Chapter 37 2 of 3
Diagnostic studies have been prescribed for a patient who presents with symptoms of aortic dissection. The nurse reviews the patient's history and identifies that magnetic resonance imaging (MRI) may can be contraindicated based on what finding?
Pacemaker surgery
xxx 1 Gastric decompression 2 Temporary hemofiltration 3 Cautious fluid resuscitation 4 Reverse Trendelenburg position
4
The nurse is preparing a patient for an open aneurysm repair. What nursing actions can assist with decreasing the risk for bowel complications? 1 Using the retroperitoneal surgical approach 2 Administering labetalol to the patient after surgery 3 Avoiding the administration of broad-spectrum antibiotics 4 Removing the indwelling urinary catheter within a short time
Answer: 1
The nurse is providing postoperative care for a patient who underwent abdominal aortic repair surgery. Which parameter needs to be monitored continuously by the nurse? 1 Electrocardiogram 2 Ankle-brachial index 3 Complete blood count 4 Activated partial thromboplastin time
Answer: 1
A patient with a suspected acute aortic dissection tells the nurse, "I think I'm having a heart attack!" The nurse should assess the patient for which manifestation of an acute aortic dissection?
Abrupt onset of excruciating chest or back pain
The nurse is providing postoperative care to a patient who underwent aneurysm repair surgery. The nurse should monitor what parameters? Select all that apply. 1 White blood cell (WBC) count 2 Blood urea nitrogen (BUN) level 3 Serum creatinine level 4 Blood glucose level 5 Thyroid hormone level
Answer: 1,2,3
Which preoperative nursing interventions are beneficial to a patient who is scheduled for aortic aneurysm surgery the following day? Select all that apply. 1 Administering a bowel preparation 2 Ensuring that the patient has nothing by mouth (NPO) after midnight 3 Cleansing the skin with an antimicrobial agent 4 Providing for a visit to the intensive care unit, if necessary 5 Informing the patient that no medications will be given after midnight
Answer: 1,2,3,4
The nurse is providing postoperative care to a patient that underwent aortic aneurysm repair surgery. The nurse should perform what intervention to maintain graft patency?
Administer intravenous (IV) fluids to maintain adequate blood pressure (BP)
A patient's diagnostic reports show calcification within the aortic wall and abnormal widening of the thoracic wall. The nurse expects what clinical manifestation? Select all that apply. 1 Back pain 2 Epigastric discomfort 3 Bluish fingers and toes 4 Decreased urine output 5 Altered bowel elimination
Answer: 1,2,5
Which interventions should the nurse implement before surgery for a patient who is scheduled for aortic dissection repair? Select all that apply. 1 Administer sedation to the patient. 2 Administer dabigatran to the patient. 3 Observe changes in the peripheral pulses. 4 Place the patient in semi-Fowler's position. 5 Place the patient's bed in the reverse Trendelenburg position
Answer: 1,3,4
A patient is scheduled to undergo surgery for repair of an aortic dissection. Which interventions should the nurse include in the preoperative care plan? Select all that apply. 1 Providing emotional support to the patient 2 Keeping the patient in bed in a supine position 3 Monitoring changes in peripheral pulses 4 Administering opioids and sedatives as prescribed 5 Managing pain and anxiety
Answer: 1,3,4,5
A patient has been diagnosed with an aortic arch aneurysm. What assessment finding does the nurse determine correlates with this diagnosis?
Angina
The nurse assesses a patient postoperatively from a repair of an aortic aneurysm and finds a heart rate of 48, cool, pale, and mottled extremities along with reports of pain. What condition does the nurse suspect is occurring? 1 Infection 2 Graft occlusion 3 Aneurysm rupture 4 Raynaud's phenomenon
Answer 2
A patient has undergone aortic dissection repair. During a follow-up visit, the patient reports depression, fatigue, and inability to maintain an erection. The nurse suspects that the cause of the patient's symptoms is what? 1 Raynaud's phenomenon 2 Peripheral arterial disease 3 A side effect of antibiotics 4 A side effect of metoprolol
Answer 4
Assessment findings indicate graft occlusion in a patient who underwent repair of an aortic aneurysm. The nurse anticipates that the plan of care will include what treatment? 1 Iloprost 2 Hydralazine 3 Gene therapy 4 Thrombolytic therapy
Answer 4
The nurse is assigned to care for a group of patients in the intensive care unit. Which patient is at greatest risk for needing a percutaneous catheter decompression? 1 A patient receiving heparin sodium 2 A patient who has dalteparin overdose 3 A patient who underwent endovascular aneurysm repair 4 A patient with severe abdominal compartment syndrome
Answer 4
A patient experiences an acute aortic dissection. The nurse identifies that what medication can be used to lower the patient's heart rate if a β-blocker is contraindicated? 1 Diltiazem 2 Morphine 3 Raloxifene 4 Epoetin alfa
Answer: 1
A patient has an asymptomatic aneurysm that is 5.8 cm in diameter. The nurse anticipates that what will be included in the patient's plan of care? 1 Preoperative education about surgical repair 2 The use of simvastatin to reduce the aneurysm 3 The use of doxycycline to eliminate the aneurysm 4 The use of hormonal therapy to reduce the aneurysm
Answer: 1
A patient is diagnosed with an abdominal aortic aneurysm. The patient undergoes minimally invasive aneurysm repair with an endovascular graft and returns to an inpatient room after the procedure. Which is the priority nursing action? 1 Assess the groin area. 2 Measure the abdominal girth. 3 Determine when the patient last urinated. 4 Ask the patient to rate pain on a 0 to 10 scale
Answer: 1
A patient with acute aortic dissection is scheduled for a medication that will be titrated to maintain a target heart rate of 60 beats/minute or less. The nurse identifies that which medication will be given? 1 Esmolol 2 Clopidogrel 3 Nadroparin 4 Rivaroxaban
Answer: 1
Which patient is at high risk for developing irreversible renal failure after an aortic aneurysm surgery?
