CSC Study Comprehensive
Questions (Frequently Tested) and
Complete Solutions Graded A+
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Following surgical repair of a thoracic aneurysm with an
endoluminal graft, the patient is unable to move his lower
extremities. The nurse should first
a. Activate stroke team and prepare to do an urgent (STAT)
computed tomography (CT) scan
,b. Prepare to return to surgery for exploration of femoral artery
occlusion
c. Call surgeon to obtain a neurology consultation in the morning
d. Prepare for lumbar drain insertion to remove cerebrospinal
fluid (CSF) - Answer: D
Spinal cord ischemia is a complication from thoracic aneurysm
repair for both open and endoluminal repair. Spinal cord ischemia
results from increased cerebral spinal pressure that compresses
the spinal nerves. Untreated spinal cord ischemia can lead to
paraplegia. It is important to recognize the signs of spinal cord
ischemia (loss of lower extremity movement) promptly.
Immediate insertion of a spinal drain can reverse the spinal cord
ischemia and prevent paraplegia. Bilateral leg paralysis is not
typically an initial symptom of stroke (A). Signs of femoral artery
occlusion (B) are the 5 Ps: pulselessness, pallor, pain,
paresthesias, and paralysis. These symptoms would be unilateral,
not bilateral. Immediate insertion of a spinal drain is needed;
waiting until morning for the consultation (C) would be
inappropriate.
A postoperative patient who had undergone coronary artery
bypass graft and ventricular aneurysm repair has a 15-beat run of
,ventricular tachycardia. The most likely cause of the dysrhythmia
is
a. Irritability of the ventricle from the aneurysm repair
b. Spasm of the right coronary artery graft
c. Potassium 4.8 mEq/dL and magnesium 2.1 mEq/L
d. Did not restart administration of the angiotensinconverting
enzyme (ACE) inhibitor (taken preoperatively) - Answer: A
Patients with left ventricular aneurysm typically have depressed
left ventricular (LV) function. Depressed LV function may lead to
increased ventricular arrhythmias. LV aneurysm repair is indicated
to improve symptoms of angina, heart failure, systemic
thromboembolism, or malignant arrhythmias. In the immediate
postoperative phase, the repaired ventricle continues to be
depressed and has the added trauma of surgery on the left
ventricle. Both of these increase the irritability of the LV, leading
to ventricular arrhythmias. Spasm (B) or occlusion of the RCA
leads to bradyarrhythmias, not ventricular arrhythmias. The
potassium and magnesium levels in (C) are normal. Low
potassium and magnesium levels increase the risk for ventricular
, arrhythmias. ACE inhibitors (D) do not have any antiarrhythmic
effect.
The nurse admits a patient after aortic valve replacement and
notes the following settings of the temporary pacemaker: DDD
rate, 80/min; atrial MA, 10; ventricular MA, 4. The underlying
rhythm is complete heart block with ventricular escape rhythm
rate 30/min. The most likely cause of the complete heart block is
a. Spasm of the right coronary artery (RCA) graft
b. Damage of the atrioventricular (AV) node during repair of the
aortic valve
c. Low potassium and magnesium levels
d. Toxic effects of β-blocker - Answer: B
The AV node and the bundle of His are near the aortic valve.
