 2 hours to detect signs of decreased perfusion to the kidneys. To obtain an accurate hourly urinary output while the patient is on bed rest, an indwelling urinary catheter is best practice.
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- Chest tubesFor patients who had an open heart procedure, chest tubes for drainage and proper reexpansion of the lungs are in place for 24 hours.
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- Multilumen central lineFor patients who had an open heart procedure, a multilumen central line is in place for medication delivery and fluid maintenance.
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- Continuous electrocardiogram (ECG) monitoringContinuous ECG monitoring for patients after an open heart procedure is necessary for close monitoring of the cardiac rate and rhythm.
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- Mechanical ventilationThe patient undergoing an open heart procedure is intubated and placed on a mechanical ventilator. The patient often continues to receive mechanical ventilation for a few hours after surgery. Once consciousness has fully returned, weaning from the ventilator is begun if oxygenation is adequate and extubation occurs.
Question 6 of 6
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Which malignancy is the most common in post-cardiac transplant patients?
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- SkinPost-transplant malignancy is a known risk factor and is believed to result from the prolonged immunosuppression. Skin cancer is the most common malignancy after organ transplant. This higher risk is caused by immunosuppressive medications, which are essential to transplant patients to prevent graft rejection and optimize graft survival.
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- BloodSkin cancer is the most common malignancy after organ transplant. This higher risk is caused by immunosuppressive medications, which are essential to transplant patients to prevent graft rejection and optimize graft survival. There is not an increased risk for cancer of the blood.
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- BoneSkin cancer is the most common malignancy after organ transplant. This higher risk is caused by immunosuppressive medications, which are essential to transplant patients to prevent graft rejection and optimize graft survival. There is not an increased risk of bone cancer.
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- LungSkin cancer is the most common malignancy after organ transplant. This higher risk is caused by immunosuppressive medications, which are essential to transplant patients to prevent graft rejection and optimize graft survival. There is not an increased risk of lung cancer.