Answer: The patient with diabetes
Which instructions should the nurse include in the discharge plan of a patient who has undergone aortic surgery? Select all that apply.
Avoid heavy lifting for six weeks. Routinely observe the color of the extremities. Palpate the peripheral pulses regularly.
A patient is admitted to the hospital with a diagnosis of abdominal aortic aneurysm. The nurse should monitor the patient for which indications of a ruptured aneurysm? Select all that apply.
Back or flank ecchymosis Severe low back pain
Which assessment finding indicates to the nurse that a patient who has undergone aortic surgery is at high risk of rupture at the suture lines?
Increased blood pressure
The nurse assesses an absence of bowel sounds in a patient who underwent aortic surgery. The patient reports severe abdominal pain. What the priority nursing action?
Preparing the patient for reoperation
A small (4.5 cm) abdominal aortic aneurysm (AAA) has been detected in a patient. The nurse recognizes that which medications may be prescribed to slow the growth rate of the aneurysm? Select all that apply.
Propranolol Doxycycline
The nurse is caring for a patient who had insertion of a temporary lumbar drain after an endovascular dissection repair. What does the nurse explain to the patient that the benefit of the drain is?
To prevent paralysis
A patient has a blood pressure of 180/98 mm Hg after aortic aneurysm surgery. Which drug will the nurse administer to reduce hypertension in this patient? 1 Protamine 2 Bivalirudin 3 Gentamicin 4 Hydralazine
Answer: 4
A patient is admitted to the emergency department with suspected aortic dissection. The nurse suspects that the aortic arch is involved based on what assessment finding? 1 Blue toe syndrome 2 Intermittent claudication 3 Epigastric discomfort 4 Weakened carotid pulse
Answer: 4
A patient is recovering from abdominal aortic aneurysm repair. After taking the patient's vital signs, which result necessitates immediate action by the nurse? 1 Temperature 99.9º F (37.7º C) 2 Apical pulse rate 86 beats/minute 3 Respiratory rate 16 per minute 4 Blood pressure 196/100
Answer: 4
The nurse is assessing a patient with patchy mottling of the feet and toes. The nurse recognizes that the assessment finding may be indicative of what? 1 Nephrotic syndrome 2 Deep vein thrombosis 3 Peripheral artery disease 4 Abdominal aortic aneurysm
Answer: 4
The nurse expects which postoperative findings in a patient who underwent an aortic surgery and experienced a disrupted blood supply to the bowel during the surgery? Select all that apply. 1 Pallor 2 Diaphoresis 3 Bloody stools 4 Abdominal distention 5 Absence of bowel sounds
Answer:3,4,5
A patient is diagnosed with coronary artery disease (CAD), which increases the patient's risk of developing several medical conditions. The nurse recognizes that it essential to provide the patient with education about which condition that requires immediate emergency treatment?
Aortic aneurysm
The nurse provides education to a nursing student about postoperative interventions for a patient who has undergone an aortic aneurysm surgery. Which statement made by the student indicates the need for further teaching?
"I should keep an indwelling urinary catheter in place until the patient is discharged."
The nurse provides discharge instructions to a patient who underwent an abdominal aortic aneurysm repair. Which statement made by the patient indicates understanding of the teaching?
"I will immediately report if the pain or drainage from incisions increase."
The nurse provides preoperative instructions to a patient who is scheduled for surgery to repair an abdominal aortic aneurysm. The patient has a history of cardiovascular disease. Which patient statement indicates the need for further teaching?
"I will not be allowed to take any medications the day of surgery."
