Which common postoperative dysrhythmia should the nurse monitor for in a patient who has undergone open chest surgery for coronary artery bypass grafting?

Second degree heart block

Atrial fibrillation or flutter

Premature junctional contractions

Ventricular ectopy

Answer and Explanation

The Correct Answer is B

Rationale:

A. Second degree heart block is incorrect because this type of heart block is less common after coronary artery bypass grafting (CABG). While conduction disturbances can occur, they are not the most frequent dysrhythmias in the postoperative period.

B. Atrial fibrillation or flutter is correct because AF or atrial flutter is the most common postoperative dysrhythmia after open-heart surgery, particularly CABG. Factors such as atrial inflammation, electrolyte imbalances, increased sympathetic activity, and fluid shifts contribute to the development of atrial arrhythmias. These can occur within the first few days postoperatively and require monitoring due to the risk of hemodynamic instability and thromboembolism.

C. Premature junctional contractions are incorrect because these are less frequent and generally less clinically significant in the postoperative CABG population. They may occur but do not represent the most common dysrhythmia.

D. Ventricular ectopy is incorrect because although PVCs or other ventricular arrhythmias may appear after surgery, they are not as common as atrial fibrillation or flutter. Ventricular arrhythmias are more concerning if sustained but occur less frequently post-CABG.

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Free Nursing Study Resources

Correct Answer is D

Explanation

Rationale:

A. Confusion & bradycardia is incorrect. Confusion can occur in thyroid storm due to severe hypermetabolism affecting the CNS, but bradycardia is not consistent with the condition. Thyroid storm typically causes tachycardia or arrhythmias, not a slow heart rate.

B. Bradycardia & fever is incorrect. Fever is a key feature of thyroid storm, often greater than 101°F (38.3°C). However, bradycardia is opposite the expected hyperdynamic response. Patients usually have rapid heart rates, palpitations, and potential cardiovascular instability.

C. Tachycardia & weight gain is incorrect. Tachycardia is correct; patients with thyroid storm are hypermetabolic and frequently present with rapid heart rates. Weight gain is incorrect because hyperthyroidism increases metabolism, leading to weight loss even if appetite is increased.

D. Fever & tremors is correct. Both fever and tremors are classic signs of thyroid storm, reflecting hypermetabolism and sympathetic nervous system overactivity. Other associated signs include tachycardia, agitation, diaphoresis, confusion, and gastrointestinal symptoms. Early recognition is critical because thyroid storm is a life-threatening emergency requiring antithyroid therapy, beta-blockers, and supportive care.

A. Rupture of a bleb B. Lung abscess C. Central line placement D. Dyspnea E. Trauma

Correct Answer is ["A","C","E"]

Explanation

Rationale:
A. Rupture of a bleb is correct because spontaneous pneumothorax often occurs when a subpleural bleb ruptures, allowing air to escape into the pleural space and causing lung collapse. This is commonly seen in young, tall, thin individuals or patients with underlying lung disease.

B. Lung abscess is incorrect because a lung abscess is a localized infection with pus formation within lung tissue. While it causes inflammation and destruction of lung parenchyma, it does not typically introduce air into the pleural space unless it ruptures, which is uncommon and not considered a primary cause of pneumothorax.

C. Central line placement is correct because iatrogenic pneumothorax can occur during procedures such as subclavian or internal jugular central venous catheter insertion if the pleura or lung is accidentally punctured.

D. Dyspnea is incorrect because dyspnea is a symptom, not a cause. It commonly occurs as a result of pneumothorax but does not cause one.

E. Trauma is correct because blunt or penetrating chest trauma (such as rib fractures or stab wounds) can allow air to enter the pleural space, leading to a traumatic pneumothorax.

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Which common postoperative dysrhythmia should the nurse monitor for in a patient who has undergone open chest surgery for coronary artery bypass grafting?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient has been diagnosed with hyperthyroidism. The nurse should observe for which signs and symptoms indicative of a thyroid storm?

Correct Answer is D

Explanation

A pneumothorax can be caused by which of the following? (Select all that apply.)

Correct Answer is ["A","C","E"]

Explanation

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