Perioperative
The patient asks the nurse how long the local infiltration anesthetic will last. What is the nurse's best response? "The anesthetic may last for 3 hours." "The anesthetic may last for 1 hour." "The anesthetic may last for 7 hours." "The anesthetic may last for 5 hours."
"The anesthetic may last for 3 hours."
Regarding the surgical client, which phase refers to the period of time that spans the entire surgical experience? Perioperative Intraoperative Postoperative Preoperative
Perioperative
An enterostomal therapy nurse is caring for a postoperative client with a gaping wound. Which nursing measure is most helpful when a wound dressing adheres to the wound bed? Allow the dressing to dry and release the wound bed. Place an emollient based ointment on the wound bed. Use normal saline to soak the dressing for removal. Place a transparent dressing between the wound and dressing.
Use normal saline to soak the dressing for removal.
The nurse is caring for a client during the immediate postoperative period. What signs and symptoms indicate that the client may be in shock? Pooling of secretions in the lungs Warm, dry skin Obstructed airway Weak and rapid pulse rate
Weak and rapid pulse rate
The nurse is caring for a patient with liver disease who had a surgical procedure. When should the nurse alert the physician? When a lactate dehydrogenase concentration is 300 units When the patient's blood ammonia concentration reaches 180 mg/dL When a serum albumin concentration is 5.0 g/dL When a serum globulin concentration reaches 2.8 g/dL
When the patient's blood ammonia concentration reaches 180 mg/dL
A nurse is caring for a bariatric client prior to a surgical procedure. What surgical complications would the nurse monitor the bariatric client for postoperatively? Select all that apply. nervous system complications cardiovascular complications gastrointestinal complications pulmonary complications renal complications
cardiovascular complications pulmonary complications
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. assesses how well the client is recovering from anesthesia. performs a complete assessment of the client. obtains a surgical consent from the client's mother.
continuously monitors the sedated client.
A nurse evaluates the potential effects of a client's medication therapies before surgery. Which drug classification may cause respiratory depression from an associated electrolyte imbalance during anesthesia? diuretics insulin corticosteroids anticoagulants
diuretics
The nurse is performing a preoperative assessment on a client going to surgery. The client informs the nurse that he drinks approximately two bottles of wine each day and has for the last several years. What postoperative difficulties should the nurse anticipate for this client? Increased risk for postoperative complications Alcohol withdrawal syndrome upon administration of general anesthesia Increased risk for allergic reactions Nonadherence to prescribed treatment after surgery following surgery
Increased risk for postoperative complications
The nurse is providing community instruction on the impact of aging and surgical incisional considerations. Which instructional areas would be included in the presentation? Select all that apply. Instruct on symptoms of wound/incision infection. Remove any crusted areas from incisional line. Cleanse wound/incision with products such as soap and water. Increase protein in the diet. Avoid showering until healing has occurred. Wash with half-strength peroxide to prevent infection.
Instruct on symptoms of wound/incision infection. Cleanse wound/incision with products such as soap and water. Increase protein in the diet.
Which is a classic sign of hypovolemic shock? Dilute urine Bradypnea High blood pressure Pallor
Pallor
The PACU nurse is caring for an adult client who had a left lobectomy. The nurse is assessing the client frequently for airway patency and cardiovascular status. The nurse should know that the most common cardiovascular complications seen in the PACU include what? Select all that apply. Hypertension Dysrhythmias Hypotension Hypervolemia Heart murmurs
Hypotension Dysrhythmias Hypertension
One of the things a nurse has taught to a client during preoperative teaching is to have nothing by mouth for the specified time before surgery. The client asks the nurse why this is important. What is the most appropriate response for the client? "The presence of food in the stomach interferes with the absorption of anesthetic agents." "The restriction of food or fluid will prevent the development of pneumonia related to decreased lung capacity." "By withholding food for 8 hours before surgery, you will not develop constipation in the postoperative period." "You will need to have food and fluid restricted before surgery so you are not at risk for choking."
"You will need to have food and fluid restricted before surgery so you are not at risk for choking."