The nurse provides postoperative care to a patient who has undergone an endovascular graft procedure. The nurse identifies that which condition may result in graft thrombosis? 1 Diaphoresis 2 Periumbilical pain 3 Prolonged low blood pressure 4 Elevated white blood cell count
Answer: 3
The nurse assesses a patient with diaphoresis, weakness, periumbilical pain, pallor, and a pulsating abdominal mass. The patient's heart rate is 120 beats/minute and blood pressure is 90/60 mm Hg. What does the nurse suspect is occurring with this patient? 1 Aneurysm rupture 2 Marfan's syndrome 3 Metoprolol adverse effects 4 Superficial vein thrombosis
Answer: 1
The nurse is caring for a group of patients and identifies that which patient is at greatest risk for developing acute kidney injury (AKI)? 1 A patient who underwent abdominal aortic aneurysm repair 2 A patient who is receiving long-term treatment with heparin 3 A patient who is receiving nadroparin therapy as well as aspirin 4 A patient who is receiving anticoagulant therapy and eating broccoli frequently
Answer: 1
A patient with a history of cardiovascular disease is scheduled for an aortic aneurysm repair surgery. Which interventions should be included on the patient's plan of care to prevent complications during surgery? Select all that apply. 1 Administer a laxative to the patient the day before surgery. 2 Administer clopidogrel to the patient 1 day before surgery. 3 Administer intravenous antibiotic 1 week before surgery. 4 Perform skin cleansing with an antimicrobial agent the day before surgery. 5 Instruct the patient not to eat or drink after midnight on the day of surgery
Answer: 1,4,5
An abdominal x-ray report of an obese patient indicates a pulsatile mass in the periumbilical area. Further tests confirm a diagnosis of abdominal aortic aneurysm (AAA). The nurse recognizes that aneurysms in the early phase are often difficult to diagnose for what reasons? Select all that apply. 1 AAAs are often asymptomatic. 2 AAAs often go undetected during routine examinations. 3 AAAs can only be diagnosed by specialized equipment. 4 AAAs may mimic the symptoms of other diseases. 5 Physical findings related to AAAs may be more difficult to detect in obese individuals.
Answer: 1,4,5
A patient is diagnosed with coronary artery disease (CAD), which increases the patient's risk of developing several medical conditions. The nurse recognizes that it essential to provide the patient with education about which condition that requires immediate emergency treatment? 1 Osteoporosis 2 Aortic aneurysm 3 Erectile dysfunction 4 Human immunodeficiency virus (HIV) infection
Answer: 2
A patient is hospitalized with a suspected abdominal aortic aneurysm. Which test is used to map the entire aortic system? 1 X-ray study 2 Angiography 3 Ultrasound study 4 Electrocardiogram
Answer: 2
The nurse is caring for a male patient after aortic surgery. The nurse should instruct the patient to report which common complication that is associated with this type of surgery? 1 Osteoporosis 2 Sexual dysfunction 3 Raynaud's phenomenon 4 Peripheral artery disease
Answer: 2
The nurse is caring for a patient who had insertion of a temporary lumbar drain after an endovascular dissection repair. What does the nurse explain to the patient that the benefit of the drain is? 1 To reduce pain 2 To prevent paralysis 3 To prevent infection 4 To stimulate angiogenesis
Answer: 2
Which nursing action is beneficial for a patient who underwent an abdominal aortic aneurysm repair and develops endoleak? 1 Administering furosemide to the patient 2 Preparing the patient for coil embolization 3 Instructing the patient to avoid spinach in the diet 4 Instructing the patient to avoiding aspirin-containing drugs
Answer: 2
The nurse reviews the history of a patient with aortic dissection and identifies what risk factors? Select all that apply. 1 Amyotrophic lateral sclerosis (ALS) 2 Marfan's syndrome 3 Male gender 4 Poorly controlled hypertension 5 Cocaine use 6 Long-term use of nonsteroidal antiinflammatory drugs (NSAIDs)
Answer: 2,3,4,5
A patient is scheduled for a chest x-ray to determine the cause of a deep, diffuse chest pain extending to the interscapular area. The patient asks the nurse why the test is being performed. How should the nurse respond? 1 "It will map the entire aortic system." 2 "It can help us rule out myocardial infarction." 3 "It can reveal abnormal widening of the thoracic aorta." 4 "It is used to determine the length and cross-sectional diameter of an aneurysm." 00:00:01 Question Answer Confidence ButtonsJust a guessPretty sureNailed it
Answer: 3
A patient who underwent abdominal aortic aneurysm repair is found to have seepage of blood back into the old aneurysm. What reason does the nurse suspect for this finding? 1 Hyperhomocysteinemia 2 Phlegmasia cerulea dolens 3 Inadequate seal at graft end 4 Intake of vitamin K-rich food
Answer: 3