Module 7: Perioperative Nursing

A postoperative client reports unrelieved pain. What intervention would the nurse take first? A. call the surgeon to request new pain medication B. administer another dose of medication C. assess the client's pain and surgical site D. reposition the client

C. Assess the client's pain and surgical site.

A nurse is teaching a client how to perform leg exercises. Which postoperative complications may be prevented with leg exercises? A. varicose veins B. varicose veins C. hemorrhage D. venous stasis

D. Venous stasis.

A nurse is explaining to a client about coughing following surgery. Which teaching statements follows the recommended guidelines? A. "if you need to cough, try to cough as lightly as possible so your incision will not be disturbed." B. "if you cough, turn your head away from the incision to protect it from microorganisms." C. "when coughing, apply firm pressure on the incision with a bath blanket to minimize discomfort." D. "try not to cough following surgery as it might disrupt your stitches."

"When coughing, apply firm pressure on the incision with a bath blanket to minimize discomfort."

The nurse is caring for a postoperative client after abdominal surgery. The client states, "I don't want to change positions in bed because I am afraid." How should the nurse respond? A. "changing position decreases your risk of pulmonary and skin complications" B. "your surgeon has prescribed for you to change position every 2 hours" C. "I will check back with you in 2 hours" D. there is nothing to be afraid of when changing position"

A. "Changing position decreases your risk of pulmonary and skin complications."

The nurse is teaching a preoperative client how to perform deep‑breathing exercises after back surgery. What is the best method to ensure that the client understands the procedure? A. ask the client for a return demonstration B. follow up with printed materials C. have the client watch a video of the procedure D. ask the client's family to describe the procedure

A. Ask the client for a return demonstration.

The nurse is caring for a postoperative client after abdominal surgery. The nurse is assisting the client to turn from the back onto the right side. On which techniques should the nurse instruct the client? A. bend the right knee and use the left hand to grasp the bed rail while pulling body over to the right B. bend the left knee and use the left hand to grasp the bed rail while pulling body over to the right side C. bend the right knee and use the right hand to grasp the bed rain while pulling body over to the right side D. bend the left knee and use the right hand to grasp the bed rail while pulling body over to the right side

A. Bend the left knee and use the left hand to grasp the bed rail while pulling body over to the right side.

The nurse is performing postoperative care for a client returning to the room following a cholecystectomy. After the first hour, how often would the nurse take the client's vital signs? A. every 30 minutes fo the next 2 hours B. every 15 minutes for the next 4 hours C. every 60 minutes for the next 4 hours D. every 20 minutes for the next 4 hours

A. Every 30 minutes for the next 2 hours.

The nurse is preparing a client on the day of surgery. Which process is priority for preparing the client physically for the surgery? A. have the client remove contact lenses, nail polish, and cosmetics B. have the client secure dentures with additional adhesive C. have the client remove all jewelry, except body piercings D. have the client don a gown over the undergarments

A. Have the client remove contact lenses, nail polish, and cosmetics.

The nurse, assessing the dressing of a postoperative client, notes that a previously clean dressing has a scant amount of dried blood. What would be the recommended nursing intervention in this situation? A. mark the area on the dressing with time and date and monitor for changes B. reinforce the dressing with another gauze pad C. replace the dressing with a new one and notify the surgeon D. remove the dressing to leave the incision open to the air

A. Mark the area on the dressing with time and date and monitor for changes.

The nurse, assessing the dressing of a postoperative client, notes that a previously clean dressing has a large amount of fresh blood. What is the recommended nursing intervention in this situation? A. notify the healthcare provider and reinforce the dressing with more bandages. B. remove the dressing to leave the incision open to the air and notify the health care provider C. apply pressure to the dressing with a gauze pad and notify the health care provider D. replace the dressing with a new one and notify the health care provider

A. Notify the healthcare provider and reinforce the dressing with more bandages.

The nurse is providing preoperative care for a client on the day of surgery. What is the most important goal of preoperative nursing? A. teach the activities that the client will perform postoperatively B. teach the client about their specific surgical procedure C. assess that the client is comfortable and well-rested prior to surgery D. assess the client for complications related to the surgery

A. Teach the activities that the client will perform postoperatively.

The nurse observes the client's correct use of the incentive spirometer when what occurs? A. the client takes slow, deep inhalations into the incentive spirometry tube 5 to 10 times per hour B. the client takes quick, short breaths in and out of the incentive spirometry tube C. the client blows forcefully several times into the incentive spirometry D. the client does not rest between inhalations into the incentive spirometry tube