The home health nurse is caring for a postoperative client who was discharged home on day 2 after surgery. The nurse is performing the initial visit on the client's postoperative day 2. During the visit, the nurse will assess for wound infection. For most clients, what is the earliest postoperative day that a wound infection becomes evident? Day 7 Day 5 Day 3 Day 9
Day 5
The perioperative nurse has completed the presurgical assessment of an 82-year-old female client who is scheduled for a left total knee replacement. When planning this client's care, the nurse should address the consequences of the client's aging cardiovascular system. These include an increased risk of which of the following? Hyperkalemia Hyponatremia Hyperphosphatemia Hypervolemia
Hypervolemia
An OR nurse is teaching a nursing student about the principles of surgical asepsis as a requirement in the restricted zone of the operating suite. What personal protective equipment should the nurse wear at all times in the restricted zone of the OR? Gloves Mask covering the nose and mouth Goggles Reusable shoe covers
Mask covering the nose and mouth
The nurse is educating clients who require surgery for various ailments about the perioperative experience. What education provided by the nurse is most appropriate? Intraoperative techniques used to perform the surgery Expected pain levels and narcotic medications used to treat the pain Three phases of surgery and safety measures for each phase Risks and benefits of the surgical procedures
Three phases of surgery and safety measures for each phase
The PACU nurse is caring for a client who has arrived from the OR. During the initial assessment, the nurse observes that the client's skin has become blue and dusky. The nurse looks, listens, and feels for breathing, and determines the client is not breathing. What is the priority intervention? Treat the possible airway obstruction by tilting the head back and pushing forward on the angle of the lower jaw. Check the client's oxygen saturation level, continue to monitor for apnea, and perform a focused assessment. Reintubate the client. Assess the arterial pulses, and place the client in the Trendelenburg position.
Treat the possible airway obstruction by tilting the head back and pushing forward on the angle of the lower jaw.
A nurse in the preoperative holding area is admitting a woman prior to reduction mammoplasty. What should the nurse include in the care given to this client? Select all that apply. Applying a grounding device to the client Verifying the surgical site with the client Taking measures to ensure the client's comfort Establishing an IV line Preparing the medications to be given in the OR
Verifying the surgical site with the client Taking measures to ensure the client's comfort Establishing an IV line
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 elective required urgent
urgent
Which method of wound healing is one in which wound edges are not surgically approximated and integumentary continuity is restored by granulation? Third-intention healing First-intention healing Second-intention healing Primary-intention healing
Second-intention healing
A client who is scheduled for knee surgery is anxious about the procedure, saying, "You hear stories on the news all the time about doctors working on the wrong body part. What if that happens to me?" What is the nurse's best response? Select all that apply. "Our surgical team would never make that mistake." "The client will be involved in the verification process prior to surgery." "The surgeon on the team has never been involved in such a mix-up." "The client can be involved in marking the knee, the site for the surgery." "The surgical team performs a 'time-out' prior to surgery to conduct a final verification."
"The client will be involved in the verification process prior to surgery." "The client can be involved in marking the knee, the site for the surgery." "The surgical team performs a 'time-out' prior to surgery to conduct a final verification."
A nurse is assessing the client's readiness for discharge from the postanesthesia care unit (PACU). The nurse can rouse the client by calling the client's name. The client can move all extremities and has a blood pressure of 134/82. Baseline preoperative blood pressure was 128/78. The most recent pulse oximetry reading was 94% on room air; the client's respirations are deep and easy at a rate of 12 breaths/minute. What is the calculated Aldrete score? 7 8 9 10
9
A patient with renal failure is scheduled for a surgical procedure. When would surgery be contraindicated for this patient due to laboratory results? A urine creatinine level of 1.2 mg/dL A blood urea nitrogen level of 42 mg/dL A creatine kinase level of 120 U/L A serum creatinine level of 0.9 mg/dL
A blood urea nitrogen level of 42 mg/dL
The nurse is triaging surgical clients. Which client would the nurse document as in need of urgent surgical care? A client with severe bleeding A client needing cataract surgery A client scheduled for cosmetic surgery A client with an acute gallbladder infection
A client with an acute gallbladder infection
A client is at postoperative day 1 after abdominal surgery. The client is receiving 0.9% normal saline at 75 mL/h, has a nasogastric tube to low wall suction with 200 mL every 8 hours of light yellow fluid, and a wound drain with 50 mL of dark red drainage every 8 hours. The 24-hour urine output total is 2430 mL. What action by the nurse is most appropriate? Document the findings and reassess in 24 hours. Assess for edema. Assess for signs and symptoms of fluid volume deficit. Discontinue the nasogastric tube suctioning.
