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CSC Study Questions with Correct Answers 100% Pass

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CSC Study Questions with Correct Answers 100% Pass 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....

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CSC Study Questions with Correct

Answers 100% Pass

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,

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,Copyright © KAYLIN 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH NOVEMBER, 2024

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

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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 of β-blockers (D) were present, the complete heart block would

have been the underlying rhythm preoperatively.

A postoperative coronary artery bypass graft and aortic valve replacement patient has been in a normal

sinus rhythm for 4 hours. The monitor is now showing P waves at a rate of 73 beats per minute with no

ventricular response. The best action would be to

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a. Administer atropine 0.5 mg intravenous bolus (IV push)

b. Connect transcutaneous pacing pads to patient

c. Connect epicardial pacing wires to a temporary pacemaker

d. Administer epinephrine 1 mg IV push and start epinephrine infusion - ANSWER✔✔-C

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. Pacing is needed to treat the conduction defect caused by the surgery. Atropine (A) and

epinephrine (D) will not work because the conduction problem is with the AV node and/or the bundle of

His. Transcutaneous (external) pacing (B) would be the next best option if epicardial wires were not

present. The heart rate should be greater than 45/min and less than 80/min.

One hour after extubation, a diabetic coronary artery bypass surgery patient is becoming slightly

lethargic. Arterial blood gas (ABG) analysis yielded the following results: pH, 7.33; PaO2, 80 mm Hg;

PaCO2, 50 mm Hg; SaO2, 95%; HCO3, 28 mEq/L; base excess, 0.5. The nurse should first

a. Obtain a blood glucose level

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