Ch. 17
The nurse concludes that teaching about pain management was effective when the client states:
"I will support my incision with my hands when I do my coughing and deep breathing exercises."
A patient with a history of alcoholism and scheduled for an urgent surgery asks the nurse, "Why is everyone so concerned about how much I drink?" What is the best response by the nurse?
"It is important for us to know how much and how often you drink to help prevent surgical complications."
Which nursing statement would best decrease a client's anxiety before an emergency operative procedure?
"Let me explain to you w8hat will happen next."
You are the nurse working in an ambulatory surgery center. A teenage son of your clients ask you why so many people have surgery. What would be your best reply?
"Many people have diagnostic or short therapeutic surgical procedures."
What is the best response by the nurse when the patient states, "I'm so nervous about my surgery"?
"Would you like to discuss the concerns that you have?"
A parent of a 16-year-old patient asks the nurse, "How could the surgeon operate without my consent?" What is the best response given by the nurse?
"Your child had life-threatening injuries that required immediate surgery."
For the patient who is taking aspirin, it is important to stop taking this medication at least how many day(s) prior to surgery?
7
What is the blood glucose level goal for a diabetic patient who will be having a surgical procedure?
80 to 110 mg/dL
The nurse expects informed consent to be obtained for insertion of:
A gastrostomy tube
The nurse is triaging the surgical patients. Which patient would the nurse document as urgent for surgical care?
A patient with an acute gallbladder infection
The on-call perioperative team is called for an urgent surgery to be performed as soon as they arrive. What surgical procedure is considered emergent?
A repair of multiple stab wounds
Patients who have received corticosteroids preoperatively are at risk for which type of insufficiency?
Adrenal
A patient preparing for a surgical procedure is taking corticosteroids for Crohn's disease. What should the patient be monitored for?
Adrenal insufficiency
A patient refuses to remove her wedding band when preparing for surgery. What is the best action for the nurse to take?
Allow the ring to stay on the patient and cover it with tape
A patient is scheduled for a surgical procedure. For which surgical procedure should the nurse prepare an informed consent form for the surgeon to sign?
An open reduction of a fracture
You are caring for a client preoperatively who is very anxious and fearful about their surgery. You know that this client's anxiety can cause problems with the surgical experience. What type of problems can this client have because of their anxiety and fear?
Anxious clients have a poor response to surgery and are prone to complications
The nurse is reviewing a preoperative informed consent when preparing the client for surgery. Which contents of the informed consent are required? Select all that apply.
Benefits of surgery Explanation of procedure Description of alternatives Potential risks
The nurse is evaluating the client's understanding of diet teaching aimed at promoting wound healing following surgery. The nurse would conclude teaching was ineffective if the client selects which of the following?
Cheeseburger, french fries, coleslaw, and ice cream
The nurse recognizes that the client most at risk for mortality associated with surgery is the:
Client with chronic alcoholism
The potential effects of prior medication therapy must be evaluated before surgery. Which of the following drug classifications may cause respiratory depression from an associated electrolyte imbalance during anesthesia?
Diuretics
At which time does the nurse realize that it is best to begin teaching about care needed during the postoperative period?
During the preoperative period
What action by the nurse best encompasses the preoperative phase?
Educating the patients on signs and symptoms of infection
A fractured skull would be classified under which category of surgery based on urgency?
Emergent
Informed consent from the surgical client is essential in all of the following categories of surgery except:
Emergent surgery
The nurse concludes that further teaching about diaphragmatic breathing is needed when the client:
Exhales forcefully with a short expiration
The nurse is caring for a client needing emergency surgery. Which preoperative teaching should be omitted to prepare the client for surgery?
Frequency of postoperative vital signs
A client taking chlorpromazine (Thorazine) is preparing to undergo surgery. Which of the following complications does the surgical team need to prepare to deal with before anesthetics are administered?
Hypotension
During the preoperative assessment, the patient states he is allergic to avocados, bananas, and hydrocodone (Vicodin). What is the priority action by the nurse?
Notify the surgical team to remove all latex-based items
A nurse knows that she must obtain a signed informed consent for which of the following procedures? Select all that apply.
Open reduction of a fracture Paracentesis Cystoscopy Arteriography
A patient is scheduled to have a cholecystectomy. Which of the nurse's finding is least likely to contribute to surgical complications?