Assess for signs and symptoms of fluid volume deficit.
The nurse is performing the shift assessment of a postsurgical client. The nurse finds the client's mental status, level of consciousness, speech, and orientation are intact and at baseline, but the client appears unusually restless. What should the nurse do next? Page the client's the physician. Assess the client's oxygen levels. Initiate a social work referral. Administer antianxiety medications.
Assess the client's oxygen levels.
The nurse determines that a patient is at risk for the development of thrombophlebitis. What interventions can the nurse provide to prevent this? (Select all that apply.) Applying compression stockings only at night Massaging the legs every 4 hours Encouraging early ambulation Avoiding placement of pillows or blanket rolls under the patient's knees Assisting the patient with leg exercises
Assisting the patient with leg exercises Encouraging early ambulation Avoiding placement of pillows or blanket rolls under the patient's knees
A nurse is preparing a client for surgery. The assessment is complete, all consents have been signed, and the client's family is present. Before administering preoperative medications, what is the nurse's first step? Check the client's ID bracelet. Ask about the client's drug allergies. Ask the client to void. Measure the client's vital signs.
Check the client's ID bracelet.
Why should the nurse be vigilant with assessment of perioperative risks on the older adult client? Select all that apply. The elasticity of skin increases and decreases the risk of shearing. Fatty tissue increases, prolonging the effects of anesthesia. Liver size decreases, reducing the metabolism of anesthetics. Peristalsis increases. Ciliary action decreases, reducing the cough reflex.
Ciliary action decreases, reducing the cough reflex. Fatty tissue increases, prolonging the effects of anesthesia. Liver size decreases, reducing the metabolism of anesthetics.
A client is undergoing a surgical procedure to repair his ulcerated colon. During your care, you discuss at length pertinent information for his condition perioperatively. Which of the following client education topics will be discussed preoperatively? Choose all correct options. Cough and deep-breathing exercises Postoperative pain control His wife's thoughts about the upcoming surgery The surgeon's fee
Cough and deep-breathing exercises Postoperative pain control
While the surgical client is anesthetized, the scrub nurse hears a member of the surgical team make an inappropriate remark about the client's weight. How should the nurse best respond? Ignore the comment because the patient is unconscious. Realize that humor is needed in the workplace. Report the comment immediately to a supervisor. Discourage the colleague from making such comments.
Discourage the colleague from making such comments.
A fractured skull would be classified under which category of surgery based on urgency? Urgent Required Elective Emergent
Emergent
Which would be included as a responsibility of the scrub nurse? Handing instruments to the surgeon and assistants Obtaining and opening wrapped sterile equipment Coordinating activities of other personnel Keeping all records and adjusting lights
Handing instruments to the surgeon and assistants
The nurse admits a client to the PACU with a blood pressure of 132/90 mm Hg and a pulse of 68 beats per minute. After 30 minutes, the client's blood pressure is 94/47 mm Hg, and the pulse is 110. The nurse documents that the client's skin is cold, moist, and pale. Of what is the client showing signs? Neurogenic shock Hypothermia Malignant hyperthermia Hypovolemic shock
Hypovolemic shock
Which stage of anesthesia is referred to as surgical anesthesia? II I IV III
III
The nurse is creating the care plan for a 70-year-old obese client who has been admitted to the postsurgical unit following a colon resection. This client's age and increased body mass index mean that she is at increased risk for what complication in the postoperative period? Azotemia Hyperglycemia Infection Falls
Infection
A 21-year-old client is positioned on the OR bed prior to knee surgery to correct a sports-related injury. The anesthesiologist administers the appropriate anesthetic. The OR nurse should anticipate which of the following events as the team's next step in the care of this client? Grounding Giving blood Making the first incision Intubating
Intubating
The intraoperative nurse is transferring a client from the OR to the PACU after replacement of the right knee. The client is an older adult. The nurse should prioritize which of the following actions? Keeping the client hydrated Keeping the client restrained Keeping the client warm Keeping the client sterile
Keeping the client warm
Corticosteroids have which effect on wound healing? Reduce blood supply May cause protein-calorie depletion Cause hemorrhage Mask the presence of infection
Mask the presence of infection
What is the priority action when the circulating nurse is completing a second verification of the surgical procedure and surgical site? Obtain the attention of all members of the surgical team. Discuss the surgical procedure and surgical site with the client. Review complications and allergies with the anesthesiologist. Ask the surgeon whether the marked surgical site is correct.
