PrepU Preoperative
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 assesses a client to determine if there is increased risk for complications intraoperatively or postoperatively. Which are general risk factors? Select all that apply.
physical condition health status age nutritional status
For the client who is taking aspirin, it is important to stop taking this medication at least how many day(s) before surgery?
7
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.
A client is undergoing thoracic surgery. respiratory complications? What priority education should the nurse provide to assist in preventing
Splint the incision site using a pillow during deep breathing and coughing exercises.
Nursing assessment findings reveal that the client is afraid of dying during the surgical procedure. Which surgical team member would be most helpful in addressing the client's concern?
Surgeon
A nurse is teaching a client with chronic bronchitis about breathing exercises. Which instruction should the nurse include in the teaching?
Use diaphragmatic breathing.
The perioperative nurse has a number of major responsibilities when a patient is admitted to a surgical unit or center. Which of the following is the most important function?
Verifies that operative consent is signed
The nurse is aware that which of the following nutrients promotes normal blood clotting?
Vitamin K
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
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 with a history of alcoholism is scheduled for urgent surgery. The client asks the nurse, "Why is everyone so concerned about how much I drink?" What is the best response by the nurse?
"It is important for us to know how much and how often you drink to help prevent surgical complications."
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?"
What is the blood glucose level goal for a diabetic client who will be having a surgical procedure?
80 to 110 mg/dL
A client is scheduled for a surgical procedure. When planning the client's care, the nurse should consider that which of the following conditions will increase the client's risk of complications after surgery?
A history of diabetes
Clients who have received corticosteroids preoperatively are at risk for which type of insufficiency?
Adrenal
In preparing the client for transfer to the operating room, which of the following actions by the nurse is inappropriate?
Allow the client to wear dentures.
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.
The nurse is evaluating the client's understanding of diet teaching aimed at promoting wound healing following surgery. The nurse would conclude teaching was ineffective if the client selects which of the following?
Cheeseburger, french fries, coleslaw, and ice cream
The nurse recognizes that the client most at risk for mortality associated with surgery is the:
Client with chronic alcoholism
Several of the clients at the clinic are preparing to have surgery within the next 2 weeks. They are completing preoperative paperwork today with their visit. What are some of the reasons that people might need to have surgery? Select all that apply.
Cosmetic Diagnostic Palliative
Why is assessment of dentition important in the patient preparing to have a surgical procedure with general anesthesia?
Decayed teeth or dental prosthesis can become dislodged during intubation.
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.
Description of alternatives Benefits of surgery Explanation of procedure Potential risks
The nurse is monitoring a presurgical patient for electrolyte imbalance. Which classification of medication may cause electrolyte imbalance?
Diuretics
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
The nurse is conducting a preoperative assessment on a client scheduled for gallbladder surgery. The client reports a frequent cough producing green sputum for 3 days and denies fever. Upon auscultation, the nurse notes rhonchi throughout the right lung, with an occasional expiratory wheeze. Respiratory rate is 20, temperature is 99.8 (taken orally), heart rate is 87, and blood pressure is 124/70. What is the best action by the nurse?
Notify the surgeon to possibly delay the surgery.
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.
During the preoperative assessment, the client mentions allergies to avocados, bananas, and hydrocodone. What is the priority action by the nurse?
Notify the surgical team to remove all latex-based items.
An elderly client is preparing to undergo surgery. The nurse participates in preoperative care knowing that which of the following is the underlying principle that guides preoperative assessment, surgical care, and postoperative care for older adults?
O Older adults have less physiologic reserve (or ability to regain physical equilibrium) than younger clients.
A client is scheduled for a cholecystectomy. Which finding by the nurse is least likely to contribute to surgical complications?
Osteoporosis
Which health care profession has the ultimate responsibility to provide appropriate information regarding a nonemergent surgery?
Physician
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.
The nurse recognizes that the client who takes hydrochlorothiazide to manage hypertension is predisposed for which interaction with anesthesia?
Respiratory depression
As a nurse working in an ambulatory surgery center, you are admitting a client who is going to have a biopsy of a skin lesion. What is an important part of the preoperative process?
Review preoperative instructions.
Which client would the nurse recognize as having the greatest risk for complications during the intraoperative or postoperative period?
The 35-year-old client with non-insulin dependent diabetes.
The nurse is caring for the client in the preoperative period and documenting rationale for a palliative surgical procedure. Which rationale is most appropriate?
The client and physician are focusing on symptom relief not a cure.
A nurse is teaching a client about diaphragmatic breathing. What client action indicates that further teaching is needed?
The client exhales forcefully with a short expiration.
When does the nurse understand the patient is knowledgeable about the impending surgical procedure?
The patient participates willingly in the preoperative preparation.
Sudden withdrawal of which of the following may result in seizures?
Tranquilizers
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 withdrawal delirium during which time period?
Up to 72 hours after alcohol withdrawal
At what point does the preoperative period end?
When the client is transferred onto the operating table
A client is preparing for a surgical procedure is taking corticosteroids for Crohn's disease. What is most important for the nurse to monitor during the operative experience with the client?
adrenal insufficiency
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
When the indication for surgery is without delay, the nurse recognizes that the surgery will be classified as
emergency.
A client is undergoing a surgical procedure to repair an ulcerated colon. Which client education topics will be discussed preoperatively? Select all that apply.
intravenous fluids and other lines and tubes cough and deep-breathing exercises postoperative pain control
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
Which nutrient plays an important role in normal blood clotting?
Vitamin K
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.
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.
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.
The nurse would identify which vitamin deficiency to prevent hemorrhaging during surgery?
Vitamin K
An example of a curative surgical procedure is
tumor excision.
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 recognizes that written informed consent is required for insertion of a(n):
Peripherally-inserted central catheter.
A patient with renal failure is scheduled for a surgical procedure. When would surgery be contraindicated for this patient due to laboratory results?
A blood urea nitrogen level of 42 mg/dL
The nurse recognizes that which of the following clients is at least risk for perioperative complications?
A 65-year-old Caucasian man who has a history of arthritis
The nurse expects informed consent to be obtained for insertion of:
A gastrostomy tube
