Brunner & Suddarths 14th Edition: Pre,Post Operative Management

A surgical patient has just been admitted to the unit from PACU with patient-controlled analgesia (PCA). The nurse should know that the requirements for safe and effective use of PCA include what? A)A clear understanding of the need to self-dose B)An understanding of how to adjust the medication dosage C)A caregiver who can administer the medication as ordered D)An expectation of infrequent need for analgesia

A)A clear understanding of the need to self-dose

The nurse is performing the shift assessment of a postsurgical patient. The nurse finds his mental status, level of consciousness, speech, and orientation are intact and at baseline, but the patient tells you he is very anxious. What should the nurse do next? A)Assess the patients oxygen levels. B)Administer antianxiety medications. C)Page the patients the physician. D)Initiate a social work referral

A)Assess the patients oxygen levels.

The perioperative nurse is providing care for a patient who is recovering on the postsurgical unit following a transurethral prostate resection (TUPR). The patient is reluctant to ambulate, citing the need to recover in bed. For what complication is the patient most at risk? A)Atelectasis B)Anemia C)Dehydration D)Peripheral edema

A)Atelectasis

The surgical nurse is preparing to send a patient from the presurgical area to the OR and is reviewing the patients informed consent form. What are the criteria for legally valid informed consent? Select all that apply. A)Consent must be freely given. B)Consent must be notarized. C)Consent must be signed on the day of surgery. D)Consent must be obtained by a physician. E)Signature must be witnessed by a professional staff member

A)Consent must be freely given D)Consent must be obtained by a physician. E)Signature must be witnessed by a professional staff member

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 patient? Select all that apply. A)Establishing an IV line B)Verifying the surgical site with the patient C)Taking measures to ensure the patients comfort D)Applying a grounding device to the patient E)Preparing the medications to be administered in the OR

A)Establishing an IV line B)Verifying the surgical site with the patient C)Taking measures to ensure the patients comfort

An adult patient has just been admitted to the PACU following abdominal surgery. As the patient begins to awaken, he is uncharacteristically restless. The nurse checks his skin and it is cold, moist, and pale. The nurse concerned the patient may be at risk for what? A)Hemorrhage and shock B)Aspiration C)Postoperative infection D)Hypertension and dysrhythmia

A)Hemorrhage and shock

The nurse is planning the care of a patient who has type 1 diabetes and who will be undergoing knee replacement surgery. This patients care plan should reflect an increased risk of what postsurgical complications? Select all that apply. A)Hypoglycemia B)Delirium C)Acidosis D)Glucosuria E)Fluid overload

A)Hypoglycemia C)Acidosis D)Glucosuria

The PACU nurse is caring for a 45-year-old male patient who had a left lobectomy. The nurse is assessing the patient 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. A)Hypotension B)Hypervolemia C)Heart murmurs D)Dysrhythmias E)Hypertension

A)Hypotension D)Dysrhythmias E)Hypertension

You are providing preoperative teaching to a patient scheduled for hip replacement surgery in 1 month. During the preoperative teaching, the patient gives you a list of medications she takes, the dosage, and frequency. Which of the following interventions provides the patient with the most accurate information? A)Instruct the patient to stop taking St. Johns wort at least 2 weeks prior to surgery due to its interaction with anesthetic agents. B)Instruct the patient to continue taking ephedrine prior to surgery due to its beneficial effect on blood pressure. C)Instruct the patient to discontinue Synthroid due to its effect on blood coagulation and the potential for heart dysrhythmias. D)Instruct the patient to continue any herbal supplements unless otherwise instructed, and inform the patient that these supplements have minimal effect on the surgical procedure

A)Instruct the patient to stop taking St. Johns wort at least 2 weeks prior to surgery due to its interaction with anesthetic agents.