A. The client takes slow, deep inhalations into the incentive spirometry tube 5 to 10 times per hour.

Which describes an accurate step taken by the nurse when applying a pneumatic compression device on a client? A. place the sleeve on top of the client's leg with the inner lining facing up B. place the sleeve on top of the client's leg with the tubing toward the heel C. put on sterile gloving and remove the sleeves from the packaging D. for knee-high sleeves, place the end of the sleeve above the back of the ankle

A. place the sleeve on top of the client's leg with the inner lining facing up

What is the most important reason to include the client's family members and/or other caregivers during preoperative teaching? A. to provide support and reinforcement of activities in the postoperative period B. to decrease the need for client postoperative analgesia C. to validate and confirm the client's correct medical history D. to eliminate postoperative risks to the client

A. to provide support and reinforcement of activities in the postoperative period

The nurse is caring for an older adult client immediately after knee surgery. The client has a Foley catheter in place. The client's spouse is concerned that the client has "never had to have a catheter before." What is the best response from the nurse? A."it is common for a postoperative client to have a urinary catheter until the effects of anesthesia have worn off and the client is more mobile." B. "the catheter will help prevent blood clots in the bladder in the immediate postoperative period" C. "it is protocol for all clients to have urinary catheters after surgery" D. "kidneys are often slow to work after surgery and take a little time to get going again"

A."It is common for a postoperative client to have a urinary catheter until the effects of anesthesia have worn off and the client is more mobile."

The healthcare provider has prescribed application of total-leg pneumatic compression device sleeves to a client's legs. Where would the nurse place the opening in the sleeve? A. at the space in front of the knee B. at the popliteal space behind the knee C. at the ankle D. where the upper thigh meets the groin muscle

B. At the popliteal space behind the knee.

The nurse is teaching a client how to perform the recommended postoperative activities to avoid potential complications. In which body system may complications most commonly be avoided by performing these activities? A. gastrointestinal B. cardiovascular C. central nervous D. endocrine

B. Cardiovascular

When initiating deep‑breathing exercises for a postoperative client, what would be the nurse's instructions for the first breath? A. inhale through the mouth and exhale through the nose B. exhale first and breath in through the nose C. exhale first and breathe in through your mouth D. inhale deeply and exhale through pursed lips

B. Exhale first and breathe in through the nose.

The nurse is correct when placing the postoperative client in which position for the client to perform incentive spirometry exercises? A. side-lying B. fowler's C. prone D. trendelenberg

B. Fowler's

The nurse is teaching deep‑breathing exercises to a client who is undergoing thoracic surgery. In what position would the nurse place the client for these exercises? A. trendelenberg B. fowler's C. prone D. side-lying

B. Fowler's

The nurse is teaching a preoperative client how to perform deep‑breathing exercises. What is the next step the client would take after exhaling first and breathing in through the nose? A. hold the breath for ten seconds and exhale through pursed lips B. hold the breath for five seconds and exhale through pursed lips C. breathe out through the mouth and inhale again through the nose D. breathe out through the nose and inhale again through the mouth

B. Hold the breath for five seconds and exhale through pursed lips.

The nurse is caring for a postoperative client after abdominal surgery. Why is it important to splint the client's incision during coughing exercises? A. it will decrease risk of postoperative pneumonia B. it will support the incision and decrease pain C. it will ensure that no incisional bleeding will occur D. it will decrease risk of incisional infection

B. It will support the incision and decrease pain.

The nurse is teaching a client about splinting and coughing postoperatively. What position would the nurse teach the client to assume for coughing? A. lying flat on the back B. sitting up and leaning forward C. sitting up and partially reclined D. lying flat on the side

B. Sitting up and leaning forward.

The nurse is assisting a postoperative client to perform leg exercises. Which is the first step in this exercise? A. point the toes of both legs towards the foot of the bed and then relax them B. straighten the knee, raise the foot, and extend the lower leg or a few seconds C. extend the legs and make circles with both ankles D. felt or pull the toes toward the chin

B. Straighten the knee, raise the foot, and extend the lower leg for a few seconds.

The nurse demonstrates that the client understands preoperative teaching by documenting which client statement? A. "blowing forcefully into the incentive spirometer will help expand my lungs." B. "I am prepared for surgery tomorrow." C. "leg exercises will help decreased risk of a blood clot." D. "I will lie in bed as much as possible after surgery"

C. "Leg exercises will help decrease risk of a blood clot."

The nurse is teaching the client about postoperative leg exercises. The nurse would instruct the client to repeat leg exercises how many times? A. 5 times B. 10 times C. 3 times D. 2 times

