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The nurse knows that educating the surgical client is extremely important for client safety. The nurse knows that which of the following would be the priority to educate the client on prior to surgery? "Your family will be updated while you are in surgery" "Do not eat or drink anything after midnight the night before the procedure" "You should be able to go home about 2 hours after the procedure "You might wake up after the procedure with a catheter"

"Do not eat or drink anything after midnight the night before the procedure" Prevention of aspiration is extremely important to the surgical client's safety.

The client who is about to have surgery is complaining to the nurse that the hospital is "starving me to death". Which of the following is the nurse's best response to the client? "I am sorry that you feel this way, you'll be able to eat soon" "I am so sorry you feel hungry. We ask clients not to eat or drink before surgery for safety" "I am so sorry you are so hungry, can I at least get you some crackers to hold you over?" "I am so sorry you feel this way, would you like to speak with the Director of Surgery?"

"I am so sorry you feel hungry. We ask clients not to eat or drink before surgery for safety" Being NPO before surgery is important to prevent aspiration.

A 30-year-old client is scheduled for an endometrial ablation and is concerned about "what everyone will see" during the procedure. The nurse knows that which of the following is the best response to this comment? "I understand your concern. Would you like to speak with your surgeon about this issue?" "I understand your concern. The circulating nurse will be with you and make sure your privacy is protected" "I understand your concern but certain things must be done and exposed in order for the surgeon to operate" "I understand your concern but you will be under anesthesia so you really won't care at that point"

"I understand your concern. The circulating nurse will be with you and make sure your privacy is protected" The nurse in surgery protects the privacy and dignity of the client.

An unconscious client is brought in to the emergency room and needs immediate surgery for bleeding from the chest. A staff member explains that surgery cannot be done because the client cannot consent. Which of the following is the best response by the nurse? a "Hopefully someone who knows this client will show up soon and the procedure can start" b "Consent is never a requirement in the emergency room if the client is conscious or not" c "Implied consent applies to this situation" d "I can provide the consent for the client as a registered nurse"

"Implied consent applies to this situation" If a client's life is depending on a procedure it is assumed that the client would consent if possible.

Your client is a 4-year-old scheduled for a tonsillectomy. During the preoperative assessment the mother informs the nurse that the client was eating fruit snacks on the way to the hospital. Because of this the surgery has been cancelled. The nurse knows that which of following is the best response to give the mother regarding NPO education? "It is so important for the child to have an empty stomach before surgery to prevent aspiration" "When a client has a full stomach anesthesia doesn't work as well" "If your child ate fruit snacks who knows what else was eaten" "The next time your child is scheduled for surgery, you should probably keep a closer watch by making sure she doesn't eat anything"

"It is so important for the child to have an empty stomach before surgery to prevent aspiration" This is explaining why being NPO is important.

The nurse is getting a client ready for a hysterectomy when the client asks "Will I have a tube down my throat?" The nurse knows that which of the following is the best response? "Yes, the anesthesia team will give you more information and answer other questions you may have" "It depends the type of anesthesia you are having" "I'm not a member of the anesthesia department, so I cannot answer that" "It's a necessary requirement if you want to breath during your surgery"

"Yes, the anesthesia team will give you more information and answer other questions you may have" With this response, the nurse is providing the client desired regarding anesthesia, as well as empowering the client to ask further questions when the anesthesia team is available.

The preoperative nurse assessing a client for a mass removal of the foot is reviewing allergies and the client states they are only allergic to bananas. The nurse knows that which of the following would be the most appropriate next action? Ask how serious the reaction is since banana allergies are often associated with a penicillin allergy Ask the client the reaction they have from bananas and document it Ask if they are allergic to latex, report this finding to the anesthesiologist and the OR staff Continue with the preoperative assessment, since food allergies are not significant to the surgery

Ask if they are allergic to latex, report this finding to the anesthesiologist and the OR staff There is an association between latex and foods like bananas, kiwi, and avocados. True latex allergies can be very dangerous so anesthesia should be aware. The OR staff must also be informed so no latex is used during the surgery.