The nurse is preparing to send a patient to the OR for a scheduled surgery. What should the nurse ensure is on the chart when it accompanies the patient to surgery? Select all that apply. A)Laboratory reports B)Nurses notes C)Verification form D)Social work assessment E)Dieticians assessment

A)Laboratory reports B)Nurses notes C)Verification form

An OR nurse will be participating in the intraoperative phase of a patients kidney transplant. What action will the nurse prioritize in this aspect of nursing care? A)Monitoring the patients physiologic status B)Providing emotional support to family C)Maintaining the patients cognitive status D)Maintaining a clean environmen

A)Monitoring the patients physiologic status

The nurse is caring for an 88-year-old patient who is recovering from an ileac-femoral bypass graft. The patient is day 2 postoperative and has been mentally intact, as per baseline. When the nurse assesses the patient, it is clear that he is confused and has been experiencing disturbed sleep patterns and impaired psychomotor skills. What should the nurse suspect is the problem with the patient? A)Postoperative delirium B)Postoperative dementia C)Senile dementia D)Senile confusion

A)Postoperative delirium

The nurse is discharging a patient home from an outpatient surgery center. The nurse has reviewed all of the discharge instructions with the patient and her caregiver. What else should the nurse do before discharging the patient from the facility? Select all that apply. A)Provide all discharge instructions in writing. B)Provide the nurses or surgeons contact information. C)Give prescriptions to the patient. D)Irrigate the patients incision and perform a sterile dressing change. E)Administer a bolus dose of an opioid analgesic

A)Provide all discharge instructions in writing. B)Provide the nurses or surgeons contact information. C)Give prescriptions to the patient

The admitting nurse in a short-stay surgical unit is responsible for numerous aspects of care. What must the nurse verify before the patient is taken to the preoperative holding area? A)That preoperative teaching was performed B)That the family is aware of the length of the surgery C)That follow-up home care is not necessary D)That the family understands the patient will be discharged immediately after surgery

A)That preoperative teaching was performed

The perioperative nurse is preparing to discharge a female patient home from day surgery performed under general anesthetic. What instruction should the nurse give the patient prior to the patient leaving the hospital? A)The patient should not drive herself home. B)The patient should take an OTC sleeping pill for 2 nights. C)The patient should attempt to eat a large meal at home to aid wound healing. D)The patient should remain in bed for the first 48 hours postoperative

A)The patient should not drive herself home.

The nurse is performing a preadmission assessment of a patient scheduled for a bilateral mastectomy. Of what purpose of the preadmission assessment should the nurse be aware? A)Verifies completion of preoperative diagnostic testing B)Discusses and reviews patients health insurance coverage C)Determines the patients suitability as a surgical candidate D)Informs the patient of need for postoperative transportation

A)Verifies completion of preoperative diagnostic testing

A clinic nurse is conducting a preoperative interview with an adult patient who will soon be scheduled to undergo cardiac surgery. What interview question most directly addresses the patients safety? A)What prescription and nonprescription medications do you currently take? B)Have you previously been admitted to the hospital, either for surgery or for medical treatment? C)How long do you expect to be at home recovering after your surgery? D)Would you say that you tend to eat a fairly healthy diet

A)What prescription and nonprescription medications do you currently take?

One of the things a nurse has taught to a patient during preoperative teaching is to have nothing by mouth for the specified time before surgery. The patient asks the nurse why this is important. What is the most appropriate response for the patient? A)You will need to have food and fluid restricted before surgery so you are not at risk for choking. B)The restriction of food or fluid will prevent the development of pneumonia related to decreased lung capacity. C)The presence of food in the stomach interferes with the absorption of anesthetic agents. D)By withholding food for 8 hours before surgery, you will not develop constipation in the postoperative period

A)You will need to have food and fluid restricted before surgery so you are not at risk for choking.

The policies and procedures on a preoperative unit are being amended to bring them closer into alignment with the focus of the Surgical Care Improvement Project (SCIP). What intervention most directly addresses the priorities of the SCIP? A)Actions aimed at increasing participation of families in planning care B)Actions aimed at preventing surgical site infections C)Actions aimed at increasing interdisciplinary collaboration D)Actions aimed at promoting the use of complementary and alternative medicine (CAM

B)Actions aimed at preventing surgical site infections

The nurse is creating the plan of care for a patient who is status post surgery for reduction of a femur fracture. What is the most important short-term goal for this patient? A)Relief of pain B)Adequate respiratory function C)Resumption of activities of daily living (ADLs) D)Unimpaired wound healing

B)Adequate respiratory function

The nurse is performing a preoperative assessment on a patient going to surgery. The patient informs the nurse that he drinks approximately two bottles of wine each day and has for the last several years. What postoperative difficulties can the nurse anticipate for this patient? A)Alcohol withdrawal syndrome immediately following surgery B)Alcohol withdrawal syndrome 2 to 4 days after his last alcohol drink C)Alcohol withdrawal syndrome upon administration of general anesthesia D)Alcohol withdrawal syndrome 1 week after his last alcohol drink

B)Alcohol withdrawal syndrome 2 to 4 days after his last alcohol drink

The nurse is preparing a patient for surgery. The patient states that she is very nervous and really does not understand what the surgical procedure is for or how it will be performed. What is the most appropriate nursing action for the nurse to take? A)Have the patient sign the informed consent and place it in the chart. B)Call the physician to review the procedure with the patient. C)Explain the procedure clearly to the patient and her family. D)Provide the patient with a pamphlet explaining the procedure

B)Call the physician to review the procedure with the patient.