C. 3 times

The nurse is reviewing the preoperative prescription for a client on the day of surgery. The nurse notes a prescription for an antibiotic to be given prior to surgery. What is the priority for the nurse? A. assess the client's vital signs prior to administration B. assess the client's home medication list C. assess the client's medication allergies D. assess the client's IV site for latency

C. Assess the client's medication allergies.

The nurse is teaching a preoperative client how to cough following a surgical procedure. Which statement accurately describes a step in this procedure? A. inhale and hold the breath for five seconds; let the breath out in five deep hacking coughs B. inhale and exhale five times, inhale and hold the breath for three seconds, and lightly cough five times C. inhale and exhale three times, inhale and hold the breath for three seconds, and lightly cough three times D. inhale and hold the breath for five seconds; let the breath out in five short coughs

C. Inhale and exhale three times, inhale and hold the breath for three seconds, and lightly cough three times.

A nurse is preparing to apply a pneumatic compression device for a client. Which statement accurately describes a contraindication for this device? A. do not use the device in combination with anticoagulant therapy B. do not use the device in combination with antiembolism stockings C. do not place the sleeves of the device above the knee D. do not use the device if skin integrity is altered

C. do not place the sleeves of the device above the knee

The nurse is assessing a postoperative client immediately upon return from the post-anesthesia care unit (PACU). The client is requesting pain medication. What is the priority action for the nurse? A. reposition the client B. check the client's IV site for patency C. administer pain medication D. check the PACU medication administration record

D check the PACU medication administration record.

The nurse is preparing a client on the day of surgery. The client states consumption of a "very small amount of oatmeal this morning." What is the proper response from the nurse? A. "I will have to cancel your surgery for today" B. "you may have more abdominal pain after surgery" C. "it should will be fine as long as it was just a small amount" D. "I will need to report that information to your surgeon"

D. "I will need to report that information to your surgeon."

The nurse is preparing a client on the day of surgery. The client is scheduled to have a total replacement of the right knee. What question would be the priority for the nurse ask the client? A. "what other knee surgeries have you had in the post?" B. "what pain medication have you been taking at home?" C. "what are your mobility goals after surgery?" D. "what procedure and location is your surgery today?"

D. "What procedure and location is your surgery today?"

The nurse is caring for a postoperative client. The client reports pain that is rate 9 on a 10-point scale. The client is not due for pain medication for another hour. After assessing the client and repositioning, the client reports no improvement in pain. What intervention does the nurse perform next? A. instruct the client on relation techniques B. administer pain medication early C. re-assess the client in one hour D. call the surgeon and report the assessment

D. Call the surgeon and report the assessment.

The nurse helps turn a postsurgical client in bed. What is the most important intervention prior to leaving the client's room? A. place pillow behind client's back for support B. document time and client's position C. dim all lights D. ensure the call light is within the client's reach

D. Ensure the call light is within the client's reach.

The nurse is teaching a client how to turn in bed postoperatively. How often is turning recommended? A. every four hours B. every three hours C. every hour D. every two hours

D. Every two hours.

The nurse is caring for a client immediately after colon surgery. The nurse checks vital signs on the client. Oxygen saturation is 89%. What action should the nurse take? A. apply oxygen at 2 L via nasal cannula B. administer dose of PRN pain medication C. call the attending surgeon to report the finding D. have the client deep breath and cough then reassess

D. Have the client deep breathe and cough then reassess.

The nurse explains to a client with a history of asthma why the health care provider has prescribed an incentive spirometer to be used postoperatively. What is the therapeutic effect of using this device? A. it helps the client to relax after surgery B. it helps the client to cough and remove mucous from the lungs C. it allows the clients to take shallow breaths after surgery D. it teaches the client to take deep breaths after surgery

D. It teaches the client to take deep breaths after surgery.

The nurse is applying a pneumatic compression device to a client's legs. Where would the nurse place the inflation pump? A. on the side table B. on the side railing C. at the head of the bed D. on the bottom of the bed

D. On the bottom of the bed.

The nurse wraps the sleeves of a pneumatic compression device around the legs of a client. How would the nurse determine if the fit is correct? A. one finger should fit between the leg and the sleeve B. the nurses fist should fit between the leg and the sleeve C. three fingers should fit between the leg and the sleeve D. two fingers should fit between the leg and the sleeve

D. Two fingers should fit between the leg and the sleeve.

The nurse is teaching a postoperative client how to use an incentive spirometer. What type of complication may be avoided with the proper use of this device? A. pulmonary embolism B. skin infection C. pneumonia D. pressure injuries

C. Pneumonia.