An 88-year-old client from a local nursing home is having surgery for a bladder tumor. The nurse knows that which of the following are ways to assess the cognitive abilities of the client? Select all that apply Ask the client to state their name, birth date, procedure, and healthcare provider's name Confirm medical power of attorney paperwork is included in the client's chart Confirm the client's vital signs are within normal limits Ask the client if they can state what they are having done Ask the client to point to where the healthcare provider be operating

Ask the client to point to where the healthcare provider be operating Verification of the surgical site and procedure are helpful in assessing the client's cognitive abilities. Ask the client if they can state what they are having done Verification of the surgical site and procedure are helpful in assessing the client's cognitive abilities. Ask the client to state their name, birth date, procedure, and healthcare provider's name Verification of name, birth date, procedure, and healthcare provider's name is helpful in assessing the client's cognitive abilities.

The nurse knows that all of the following are goals of education for the surgical patient except which of the following? Decrease surgical complications Decrease client autonomy Decrease fear and anxiety Decrease healing time after surgery

Decrease client autonomy This is not a goal of education for a surgical client. Education increases client autonomy.

When the perioperative nurse assesses the client for surgery, the BMI is assessed as low. The nurse knows that which of the following could be a concern? Select all that apply. Issues with intubation Delayed wound healing Risk of pressure ulcers Issues with body temperature regulation An increase in surgical complications

Issues with body temperature regulation This is a concern with low BMI because there isn't enough weight on the client to provide adequate warmth. Delayed wound healing This is a concern with low BMI because the client doesn't have adequate calories to heal. Risk of pressure ulcers This is a concern with low BMI because there might be more bony prominences that will increase the risk of pressure ulcers forming with positioning. An increase in surgical complications This is a concern with low BMI because the client is not as healthy as someone with average BMI.

The preoperative nurse knows that all except which of the following are goals of assessment? Provide education to the client regarding postoperative wound care Share critical values with perioperative team members Identify risk factors to the surgery Identify client specific needs

Provide education to the client regarding postoperative wound care This is not a goal of the preoperative assessment.

The nurse is caring for a client taking furosemide for congestive heart failure. The nurse knows that the priority is to monitor which of the following? a. electrolytes b. hematocrit and hemoglobin c. LOC d. abdominal circumfrence

a. electrolytes Furosemide is a loop diuretic. Loop diuretics help the body excrete sodium, potassium and calcium along with water. A client taking this type of diuretic must have their electrolytes monitored closely to avoid electrolyte imbalances.

If the client provides informed consent the nurse knows that the client can explain all of the following regarding their procedure except which of the following? a. Risks b. Cost c. Alternative procedure d. Reason for procedure

b. Cost This is not an element that is necessary to discuss with informed consent.

The nurse is speaking with a client in the preoperative area before their scheduled cervical fusion. The client states they are planning on completing a triathlon next week. Which of the following is the best action for the nurse to take? a. Wish the client good luck on this goal for after a cervical fusion b. Review the side effects, risks, alternatives, and reason for the surgery with the client c. Coordinate a conversation with the client and the provider before surgery d. Tell the client they should postpone the surgery if they really want to do this triathlon

c. Coordinate a conversation with the client and the provider before surgery As the registered nurse, it is your responsibility to confirm that informed consent is given.

The nurse is having a conversation with the client who is scheduled to start their third round of chemotherapy. The client states "I do not want to do this, my spouse is forcing me." The nurse knows that which of the following components of informed consent is being broken? a. The provider determines if the client is able to provide informed consent b. Informed consent is always a family decision c. Informed consent must be voluntary d. Certain procedures like chemotherapy do not require informed consent

c. Informed consent must be voluntary The decision must be voluntary and in this instance, the client is stating they are being forced.

The nurse is caring for a client who is signing informed consent for a procedure. The nurse knows that the client needs to understand which of the following relating to informed consent? Select all that apply. a. Alternative treatment options b. The benefits of the procedure c. Why the procedure is being performed d. The potential consequences if the client does not get the procedure e. Privacy rights according to HIPAA

c. Why the procedure is being performed Informed consent means that the client understands the reason for the procedure, the benefits and risks of the procedure, the risks of not getting the procedure and all options/alternatives to getting the procedure. Additionally, the nurse can monitor for paternalism as the provider is obtaining informed consent, which is coercion by the provider to get the client to sign the consent. d. The potential consequences if the client does not get the procedure This is an aspect of informed consent that the client must understand. a. Alternative treatment options This is an aspect of informed consent that the client must understand. b. The benefits of the procedure This is an aspect of informed consent that the client must understand.

