Ch. 17: Preoperative Nursing Management
For the client who is taking aspirin, it is important to stop taking this medication at least how many day(s) before surgery? A) 7 B) 1 C) 3 D) 5
Ans: 7
Which nutrient plays an important role in normal blood clotting? A) Vitamin C B) Zinc C) Protein D) Vitamin K
Ans: D
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? Ensure that sufficient surgical supplies are available. Check that all surgical personnel are properly attired. Review the scheduled procedure, site, and client. Confirm that informed consent has been obtained.
Review the scheduled procedure, site, and client.
Sudden withdrawal of which of the following may result in seizures? Tranquilizers Steroids Monoamine-oxidase inhibitors Thiazide diuretics
Tranquilizers
A nurse is assessing a postoperative client with hyperglycemic blood glucose levels. Which post-surgical risk factor would decrease if the surgical client maintained strict blood glycemic control? nutrient deficiencies respiratory complications wound healing liver dysfunction
wound healing
A client is having surgery through an ambulatory surgical center. Which information will the nurse provide to the client's family? "Be prepared to take the client home as soon as the surgery is over." "The client will go to the postanesthesia care unit after the surgery." "You can go home and I will call you in a day or two when the client can be discharged." "I will give you the name of the hospital that the client will be transferred to after the surgery."
"The client will go to the postanesthesia care unit after the surgery."
The nurse has provided preoperative instructions to a client scheduled for surgery at an ambulatory care center. Which statement, made by the client, would indicate that further instruction is needed? "If I do not follow the instructions, my surgery could be cancelled." "The nurse will explain the details of the surgery before I sign a consent." "My medical records will be sent to the ambulatory care center prior to my surgery." "The physician will update my family after the procedure and provide specific discharge instructions."
"The nurse will explain the details of the surgery before I sign a consent." This is the physician's job, not the nurses
For the client who is taking aspirin, it is important to stop taking this medication at least how many day(s) before surgery? 1 3 5 7
7 Aspirin causes excessive bleeding
A client refuses to remove her wedding band when preparing for surgery. What is the best action for the nurse to take? Discuss the risk for infection caused by wearing the ring. Allow the client to wear the ring and cover it with tape. Notify the surgeon to cancel surgery. Remove the ring once the client is sedated.
Allow the client to wear the ring and cover it with tape.
A client is scheduled for elective surgery. To prevent the complications of hypotension and cardiovascular collapse, the nurse should report the use of which medication? A) Prednisone B) Erythromycin C) Hydrochlorothiazide D) Warfarin
Ans: A
A client with a skull fracture after falling from a ladder requires surgery. The nurse should anticipate transporting the client to surgery during what time frame? A) Immediately B) In a day C) In 48-72 hours D) In 1 week
Ans: A
The patient of a 16 yr. old client asks the nurse, "How could the surgeron operate without my consent?" What is the best response by the nurse? A) "Your child had life-threatening that required immediate surgery" B) "2 doctors decided your child needed the surgery, therefore we did not need to get consent" C) "We obtained consent from your child after your chiild requested the surgery" D) "The surgical procedure being performed does not require consent"
Ans: A
Which health care professional has the ultimate responsibility to provide appropriate information regarding a nonemergent surgery? A) Physician B) Case Manager C) Certified nurse's aide D) Nurse
Ans: A
When a client with a history of chronic alcoholism is admitted to the hospital for surgery, the nurse anticipates that the client may show signs of alcohol withdrawl delirium during which time period? A) Immediately upon admission B) Up to 72 rs. after alcohol withdrawal C) Up to 24 hours after alcohol withdrawal D) Upon awakening in the postanesthesia care unit
Ans: B
When the indication for surgery is without delay, the nurse recognizes that the surgery will be classified as A) Urgent B) Emergency C) Required D) Elective
Ans: B
Which would be considered to require an urgent surgical procedure? A) Cataract B) Acute gallbladder infection C) Severe bleeding D) Loose facial skin
Ans: B
An anxious client being prepared for surgery is encouraged to concentrate on a pleasant experience or restful scene. What cognitive coping strategy would the nurse document as being used? A) Distraction B) Optimistic self-recitaiton C) Imagery D) Progressive muscular relaxation
Ans: C
The nurse is educating clients who require surgery for various aliments about the perioperative experience. What education provided by the nurse is most appropriate? A) Expected pain levels and narcotic medications used to treat the pain B) Intraoperative techniques used to perform the surgery C) 3 phases of surgery and safety measures for each phase D) Risks and benefits of the surgical procedures
Ans: C
The nurse would identify which vitamin deficiency to prevent hemorrhaging during surgery? A) Magnesium B) Vitamin A C) Vitamin K D) Zinc
Ans: C
When a client states, "I know all will go well," what cognitive coping strategy is the client using? A) Distraction B) Imagery C) Optimistic self-recitation D) Music Therapy
Ans: C
A client is schduled for an invasive procedure. What should the nurse documaent in the chart regarding the procedure? A) A report for the dietician B) A signed consent form from the client/s family C) A detailed urinalysis report D) A signed consent form from the client
Ans: D
A fractured skull would be classified. under which category of surgery based on urgency? A) Elective B) Urgent C) Required D) Emergent
Ans: D
Clients who have received corticosteroids preoperatively are at risk for which type of insufficiency? A) Thyroid B) Pituitary C) Parathyroid D) Adrenal
Ans: D
In which instance may a surgeon operate without informed consent? A) Invasive procedures B) Radiologic procedures C) Procedures requiring sedation D) Emergency situations
Ans: D
Regarding the surgical client, which phase refers to the period of time that spans the entire surgical experience? A) Intraroperative B) Postoperative C) Preoperative D) Perioperative
Ans: D
What is the major purpose of withholding food and fluid before surgery? A) Prevent overhydration B) Decrease risk of constipation C) Decrease urine output D) Prevent aspiration
Ans: D
When a client is encouraged to concentrate on a pleasant experience or restful scene, the client is using the cognitive coping strategy called A) Progressive muscular relaxation B) Distraction C) Optimistic self-recitation D) Imagery
Ans: D
Which domain of preoperative nursing practice focuses on clinical processes and outcomes? A) Physiological responses B) Behavioral responses C) Safety D) Health care systems
Ans: D
Which is the least important issue concerning safety for the perioperative team before proceeding to the operating room? A) Surgical site B) Client identification C) Surgical procedure D) Client's ambulatory aids
Ans: D
A client has been transported to the operating room for emergent surgery. Which statement by the nurse best supports the need for emergent surgery? A) " The client had severe pain and laceration to the face with minimal bleeding after being attacked by a dog 1 hour ago" B) "The client was unresponsive had distended abdomen and had unstable vital signs after an MVA" C) "The client had epigastric abdominal pain, an elevated white blood count, and vomiting for 1 day" D) "The client was tachycardiac, had progressive weight loss, and experienced bouts of insomnia as a result of hyperthyroidism"
Ans:B
A client with osteoarthritis receives a recommendation to have joint replacement surgery. For which type of surgery will the nurse plan teaching for this client? Urgent Elective Required Emergent
Elective The client SHOULD get it, but it wont be catastrophic if they dont
A fractured skull would be classified under which category of surgery based on urgency? Elective Required Urgent Emergent
Emergent
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. Explanation of procedure Estimated time of procedure Potential risks Benefits of surgery Personnel present Description of alternatives
Explanation of procedure Potential risks Benefits of surgery Description of alternatives
Which health care profession has the ultimate responsibility to provide appropriate information regarding a nonemergent surgery? Nurse Physician Case manager Certified nurse's aide
Physician The physician is the one performing the surgery!
A nurse is witnessing a client sign the consent form for surgery. After signing the consent form, the client starts asking questions regarding the risks and benefits of a surgical procedure. What action by the nurse is most appropriate? Answer the client's questions. Request that the surgeon come and answer the questions. Place the consent form in the client's medical record. Notify the nurse manager of the client's questions.
Request that the surgeon come and answer the questions. The nurse is not the one performing the surgery!! The surgeon knows the surgery best!
A client 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. Pain medication should be taken before completing deep breathing and coughing exercises. Deep breathing and coughing exercises should be completed every 8 hours. Deep breathing and coughing exercises may be used as relaxation techniques.
Splint the incision site using a pillow during deep breathing and coughing exercises.
A nurse is teaching a client about diaphragmatic breathing. What client action indicates that further teaching is needed? The client places the hands on the lower chest to feel the rise and fall with breathing. The client performs diaphragmatic breathing in a semi-Fowler's position. The client exhales forcefully with a short expiration. The client breathes in deeply through the nose and mouth.
The client exhales forcefully with a short expiration.
A 17-year-old client is having same-day surgery. Solely during the intraoperative phase of perioperative care, the nurse: continuously monitors the sedated client. performs a complete assessment of the client. obtains a surgical consent from the client's mother. assesses how well the client is recovering from anesthesia.
continuously monitors the sedated client.
A perioperative nurse is assigned to complete a preoperative assessment on a client who is scheduled for surgery for kidney stones the next day. What category of surgery does this procedure fall into? emergent urgent required elective
urgent