The nurse is preparing to change a patients abdominal dressing. The nurse recognizes the first step is to provide the patient with information regarding the procedure. Which of the following explanations should the nurse provide to the patient? A)The dressing change is often painful, and we will be giving you pain medication prior to the procedure so you do not have to worry. B)During the dressing change, I will provide privacy at a time of your choosing, it should not be painful, and you can look at the incision and help with the procedure if you want to. C)The dressing change should not be painful, but you can never be sure, and infection is always a concern. D)The best time for doing a dressing change is during lunch so we are not interrupted. I will provide privacy, and it should not be painful

B)During the dressing change, I will provide privacy at a time of your choosing, it should not be painful, and you can look at the incision and help with the procedure if you want to.

The surgeons preoperative assessment of a patient has identified that the patient is at a high risk for venous thromboembolism. Once the patient is admitted to the postsurgical unit, what intervention should the nurse prioritize to reduce the patients risk of developing this complication? A)Maintain the head of the bed at 45 degrees or higher. B)Encourage early ambulation. C)Encourage oral fluid intake. D)Perform passive range-of-motion exercises every 8 hour

B)Encourage early ambulation.

The nurse admits a patient to the PACU with a blood pressure of 132/90 mm Hg and a pulse of 68 beats per minute. After 30 minutes, the patients blood pressure is 94/47 mm Hg, and the pulse is 110. The nurse documents that the patients skin is cold, moist, and pale. Of what is the patient showing signs? A)Hypothermia B)Hypovolemic shock C)Neurogenic shock D)Malignant hyperthermia

B)Hypovolemic shock

A nurse is providing preoperative teaching to a patient who will soon undergo a cardiac bypass. The nurses teaching plan includes exercises of the extremities. What is the purpose of teaching a patient leg exercises prior to surgery? A)Leg exercises increase the patients muscle mass postoperatively. B)Leg exercises improve circulation and prevent venous thrombosis. C)Leg exercises help to prevent pressure sores to the sacrum and heels. D)Leg exercise help increase the patients level of consciousness after surge

B)Leg exercises improve circulation and prevent venous thrombosis.

The nurse is caring for a patient who has just been transferred to the PACU from the OR. What is the highest nursing priority? A)Assessing for hemorrhage B)Maintaining a patent airway C)Managing the patients pain D)Assessing vital signs every 30 minute

B)Maintaining a patent airway

A patient is 2 hours postoperative with a Foley catheter in situ. The last hourly urine output recorded for this patient was 10 mL. The tubing of the Foley is patent. What should the nurse do? A)Irrigate the Foley with 30 mL normal saline. B)Notify the physician and continue to monitor the hourly urine output closely. C)Decrease the IV fluid rate and massage the patients abdomen. D)Have the patient sit in high-Fowlers position

B)Notify the physician and continue to monitor the hourly urine output closely.

During the care of a preoperative patient, the nurse has given the patient a preoperative benzodiazepine. The patient is now requesting to void. What action should the nurse take? A)Assist the patient to the bathroom. B)Offer the patient a bedpan or urinal. C)Wait until the patient gets to the operating room and is catheterized. D)Have the patient go to the bathroom.

B)Offer the patient a bedpan or urinal.

The nursing instructor is discussing the difference between ambulatory surgical centers and hospital- based surgical units. A student asks why some patients have surgery in the hospital and others are sent to ambulatory surgery centers. What is the instructors best response? A)Patients who go to ambulatory surgery centers are more independent than patients admitted to the hospital. B)Patients admitted to the hospital for surgery usually have multiple health needs. C)In most cases, only emergency and trauma patients are admitted to the hospital. D)Patients who have surgery in the hospital are those who need to have anesthesia administereD

B)Patients admitted to the hospital for surgery usually have multiple health needs.

The nurse is caring for a patient who is postoperative day 2 following a colon resection. While turning him, wound dehiscence with evisceration occurs. What should be the nurses first response? A)Return the patient to his previous position and call the physician. B)Place saline-soaked sterile dressings on the wound. C)Assess the patients blood pressure and pulse. D)Pull the dehiscence closed using gloved hands

B)Place saline-soaked sterile dressings on the wound.

A patient is on call to the OR for an aortobifemoral bypass and the nurse administers the ordered preoperative medication. After administering a preoperative medication to the patient, what should the nurse do? A)Encourage light ambulation. B)Place the bed in a low position with the side rails up. C)Tell the patient that he will be asleep before he leaves for surgery. D)Take the patients vital signs every 15 minute

B)Place the bed in a low position with the side rails up.

A postoperative patient rapidly presents with hypotension; rapid, thready pulse; oliguria; and cold, pale skin. The nurse suspects that the patient is experiencing a hemorrhage. What should be the nurses first action? A)Leave and promptly notify the physician. B)Quickly attempt to determine the cause of hemorrhage. C)Begin resuscitation. D)Put the patient in the Trendelenburg position

B)Quickly attempt to determine the cause of hemorrhage.

A surgical patient has been in the PACU for the past 3 hours. What are the determining factors for the patient to be discharged from the PACU? Select all that apply. A)Absence of pain B)Stable blood pressure C)Ability to tolerate oral fluids D)Sufficient oxygen saturation E)Adequate respiratory function

B)Stable blood pressure D)Sufficient oxygen saturation E)Adequate respiratory function

The nursing instructor is discussing postoperative care with a group of nursing students. A student nurse asks, Why does the patient go to the PACU instead of just going straight up to the postsurgical unit? What is the nursing instructors best response? A)The PACU allows the patient to recover from anesthesia in a stimulating environment to facilitate awakening and reorientation. B)The PACU allows the patient to recover from the effects of anesthesia, and the patient stays in the PACU until he or she is oriented, has stable vital signs, and is without complications. C)Frequently, patients are placed in the medical surgical unit to recover, but hospitals are usually short of beds, and the PACU is an excellent place to triage patients. D)Patients remain in the PACU for a predetermined time because the surgeon will often need to reinforce or alter the patients incision in the hours following surgery

B)The PACU allows the patient to recover from the effects of anesthesia, and the patient stays in the PACU until he or she is oriented, has stable vital signs, and is without complications.

The nurse is caring for a postoperative patient who needs daily dressing changes. The patient is 3 days postoperative and is scheduled for discharge the next day. Until now, the patient has refused to learn how to change her dressing. What would indicate to the nurse the patients possible readiness to learn how to change her dressing? Select all that apply. A)The patient wants you to teach a family member to do dressing changes. B)The patient expresses interest in the dressing change. C)The patient is willing to look at the incision during a dressing change. D)The patient expresses dislike of the surgical wound. E)The patient assists in opening the packages of dressing material for the nurse

B)The patient expresses interest in the dressing change. C)The patient is willing to look at the incision during a dressing change. E)The patient assists in opening the packages of dressing material for the nurse

A patient underwent an open bowel resection 2 days ago and the nurses most recent assessment of the patients abdominal incision reveals that it is dehiscing. What factor should the nurse suspect may have caused the dehiscence? A)The patients surgical dressing was changed yesterday and today. B)The patient has vomited three times in the past 12 hours. C)The patient has begun voiding on the commode instead of a bedpan. D)The patient used PCA until this morning

B)The patient has vomited three times in the past 12 hours.

You are the nurse caring for an unconscious trauma victim who needs emergency surgery. The patient is a 55-year-old man with an adult son. He is legally divorced and is planning to be remarried in a few weeks. His parents are at the hospital with the other family members. The physician has explained the need for surgery, the procedure to be done, and the risks to the children, the parents, and the fiancé. Who should be asked to sign the surgery consent form? A)The fiancé B)The son C)The physician, acting as a surrogate D)The patients father

B)The son

You are caring for an 88-year-old woman who is scheduled for a right mastectomy. You know that elderly patients are frequently more anxious prior to surgery than younger patients. What would you increase with this patient to decrease her anxiety? A)Analgesia B)Therapeutic touch C)Preoperative medication D)Sleeping medication the night before surgery