A nurse is assisting a provider with obtaining informed consent about a medical procedure. Which of the following best describes the nurse's role in obtaining informed consent? a. The nurse acts as a legal representative for the client to stand by if he does not understand the consent b. The nurse describes the process of the surgical procedure as well as its risks and benefits c. The nurse only acts as a witness to the client's signature d. The provider fills out the consent form and the nurse asks the client if he has any questions about the procedure

c. nurse only acts as a witness to the client's signature Informed consent means that when a client signs a consent form, he or she has been fully informed about the procedure, as well as its risks and benefits. The nurse's role in the informed consent process is to act as a witness and to ensure that the client seems to understand what the provider is saying. It is the provider's responsibility to explain the procedure and its risks to the client. **Test-taking tip: Sometimes seeing "only" as an absolute word will make you think this answer can't be right. However, in this case it is TRUE - always use your contextual knowledge as well!**

The staff in the emergency room provide care and treatment for an unconscious client who was brought in by ambulance with no family present. In this emergency situation, the law allows for implied consent, which means which of the following? a. The client would need surgery b. The client is a minor and has a legal guardian c. The client does not have the cognitive capacity to make the decision d. Assume the client would consent under normal circumstances

d. Assume the client would consent under normal circumstances Implied consent refers to a situation in which a client is unable to give consent because he or she is unconscious or is otherwise unable to verbalize the choice. Implied consent means that if a client's condition is life-threatening, providers will intervene under the assumption that he or she would normally provide consent. Caregivers are allowed to provide care for life-threatening injuries for clients through implied consent when they cannot say so.

A nurse is preparing a client for a surgical procedure. At the last minute, the nurse realizes that the client has not signed an informed consent for the procedure. Which of the following actions of the nurse is most appropriate? a. Notify the family and ask them what they would want b. Have the client sign the consent in arrears after the surgery c. Contact the house supervisor to reschedule the surgery d. Notify the provider and ask about the consent

d. Notify the provider and ask about the consent If a nurse notices that a client has not signed an informed consent prior to a procedure, the nurse is obligated to notify the provider before going ahead with the process. The nurse could be held legally responsible and charged with negligence or battery for failing to notify the healthcare provider if the nurse knew that the client did not sign consent.

A surgeon is telling a client about an upcoming surgical procedure so that the client can provide informed consent. Which of the following describes the concept of a reasonable client standard when signing informed consent? Select all that apply. a. The data is what any provider would say when explaining the procedure b. The information is general and applies to most surgical procedures c. The information that is needed to know to be able to make a decision and sign consent is provided d. The information is what a typical client would need to know to sign consent e. The data is tailored precisely to the client's needs

d. The information is what a typical client would need to know to sign consent When signing consent, a reasonable client standard describes the information that a typical and reasonable client would need to know to be able to make a decision and sign consent. c. The information that is needed to know to be able to make a decision and sign consent is provided This describes a reasonable standard for a client in order to sign consent.

The nurse is interviewing a client going to the operating room for a total hip replacement. During the interview, the client is unable to state their name or birthdate. The client takes medication for dementia. The nurse would expect which of the following when obtaining the informed consent? Select all a. The client's legal surrogate decision-maker is aware of the information related to the procedure b. The client's legal surrogate has signed their name to the written consent form c. The client signed their name to the written consent form d. The client and their surrogate decision-maker signed their names to the consent form e. The client is not considered "competent" which is necessary with informed consent

the client is not considered "competent" which is necessary with informed consent hey are not oriented to the situation and are unable to make decisions for themselves. The client's legal surrogate decision-maker is aware of the information related to the procedure They are the clent's legal decision maker. The client's legal surrogate has signed their name to the written consent form They will be receiving the information necessary to accept the procedure on behalf of the client.

A client with a high bmi would be at risk for complications in surgery involving intubation. T/F?

true.


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