Osteoporosis
An intravenous anesthetic that, in large doses, has a powerful respiratory depressant effect sufficient to cause apnea and cardiovascular depression is:
Pentothal
The nurse recognizes that written informed consent is required for insertion of a(n):
Peripherally-inserted central catheter
Which health care profession has the ultimate responsibility to provide appropriate information regarding a nonemergent surgery?
Physician
The nurse is reviewing the pre-admission laboratory findings of the client scheduled for surgery. Which of the following values would be of greatest concern to the nurse?
Potassium 6.2 mEq/L
A patient is scheduled for elective surgery. To prevent the complication of hypotension and cardiovascular collapse, the nurse should report the use of what medication?
Prednisone (Deltasone)
Your client, a 2-year-old male, is scheduled to have surgery related to his cleft palate. You will be preparing this client for which type of surgery?
Reconstructive
A nurse is witnessing a patient sign the consent form for surgery. After the patient signs the consent form, the patient starts asking questions regarding the risks and benefits of a surgical procedure. What action by the nurse is most appropriate?
Request that the surgeon come and answer the questions
Once the operating team has assembled in the room, the circulating nurse calls for a "time out." What action should the nurse take during the time out?
Review the scheduled procedure, site, and client
A patient is undergoing thoracic surgery. What priority education should the nurse provide to assist in preventing respiratory complications?
Splint the incision site using a pillow during deep breathing and coughing exercises
Nursing assessment findings reveal that the client is afraid of dying during the surgical procedure. Which surgical team member would be most helpful in addressing the client's concern?
Surgeon
When does the nurse understand the patient is knowledgeable about the impending surgical procedure?
The patient participates willingly in the preoperative preparation
The nurse discovers that the client did not sign the operative consent before receiving the preoperative medication. The appropriate nursing action is:
To notify the surgeon
When a person with a history of chronic alcoholism is admitted to the hospital for surgery, the nurse anticipates that the patient may show signs of alcohol withdrawal delirium during which time period?
Up to 72 hours after alcohol withdrawal
Following diagnostic testing, a patient requires a cholecystectomy. This surgical procedure would be categorized as which of the following?
Urgent
A nurse is teaching a client with chronic bronchitis about breathing exercises. Which instruction should the nurse include in the teaching?
Use diaphragmatic breathing
Which nutrient plays an important role in normal blood clotting?
Vitamin K
At what point does the preoperative period end?
When the client is transferred onto the operating table
When assessing a postoperative client, the nurse is correct to relate which surgical risk factor that would decrease if the surgical client maintained a blood glucose level under 150 mg/dL?
Wound healing
When the indication for surgery is without delay, the nurse recognizes that the surgery will be classified as:
emergency
When the patient is encouraged to concentrate on a pleasant experience or restful scene, the cognitive coping strategy being employed by the nurse is:
imagery
A physically fit 86-year-old is scheduled for right knee replacement. What factor in this client makes them at increased risk for surgery?
Age
In preparing the client for transfer to the operating room, which of the following actions by the nurse is inappropriate?
Allow the client to wear dentures
An elderly client is preparing to undergo surgery. The nurse participates in preoperative care knowing that which of the following is the underlying principle that guides preoperative assessment, surgical care, and postoperative care for older adults?
Older adults have less physiologic reserve (or ability to regain physical equilibrium) than younger clients
A 17-year-old male client is having same-day surgery to remove a neuroma from his foot. Which of the following nursing interventions would occur during the intra operative phase of peri operative care?
The nurse continuously monitors the sedated client
A patient having a surgical procedure takes aspirin 325 mg daily for prevention of platelet aggregation. When should the patient stop taking the aspirin before the surgery?
7 to 10 days
Completing your preoperative assessment, you mentally rehearse your client's needs to determine if there is increased risk for complications intra operatively or postoperatively. Which of the following are general risk factors? Select all that apply.
Nutritional status Age Physical condition Health status
When is the ideal time to discuss preoperative teaching?
Preadmission visit
A client is scheduled for a surgical procedure. When planning the client's care, the nurse should consider that which of the following conditions will increase the client's risk of complications after surgery?
A history of diabetes
The nurse in the preoperative area has just medicated her client according to the anesthesiologist's orders. What is the nurse's priority action at this time?
Place the side rails in the up position and make sure the call button is in reach
The nurse is educating a community group regarding types of surgery. A member of the group asks the nurse to describe a type of surgery that is curative. What response by the nurse is true?
The excision of a tumor