Obtain the attention of all members of the surgical team.
An example of an intravenous anesthetic that is a hypnotic and produces excellent amnesia is: Ketalar Diprivan Midazolam Amidate
Midazolam
A postoperative client is moving from the bed to a chair when blood drips from the dressing. The nurse assesses the incision and notes evisceration. What does the nurse do first? Place a pressure dressing over the opening and secure. Place a dry, sterile dressing over the protruding organs. Moisten sterile gauze with sterile normal saline and place on the protruding organ. Have the client lay quietly on back and call the physician.
Moisten sterile gauze with sterile normal saline and place on the protruding organ.
A client has undergone surgery to repair a hernia, with no complications. In the immediate postoperative period, which action by the nurse is most appropriate? Measure urinary output every 15 minutes Assess pupillary response every 5 minutes Measure arterial blood gas every 5 minutes Monitor vital signs every 15 minutes
Monitor vital signs every 15 minutes
A client is 2 hours postoperative with a Foley catheter in situ. The last hourly urine output recorded for this client was 10 mL. The tubing of the Foley is confirmed to be patent. What should the nurse do? Irrigate the Foley with 30 mL normal saline. Decrease the IV fluid rate and massage the client's abdomen. Have the client sit in high-Fowler's position. Notify the physician and continue to monitor the hourly urine output closely.
Notify the physician and continue to monitor the hourly urine output closely.
A client is administered succinylcholine and propofol for induction of anesthesia. One hour after administration, the client demonstrates muscle rigidity with a heart rate of 180. What should the nurse do first? Document the assessment findings. Obtain cooling blankets. Notify the surgical team. Administer dantrolene sodium.
Notify the surgical team.
Which type of anesthesia involves injecting an anesthetic agent around the nerves so that the area supplied by these nerves is anesthetized? Inhalation Regional General Local
Regional
A postanesthesia care unit (PACU) nurse is preparing to discharge a client home following ankle surgery. The client keeps staring at the ceiling while being given discharge instructions. What action by the nurse is appropriate? Give the written instructions to the client's 16-year-old child. Ask the client, "Do you understand?" Continuously repeat the instructions until the client restates them. Review the instructions with the client and an accompanying adult.
Review the instructions with the client and an accompanying adult.
Which zone of the surgical area only requires attire in the form of scrub clothes and caps? Unrestricted zone Restricted zone Semi-restricted zone Operative zone
Semi-restricted zone
The surgical client has been intubated and general anesthesia has been administered. The client exhibits cyanosis, shallow respirations, and a weak, thready pulse. The nurse recognizes that the client is in which stage of general anesthesia? Stage I Stage III Stage II Stage IV
Stage IV
The nurse is caring for a 78-year-old man who has had an outpatient cholecystectomy. The nurse is getting him up for his first walk postoperatively. To decrease the potential for orthostatic hypotension and consequent falls, what should the nurse have the client do? Sit in a chair for 10 minutes prior to ambulating. Stand upright for 2 to 3 minutes prior to ambulating. Perform range-of-motion exercises for each joint. Drink plenty of fluids to increase circulating blood volume.
Stand upright for 2 to 3 minutes prior to ambulating.
Which of the following stimulates the wound healing process? Sufficient oxygenation Hemorrhage Immobility Nutritional deficiencies
Sufficient oxygenation
Which clinical manifestation is often the earliest sign of malignant hyperthermia? Elevated temperature Hypotension Oliguria Tachycardia (heart rate >150 beats per minute)
Tachycardia (heart rate >150 beats per minute)
The nurse is providing preoperative teaching to a client scheduled for surgery. The nurse is instructing the client on the use of deep breathing, coughing, and the use of incentive spirometry when the client states, "I don't know why you're focusing on my breathing. My surgery is on my hip, not my chest." What rationale for these instructions should the nurse provide? To promote optimal lung expansion To enhance peripheral circulation To prevent pneumothorax To prevent chronic obstructive pulmonary disease (COPD)
To promote optimal lung expansion
The nurse cares for a client who is three hours post op abdominal hysterectomy and begins to develop hiccups. What nursing assessment will the nurse monitor more closely with the client's new symptoms? Wound drainage Respiratory rate Temperature Wound approximation
Wound approximation
A client asks the nurse how an inhalant general anesthetic is expelled by the body. What is the best response by the nurse? "The kidneys will eliminate the inhalant with urination." "The skin will eliminate the anesthesia through evaporation." "The liver will eliminate the inhalant anesthesia." "The lungs primarily eliminate the anesthesia."
"The lungs primarily eliminate the anesthesia."
The nurse is preparing a client for surgery prior to her hysterectomy without oophorectomy. The nurse is witnessing the client's signature on a consent form. Which comment by the client would best indicate informed consent? "I know I'll be fine because the physician said he has done this procedure hundreds of times." "I know I'll have pain after the surgery but they'll do their best to keep it to a minimum." "The physician is going to remove my uterus and told me about the risk of bleeding." "Because the physician isn't taking my ovaries, I'll still be able to have children."
"The physician is going to remove my uterus and told me about the risk of bleeding."
The circulating nurse is performing a skin preparation for a client who is unconscious from general anesthesia when the scrub nurse states, "I know her, she sure has gotten fat!" What is the best response by the circulating nurse? "If you say anything like that again, I will report you to the nurse manager." "It is inappropriate to make comments even when clients appear to be unconscious from anesthesia." "She sure has gained weight. I hope that she will heal after the surgery." "Be sure you don't say anything like that when she is coming out of the anesthesia in case she hears you."
"It is inappropriate to make comments even when clients appear to be unconscious from anesthesia."
Which nursing diagnosis should the nurse plan to address first in the client upon arrival in the intraoperative setting? Risk of latex allergy response related to possible exposure in the OR environment Anxiety related to ineffective coping with surgical concerns Risk for perioperative positioning injury related to positioning in the OR Disturbed sensory perception related to the effects of general anesthesia
Anxiety related to ineffective coping with surgical concerns
The physician schedules an elective surgical procedure for a patient who smokes cigarettes. When should the nurse recommend that the patient cease smoking before the surgical procedure to minimize risks associate with cigarette smoking? 3 to 4 months 3 weeks 1 to 2 months 2 weeks
1 to 2 months
An intraoperative nurse is applying interventions that will address surgical clients' risks for perioperative positioning injury. What factors contribute to this increased risk for injury in the intraoperative phase of the surgical experience? Select all that apply. Loss of pain sensation Diminished ability to communicate Nausea resulting from anesthetic Reduced blood pressure Absence of reflexes
Absence of reflexes Diminished ability to communicate Loss of pain sensation
Which would be considered to require an urgent surgical procedure? Loose facial skin Severe bleeding Cataract Acute gallbladder infection
Acute gallbladder infection
The nurse is creating the plan of care for a postoperative client for reduction of a femur fracture. What is the most important short-term goal for this client? Adequate respiratory function Resumption of activities of daily living (ADLs) Relief of pain Unimpaired wound healing
Adequate respiratory function
To prevent pneumonia and promote the integrity of the pulmonary system, an essential postoperative nursing intervention includes: Ambulating the client as soon as possible Assessing breath sounds at least every 2 hours Assisting with incentive spirometry every 6 hours Positioning the client in a supine position
Ambulating the client as soon as possible
The nurse has received shift report on a postoperative surgical client. Which medication order would indicate that the medication was being administered prophylactically? Humulin NPH 12 units at 0800. Percocet two tablets every 4 hours as needed for pain A 5% dextrose in 0.5 NSS to infuse at 100mL/hr Amoxicillin 500mg two tablets every 8 hours for 48 hours
Amoxicillin 500mg two tablets every 8 hours for 48 hours
The OR will be caring for a client who will receive a transsacral block. For what client would the use of a transsacral block be appropriate for pain control? An older adult man who will undergo an inguinal hernia repair A middle-aged man who is scheduled for a thoracotomy A 50-year-old woman who will be having a reduction mammoplasty A child who requires closed reduction of a right humerus fracture
An older adult man who will undergo an inguinal hernia repair
The intraoperative nurse advocates for each client who receives care in the surgical setting. How can the nurse best exemplify the principles of client advocacy? By encouraging the client to perform deep breathing preoperatively By maintaining the privacy of each client By limiting the client's contact with family members preoperatively By eliciting informed consent from clients
By maintaining the privacy of each client
A PACU nurse is caring for a postoperative client who received general anesthesia and has a hard, plastic oral airway in place. The patient has clear lung sounds, even and unlabored respirations of 16, and 98% oxygen saturation. The client is minimally responsive to painful stimuli. What action by the nurse is most appropriate? Notify the physician of impaired neurological status. Remove the oral airway. Continue with frequent client assessments. Obtain vital signs, including pulse oximetry, every 5 minutes.
Continue with frequent client assessments.
A PACU nurse is caring for a postoperative client who received general anesthesia and has a hard, plastic oral airway in place. The patient has clear lung sounds, even and unlabored respirations of 16, and 98% oxygen saturation. The client is minimally responsive to painful stimuli. What action by the nurse is most appropriate? Obtain vital signs, including pulse oximetry, every 5 minutes. Notify the physician of impaired neurological status. Continue with frequent client assessments. Remove the oral airway.
Continue with frequent client assessments.
A patient has a wound that has hemorrhaged. What does the nurse understand is the cause of the patient's increased risk of infection? Reduced amounts of oxygen and nutrients are available Dead space and dead cells provide a culture medium The tissue becomes less resilient Retrograde bacterial contamination may occur
Dead space and dead cells provide a culture medium
Preoperative medications are administered for very specific reasons with very specific outcomes expected. When an anticholinergic medication is administered, what is its expected effect? Decrease gastric acidity and volume Enhance proper sedation Reduce preoperative anxiety Decrease respiratory secretions
Decrease respiratory secretions
What action by the nurse best encompasses the preoperative phase? Educating clients on signs and symptoms of infection Documenting the application of sequential compression devices (SCDs) Monitoring vital signs every 15 minutes Shaving the client using a straight razor
Educating clients on signs and symptoms of infection
The nurse is providing preoperative teaching to a client scheduled for hip replacement surgery in 1 month. During the preoperative teaching, the client gives the nurse a list of medications she takes, the dosage, and frequency. What intervention provides the client with the most accurate information? Instruct the client to continue any herbal supplements unless otherwise instructed, and inform the client that these supplements have minimal effect on the surgical procedure. Instruct the client to stop taking St. John's wort at least 2 weeks prior to surgery due to its interaction with anesthetic agents. Instruct the client to continue taking ephedrine prior to surgery due to its beneficial effect on blood pressure. Instruct the client to discontinue Synthroid due to its effect on blood coagulation and the potential for heart dysrhythmias.
Instruct the client to stop taking St. John's wort at least 2 weeks prior to surgery due to its interaction with anesthetic agents.
The client required reversal drugs after surgery. What nursing intervention is required when caring for a client who is treated with reversal drugs? Observe the client for an extended period. Instruct the client to lie flat. Help the client slowly move to an upright or standing position. Emphasize the dietary restriction.
Observe the client for an extended period.
The nurse is caring for a client being transitioned from the postanesthesia care unit (PACU) to the surgical nursing floor. Which nursing action is first when a client states, "I am nauseated"? Encourage sips of clear liquids. Obtain an emesis basin and cool washcloth. Check the medication record for antiemetic medication orders. Obtain vital signs.
Obtain an emesis basin and cool washcloth.
During the care of a preoperative client, the nurse has given the client a preoperative benzodiazepine. The client is now requesting to void. What action should the nurse take? Assist the client to the bathroom. Have the client go to the bathroom. Offer the client a bedpan or urinal. Wait until the client gets to the operating room and is catheterized.
Offer the client a bedpan or urinal.
The nurse is caring for a client who is scheduled to have a needle biopsy of the pleura. The client has had a consultation with the anesthesiologist and a conduction block will be used. Which local conduction block can be used to block the nerves leading to the chest? Peudental block Transsacral block Paravertebral block Brachial plexus block
Paravertebral block
Which health care profession has the ultimate responsibility to provide appropriate information regarding a nonemergent surgery? Case manager Certified nurse's aide Physician Nurse
Physician
A client who had a colonoscopy is recovering from the effects of sedation. Which nursing interventions would the nurse use to care for this client? Select all that apply. Allow the client to drive home alone. Instruct the client to ambulate. Position the client in a semi-Fowler's position. Monitor the client for a return to presedation consciousness. Encourage the client to take deep breaths.
Position the client in a semi-Fowler's position. Monitor the client for a return to presedation consciousness. Encourage the client to take deep breaths.
The nurse is caring for a client needing emergency surgery. Which preoperative teaching is least important to prepare the client for surgery? Types of postoperative pain medication Effective coughing and deep breathing Knowledge of surgical procedure Post-discharge diet
Post-discharge diet
A client is undergoing a surgical procedure to repair his ulcerated colon. During your care, you discuss at length pertinent information for his condition perioperatively. Which of the following client education topics will be discussed preoperatively? Choose all correct options. His wife's thoughts about the upcoming surgery The surgeon's fee Postoperative pain control Cough and deep-breathing exercises
Postoperative pain control Cough and deep-breathing exercises
A written informed consent is necessary for which of the following? Select all that apply. Procedures requiring sedation Procedures requiring radiation Invasive procedures IV insertion
Procedures requiring sedation Procedures requiring radiation Invasive procedures
A client is preparing to undergo a curative surgical procedure. Which of the following is the type of surgery the client could be having? Select all that apply. Insertion of a gastrostomy tube Removal of a diseased appendix Skin biopsy Removal of a tumor Mammoplasty
Removal of a diseased appendix Removal of a tumor
A client is preparing to undergo a curative surgical procedure. Which of the following is the type of surgery the client could be having? Select all that apply. Mammoplasty Removal of a tumor Skin biopsy Removal of a diseased appendix Insertion of a gastrostomy tube
Removal of a tumor Removal of a diseased appendix
A surgical client has been transferred to the holding area. What nursing intervention(s) promote safe and effective nursing care? Select all that apply. Maintain an aseptic environment. Review the medical records. Provide oral fluids to the patient. Verify the surgical site has been marked per institutional policy Apply grounding devices to the client. Identify the client using two identifiers.
Review the medical records. Verify the surgical site has been marked per institutional policy Identify the client using two identifiers.
A client is being prepared for a same-day surgical procedure and is discussing with the nurse what potential ramifications this type of surgery has. Which of the following would the nurse correctly identify? Select all that apply. Need for teaching is increased. The client must be prepared to take on more self-care than he or she may have done in the past. Discharge planning is minimal because the stay is so short. The client will leave the hospital sooner than in the past. Home care and other referrals are unlikely because same-day surgeries are usually minor.
The client will leave the hospital sooner than in the past. Need for teaching is increased. The client must be prepared to take on more self-care than he or she may have done in the past.
What action during a surgical procedure requires immediate intervention by the circulating nurse? The scrub nurse calling the blood bank to obtain blood products The anesthesiologist monitoring blood gas levels The surgeon reaching within the sterile field to obtain equipment The registered nurse's first assistant suturing the surgical wound
The scrub nurse calling the blood bank to obtain blood products
The patient is NPO prior to having a colonoscopy. The patient is to take a daily blood pressure pill prior to the procedure. Until when may water be given prior to the procedure? Up to 8 hours before surgery Up to 2 hours before surgery Up to 6 hours before surgery Up to 4 hours before surgery
Up to 2 hours before surgery
The nurse is caring for a client who anticipates pain and anxiety following his prostatectomy. Which intervention will likely best assist in decreasing the client's pain and anxiety? Use of deep breathing and coughing exercises Administration of NSAIDs rather than opioids Allowing the client to increase activity Use of guided imagery along with pain medication
Use of guided imagery along with pain medication
The nurse is preparing to send a client to the OR for a scheduled surgery. What should the nurse ensure is on the chart when it accompanies the client to surgery? Select all that apply. Verification form Laboratory reports Social work assessment Nurses' notes Dietitian's assessment
Verification form Laboratory reports Nurses' notes
The nurse is performing a preadmission assessment of a client scheduled for a bilateral mastectomy. The nurse should be aware of what purpose of the preadmission assessment? Informs the client of need for postoperative transportation Discusses and reviews client's financial status Verifies completion of preoperative diagnostic testing Determines the client's suitability as a surgical candidate
Verifies completion of preoperative diagnostic testing