Page 1 of 369
AACN CSC (CARDIAC SURGERY
CERTIFICATION) EXAM QUESTION BANK |
FREQUENTLY TESTED QUESTIONS WITH
CORRECT ANSWERS | BRAND NEW!
Following a post-CABG, a chest x-ray was performed. Several
hours later the nurse notes the mediastinal chest tube drainage
system has become disconnected from the suction. Assessment
reveals the lung fields are diminished with the left greater than
right and a small area of subcutaneous emphysema can be
palpated at the chest tube insertion site. The SPO2 is 98% on 3L
NC, and the patient does not appear to be in distress. After
reconnecting the suction tubing, which of the following
interventions is BEST?
A) Place the patient on BiPAP.
B) Notify the provider immediately.
C) Obtain ABGs.
D) Obtain a repeat chest x-ray. - ✔✔✔ Correct Answer > D) A chest x-
ray can be used to diagnose pneumomediastinum. The condition
is usually self-limiting and resolves on its own.
Treatment is focused on symptom management.
,Page 2 of 369
A patient is admitted to the unit following a mitral valve repair.
The patient has a history of stroke without deficits and remains
intubated. The patient is awake, visibly anxious, and attempting to
write. The nurse knows the MOST appropriate pain scale is
A) FACES.
B) unable to assess due to intubation.
c) Numeric Rating Scale (NRS)
D) Critical-Care Pain Observation Tool (COT). - ✔✔✔ Correct Answer >
D) Utilization of a behavioral observation pain assessment tool
may be necessary based on the patient's condition. The
Behavioral Pain Scale and the Critical-Care Pain Observation
Tool (CPOT) are valid and reliable tools that measure the
presence or
absence of pain. Observational behaviors include facial
expressions, body movements, ease of breathing, vocalization,
and muscle tension. Healthcare providers must not assume
nonverbal patients are not in pain. FACES was developed
originally for use in children. NRS requires patients to be able to
verbalize pain levels. Pain is a unique, subjective, and
individualized experience. The American Society for Pain
Management Nursing recommends the use of a hierarchical
approach for pain
assessment.
Which patient would have the highest risk for the development of
postoperative myocardial stunning?
,Page 3 of 369
A) transcatheter aortic valve replacement
B) open repair of a thoracic aorta aneurysm
C) CABG with cardiopulmonary bypass
D) CABG without cardiopulmonary bypass - ✔✔✔ Correct Answer > C)
CABG with CPB. Myocardial stunning is a period of impaired
contractility following temporary ischemia, in which the
dysfunction persists despite the return of blood flow. Myocardial
stunning may occur after cardiopulmonary bypass, and
postoperative cardiac dysfunction (i.e., decreased ventricular
function) is often attributed to its effects. Myocardial hibernation
is considered a compensatory or protective mechanism to
safeguard the capacity and integrity of the myocardium during
times of decreased blood flow.
The nurse caring for a patient post-CABG and notes increased
dyspnea.
Auscultation of the lung fields reveals crackles with diminished
bilateral bases.
Density is seen on the chest x-ray. Data are:
BP 100/53
HR 117
RR 33
T 99.9 degrees F (37.7 degrees C)
SpO2 89% on 2L nasal cannula
, Page 4 of 369
Which INITIAL intervention should the nurse perform?
A) obtain ABGs
B) prepare for intubation
c) incentive spirometry
D) increase FiO2 - ✔✔✔ Correct Answer > C) Perfusion of blood past
under ventilated alveoli decreases the availability of oxygen for
gas exchange, leading to poorly oxygenated blood in the
pulmonary vasculature, Deep breathing and the use of incentive
spirometry are encouraged regularly.
These activities both help promote lung re-expansion of
collapsed lung tissue and prevent atelectasis.
A patient is admitted from the OR following an aortic valve
replacement and
CABG X 3. Data on admission to one hour later shows:
BP 100/60 —> 75/50
HR 100 —> 120
CVP 6 mm Hg —> 18 mm Hg
PAP 20/8 mm Hg —> 25/18 mm Hg
CI 2.3 L/min/m2 —> 1.5 L/min/m2
Chest tube 240 mL mark —> 240 mL mark
The nurse should suspect:
AACN CSC (CARDIAC SURGERY
CERTIFICATION) EXAM QUESTION BANK |
FREQUENTLY TESTED QUESTIONS WITH
CORRECT ANSWERS | BRAND NEW!
