Iggy Chapter 16 Post-Op
The RN has just received reports about all of these clients on the inpatient surgical unit. Which client does the nurse care for first? A. A 43-year-old who had a bowel resection 7 days ago and has new sero-sanguineous drainage on the dressing B. A 46-year-old who had a thoracotomy 5 days ago and needs discharge teaching before going home C. A 48-year-old who had bladder surgery earlier in the day and is reporting pain when coughing D. A 49-year-old who underwent repair of a dislocated shoulder this morning and has a temperature of 100.4° F (38° C)
A. A 43-year-old who had a bowel resection 7 days ago and has new sero-sanguineous drainage on the dressing
In conducting a postoperative assessment of a client, what is important for the nurse to examine first? A. Breathing pattern B. Level of consciousness C. Oxygen saturation D. Surgical site
A. Breathing pattern
A client has an acute case of opioid depression and receives a dose of naloxone (Narcan). Which statement is true about this client? A. Supplemental pain reduction is needed. B. One dose is needed. C. This is an acute emergency. D. The client will be hostile.
A. Supplemental pain reduction is needed.
Which client is at greatest risk for slow wound healing? A. A 12-year-old healthy girl B. A 47-year-old obese man with diabetes C. A 48-year-old woman who smokes D. A 98-year-old healthy man
B. A 47-year-old obese man with diabetes
Which action does the nurse implement for a client with wound evisceration? A. Apply direct pressure to the wound. B. Cover the wound with a sterile, warm, moist dressing. C. Irrigate the wound with warm, sterile saline. D. Replace tissue protruding into the opening.
B. Cover the wound with a sterile, warm, moist dressing.
An RN and an LPN/LVN are working together in caring for a client who needs all of these interventions after orthopedic surgery. Which actions would be best for the RN to accomplish? A. Reinforce the need to cough and deep-breathe every 2 to 4 hours. B. Develop the discharge teaching plan in conjunction with the client. C. Administer narcotic pain medications before assisting the client with ambulation. D. Listen for bowel sounds and monitor the abdomen for distention and pain.
B. Develop the discharge teaching plan in conjunction with the client.
The nurse assesses a client's wound 24 hours postoperatively. Which finding causes the nurse the greatest concern? A. Crusting along the incision line B. Redness and swelling around the incision C. Sanguineous drainage at the suture site D. Serosanguineous drainage on the dressing
B. Redness and swelling around the incision
After gastric surgery, a client arrives in the post-anesthesia care unit. Which nursing action is most appropriate for the RN to delegate to an experienced nursing assistant? A. Monitor respiratory rate and airway patency. B. Irrigate the NG tube with saline. C. Position the client on the left side. D. Assess the client's pain level.
C. Position the client on the left side.
Five RNs have been floated to the postanesthesia care unit for the day. A 16-year-old diabetic client has also just arrived from the operating room (OR) after having laparoscopic abdominal surgery. The charge nurse assigns the floating RN with which kind of experience to care for this new client? A. RN who usually works on the inpatient pediatric unit B. RN who provides education to diabetic clients in a clinic C. RN who has 5 years of experience in the delivery room D. RN who ordinarily works as a scrub nurse in the OR
C. RN who has 5 years of experience in the delivery room
Which assessment finding in a postoperative client after general anesthesia requires immediate intervention? A. HR of 58 beats/min B. Pale, cool extremities C. Respiratory rate of 6 breaths/minute D. Suppressed gag reflex
C. Respiratory rate of 6 breaths/minute
How does the nurse position a client with postoperative nausea and vomiting? A. Flat in bed, with the head in alignment with the body B. Prone, with the head of the bed flat C. Side-lying, with the head in a neutral position D. Supine in bed, with the neck flexed
C. Side-lying, with the head in a neutral position
A client has just undergone a surgical procedure with general anesthesia. Which finding indicates that the client needs further assessment in the post-anesthesia care unit? A. Pain at the surgical site B. Requirement for verbal stimuli to awaken C. Snoring sounds when inhaling D. Sore throat on swallowing
C. Snoring sounds when inhaling
Why is it important to wear sterile gloves during a dressing change? A. They protect the client from infection. B. They protect the nurse from infection. C. They protect both the client and the nurse from infection. D. Their use prevents lawsuits.
C. They protect both the client and the nurse from infection.
The nurse reviews with a client a routine discharge teaching plan concerning postoperative care. Which statement by the client indicates that teaching was effective? A. "I may need to restrict my activities for several months." B. "The dressing should stay in place unless it gets wet." C. "The incision needs to be cleaned every 4 hours with hydrogen peroxide." D. "The wound will completely heal in about 2 months."
D. "The wound will completely heal in about 2 months."
What pain management does a client who has been admitted to the post-anesthesia care unit typically receive? A. IM non-opioid analgesics B. IM opioid analgesics C. IV non-opioid analgesics D. IV opioid analgesics
D. IV opioid analgesics