During aortic valve replacement, hemorrhage, edema, suturing, or
debridement near the AV node and the bundle of His may cause
heart blocks. Typically the epicardial pacing is only needed for a
few days until the edema resolves. If complete heart block
persists after a few days, a permanent pacemaker may be
required. The RCA supplies oxygen to the sinoatrial (SA) and AV
nodes and spasm of the RCA graft (A) may cause bradycardia
and/or heart blocks. This patient did not have bypass surgery, so
RCA spasm would not be a postoperative complication. Low
potassium and magnesium levels (C) increase the risk for
ventricular arrhythmias, not AV conduction defects. If toxic effects
Questions (Frequently Tested) and
Complete Solutions Graded A+
Professional Academic Assistance Services
Services Offered
• Proctored Exam Assistance
• Online Class Management (Full Course Support)
• Exam Preparation & Study Materials
• Assignments and Coursework Support
• Essay and Research Paper Writing
• Discussion Posts & Responses
• Editing and Proofreading
• Confidential Academic Consultation
Contact Information
Email:
WhatsApp link: https://wa.me/254704846336
Fast Response | Confidential | Reliable Academic Support
Helping Students Achieve Academic Excellence
Following surgical repair of a thoracic aneurysm with an
endoluminal graft, the patient is unable to move his lower
extremities. The nurse should first
a. Activate stroke team and prepare to do an urgent (STAT)
computed tomography (CT) scan
,b. Prepare to return to surgery for exploration of femoral artery
occlusion
c. Call surgeon to obtain a neurology consultation in the morning
d. Prepare for lumbar drain insertion to remove cerebrospinal
fluid (CSF) - Answer: D
Spinal cord ischemia is a complication from thoracic aneurysm
repair for both open and endoluminal repair. Spinal cord ischemia
results from increased cerebral spinal pressure that compresses
the spinal nerves. Untreated spinal cord ischemia can lead to
paraplegia. It is important to recognize the signs of spinal cord
ischemia (loss of lower extremity movement) promptly.
Immediate insertion of a spinal drain can reverse the spinal cord
ischemia and prevent paraplegia. Bilateral leg paralysis is not
typically an initial symptom of stroke (A). Signs of femoral artery
occlusion (B) are the 5 Ps: pulselessness, pallor, pain,
paresthesias, and paralysis. These symptoms would be unilateral,
not bilateral. Immediate insertion of a spinal drain is needed;
waiting until morning for the consultation (C) would be
inappropriate.
A postoperative patient who had undergone coronary artery
bypass graft and ventricular aneurysm repair has a 15-beat run of
,ventricular tachycardia. The most likely cause of the dysrhythmia
is
a. Irritability of the ventricle from the aneurysm repair
b. Spasm of the right coronary artery graft
c. Potassium 4.8 mEq/dL and magnesium 2.1 mEq/L
d. Did not restart administration of the angiotensinconverting
enzyme (ACE) inhibitor (taken preoperatively) - Answer: A
Patients with left ventricular aneurysm typically have depressed
left ventricular (LV) function. Depressed LV function may lead to
increased ventricular arrhythmias. LV aneurysm repair is indicated
to improve symptoms of angina, heart failure, systemic
thromboembolism, or malignant arrhythmias. In the immediate
postoperative phase, the repaired ventricle continues to be
depressed and has the added trauma of surgery on the left
ventricle. Both of these increase the irritability of the LV, leading
to ventricular arrhythmias. Spasm (B) or occlusion of the RCA
leads to bradyarrhythmias, not ventricular arrhythmias. The
potassium and magnesium levels in (C) are normal. Low
potassium and magnesium levels increase the risk for ventricular
, arrhythmias. ACE inhibitors (D) do not have any antiarrhythmic
effect.
The nurse admits a patient after aortic valve replacement and
notes the following settings of the temporary pacemaker: DDD
rate, 80/min; atrial MA, 10; ventricular MA, 4. The underlying
rhythm is complete heart block with ventricular escape rhythm
rate 30/min. The most likely cause of the complete heart block is
a. Spasm of the right coronary artery (RCA) graft
b. Damage of the atrioventricular (AV) node during repair of the
aortic valve
c. Low potassium and magnesium levels
d. Toxic effects of β-blocker - Answer: B
The AV node and the bundle of His are near the aortic valve.
During aortic valve replacement, hemorrhage, edema, suturing, or
debridement near the AV node and the bundle of His may cause
heart blocks. Typically the epicardial pacing is only needed for a
few days until the edema resolves. If complete heart block
persists after a few days, a permanent pacemaker may be
required. The RCA supplies oxygen to the sinoatrial (SA) and AV
nodes and spasm of the RCA graft (A) may cause bradycardia
and/or heart blocks. This patient did not have bypass surgery, so
RCA spasm would not be a postoperative complication. Low
potassium and magnesium levels (C) increase the risk for
ventricular arrhythmias, not AV conduction defects. If toxic effects