Following a post-CABG, a chest x-ray was performed. Several
hours later the nurse notes the mediastinal chest tube drainage
system has become disconnected from the suction. Assessment
reveals the lung fields are diminished with the left greater than
right and a small area of subcutaneous emphysema can be
palpated at the chest tube insertion site. The SPO2 is 98% on 3L
NC, and the patient does not appear to be in distress. After
reconnecting the suction tubing, which of the following
interventions is BEST?
A) Place the patient on BiPAP.
B) Notify the provider immediately.
C) Obtain ABGs.
D) Obtain a repeat chest x-ray. - ✔✔✔ Correct Answer > D) A chest x-
ray can be used to diagnose pneumomediastinum. The condition
is usually self-limiting and resolves on its own.
Treatment is focused on symptom management.
,Page 2 of 369
A patient is admitted to the unit following a mitral valve repair.
The patient has a history of stroke without deficits and remains
intubated. The patient is awake, visibly anxious, and attempting to
write. The nurse knows the MOST appropriate pain scale is
A) FACES.
B) unable to assess due to intubation.
c) Numeric Rating Scale (NRS)
D) Critical-Care Pain Observation Tool (COT). - ✔✔✔ Correct Answer >
D) Utilization of a behavioral observation pain assessment tool
may be necessary based on the patient's condition. The
Behavioral Pain Scale and the Critical-Care Pain Observation
Tool (CPOT) are valid and reliable tools that measure the
presence or
absence of pain. Observational behaviors include facial
expressions, body movements, ease of breathing, vocalization,
and muscle tension. Healthcare providers must not assume
nonverbal patients are not in pain. FACES was developed
originally for use in children. NRS requires patients to be able to
verbalize pain levels. Pain is a unique, subjective, and
individualized experience. The American Society for Pain
Management Nursing recommends the use of a hierarchical
approach for pain
assessment.
Which patient would have the highest risk for the development of
postoperative myocardial stunning?
,Page 3 of 369
A) transcatheter aortic valve replacement
B) open repair of a thoracic aorta aneurysm
C) CABG with cardiopulmonary bypass
D) CABG without cardiopulmonary bypass - ✔✔✔ Correct Answer > C)
CABG with CPB. Myocardial stunning is a period of impaired
contractility following temporary ischemia, in which the
dysfunction persists despite the return of blood flow. Myocardial
stunning may occur after cardiopulmonary bypass, and
postoperative cardiac dysfunction (i.e., decreased ventricular
function) is often attributed to its effects. Myocardial hibernation
is considered a compensatory or protective mechanism to
safeguard the capacity and integrity of the myocardium during
times of decreased blood flow.
The nurse caring for a patient post-CABG and notes increased
dyspnea.
Auscultation of the lung fields reveals crackles with diminished
bilateral bases.
Density is seen on the chest x-ray. Data are:
BP 100/53
HR 117
RR 33
T 99.9 degrees F (37.7 degrees C)
SpO2 89% on 2L nasal cannula
, Page 4 of 369
Which INITIAL intervention should the nurse perform?
A) obtain ABGs
B) prepare for intubation
c) incentive spirometry
D) increase FiO2 - ✔✔✔ Correct Answer > C) Perfusion of blood past
under ventilated alveoli decreases the availability of oxygen for
gas exchange, leading to poorly oxygenated blood in the
pulmonary vasculature, Deep breathing and the use of incentive
spirometry are encouraged regularly.
These activities both help promote lung re-expansion of
collapsed lung tissue and prevent atelectasis.
A patient is admitted from the OR following an aortic valve
replacement and
CABG X 3. Data on admission to one hour later shows:
BP 100/60 —> 75/50
HR 100 —> 120
CVP 6 mm Hg —> 18 mm Hg
PAP 20/8 mm Hg —> 25/18 mm Hg
CI 2.3 L/min/m2 —> 1.5 L/min/m2
Chest tube 240 mL mark —> 240 mL mark
The nurse should suspect:
