MED-SURG PREPU CH.17 EXAM 2

What is the blood glucose level goal for a diabetic client who will be having a surgical procedure?

80 to 110 mg/dL

A nurse is teaching a client about pain management after surgery. Which client statement indicates the teaching was effective?

I will support my incision with my hands when I cough and do my deep breathing exercises.

A client is undergoing preoperative assessment. During admission paperwork, the client reports having enjoyed a hearty breakfast this morning to be ready for the procedure. What is the nurse's next action?

Notify the surgeon.

The nurse is educating a community group about 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?

Tumor excision

A physically fit older adult is scheduled for right knee replacement. What factor for the client creates an increased risk for postoperative complications?

current smoking history

The nurse assesses a client to determine if there is increased risk for complications intraoperatively or postoperatively. Which are general risk factors? Select all that apply.

nutritional status age physical condition health status

Which nursing statement would best decrease a client's anxiety before an emergency operative procedure?

"Let me explain to you what will happen next."

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?

"The nurse will explain the details of the surgery before I sign a consent."

Which question is most important for the nurse to ask the client when obtaining the preoperative admission history?

"When is the last time you ate or drank?"

For the client who is taking aspirin, it is important to stop taking this medication at least how many day(s) before surgery?

7

A client having a surgical procedure takes aspirin 325 mg daily for prevention of platelet aggregation. When should the client stop taking the aspirin before the surgery?

7 to 10 days

The nurse is triaging surgical clients. Which client would the nurse document as in need of urgent surgical care?

A client with an acute gallbladder infection

The nurse expects informed consent to be obtained for insertion of:

A gastrostomy tube

Clients who have received corticosteroids preoperatively are at risk for which type of insufficiency?

Adrenal

A client refuses to remove her wedding band when preparing for surgery. What is the best action for the nurse to take?

Allow the client to wear the ring and cover it with tape.

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 aware that which of the following helps to stimulate T-cell response:

Arginine

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 clients on signs and symptoms of infection

A fractured skull would be classified under which category of surgery based on urgency?

Emergent

A gunshot wound 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

A patient with uncontrolled diabetes is scheduled for a surgical procedure. What chief life-threatening hazard should the nurse monitor for?

Hypoglycemia

The nurse is conducting a health history of a preoperative client. The client shares that she experienced vaginal itching and burning and labial swelling after her partner tried a new brand of condoms. The nurse suspects that the client:

May have a latex allergy.

An inappropriate nursing action implemented to keep the client safe includes:

Moving the client swiftly

During the admission history the client reports to the nurse of taking the usual dose of warfarin the previous day. What is an appropriate nursing action?

Notify the surgeon that the client took warfarin the day before surgery.

A client is scheduled for a cholecystectomy. Which finding by the nurse is least likely to contribute to surgical complications

Osteoporosis

The nurse recognizes that written informed consent is required for insertion of a(n):

Peripherally-inserted central catheter.

The nurse is caring for a client needing emergency surgery. Which preoperative teaching is least important to prepare the client for surgery?

Post-discharge diet

When is the ideal time to discuss preoperative teaching

Preadmission visit

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?

Request that the surgeon come and answer the questions.

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.

The nurse should determine that a client is coughing effectively after surgery if the nurse observes which of the following activities?

The client takes a deep abdominal breath and then "huff" or "hack" coughs three or four times.

A nurse is teaching a client with chronic bronchitis about breathing exercises. Which instruction should the nurse include in the teaching?

Use diaphragmatic breathing.

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.

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

When the indication for surgery is without delay, the nurse recognizes that the surgery will be classified as

emergency.

In advance of a client's scheduled appendectomy, the nurse spends significant time explaining to the client what will happen, both before the procedure and after the procedure is complete. The primary reason the nurse puts so much effort into preoperative teaching is to:

increase the likelihood of a successful recovery.

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?

urgent

A nurse is assessing a postoperative client with hyperglycemic blood glucose levels. Which client surgical risk factor would decrease if the surgical client maintained strict blood glycemic control?

wound healing