B)Therapeutic touch

The nurse is providing preoperative teaching to a patient scheduled for surgery. The nurse is instructing the patient on the use of deep breathing, coughing, and the use of incentive spirometry when the patient 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? A)To prevent chronic obstructive pulmonary disease (COPD) B)To promote optimal lung expansion C)To enhance peripheral circulation D)To prevent pneumothorax

B)To promote optimal lung expansion

The PACU nurse is caring for a patient who has arrived from the OR. During the initial assessment, the nurse observes that the patients skin has become blue and dusky. The nurse looks, listens, and feels for breathing, and determines the patient is not breathing. What is the priority intervention? A)Check the patients oxygen saturation level, continue to monitor for apnea, and perform a focused assessment. B)Treat the possible airway obstruction by tilting the head back and pushing forward on the angle of the lower jaw. C)Assess the arterial pulses, and place the patient in the Trendelenburg position. D)Reintubate the patient

B)Treat the possible airway obstruction by tilting the head back and pushing forward on the angle of the lower jaw.

A 77-year-old mans coronary artery bypass graft has been successful and discharge planning is underway. When planning the patients subsequent care, the nurse should know that the postoperative phase of perioperative nursing ends at what time? A)When the patient is returned to his room after surgery B)When a follow-up evaluation in the clinical or home setting is done C)When the patient is fully recovered from all effects of the surgery D)When the family becomes partly responsible for the patients care

B)When a follow-up evaluation in the clinical or home setting is done

The nurse just received a postoperative patient from the PACU to the medical surgical hip replacement. Which of the following concerns should the nurse prioritize for this patient in the first few hours on the unit? A)Beginning early ambulation B)Maintaining clean dressings on the surgical site C)Close monitoring of neurologic status D)Resumption of normal oral intake

C)Close monitoring of neurologic status

The home health nurse is caring for a postoperative patient who was discharged home on day 2 after surgery. The nurse is performing the initial visit on the patients post operative day 2. During the visit, the nurse will assess for wound infection. For most patients, what is the earliest postoperative day that a wound infection becomes evident? A)Day 9 B)Day 7 C)Day 5 D)Day 3

C)Day 5

The nurse is doing a preoperative assessment of an 87-year-old man who is slated to have a right lung lobe resection to treat lung cancer. What underlying principle should guide the nurses preoperative assessment of an elderly patient? A)Elderly patients have a smaller lung capacity than younger patients. B)Elderly patients require higher medication doses than younger patients. C)Elderly patients have less physiologic reserve than younger patients. D)Elderly patients have more sophisticated coping skills than younger patient

C)Elderly patients have less physiologic reserve than younger patients.

The nurse is caring for a patient who is admitted to the ER with the diagnosis of acute appendicitis. The nurse notes during the assessment that the patients ribs and xiphoid process are prominent. The patient states she exercises two to three times daily and her mother indicates that she is being treated for anorexia nervosa. How should the nurse best follow up these assessment data? A)Inform the postoperative team about the patients risk for wound dehiscence. B)Evaluate the patients ability to manage her pain level. C)Facilitate a detailed analysis of the patients electrolyte levels. D)Instruct the patient on the need for a high-sodium diet to promote healing

C)Facilitate a detailed analysis of the patients electrolyte levels.

You are caring for a 71-year-old patient who is 4 days postoperative for bilateral inguinal hernias. The patient has a history of congestive heart failure and peptic ulcer disease. The patient is highly reluctant to ambulate and will not drink fluids except for hot tea with her meals. The nurses aide reports to you that this patients vital signs are slightly elevated and that she has a nonproductive cough. When you assess the patient, you auscultate crackles at the base of the lungs. What would you suspect is wrong with your patient? A)Pulmonary embolism B)Hypervolemia C)Hypostatic pulmonary congestion D)Malignant hyperthermia

C)Hypostatic pulmonary congestion

The clinic nurse is doing a preoperative assessment of a patient who will be undergoing outpatient cataract surgery with lens implantation in 1 week. While taking the patients medical history, the nurse notes that this patient had a kidney transplant 8 years ago and that the patient is taking immunosuppressive drugs. For what is this patient at increased risk when having surgery? A)Rejection of the kidney B)Rejection of the implanted lens C)Infection D)Adrenal storm

C)Infection

The intraoperative nurse is transferring a patient from the OR to the PACU after replacement of the rightknee. The patient is a 73-year-old woman. The nurse should prioritize which of the following actions? A)Keeping the patient sterile B)Keeping the patient restrained C)Keeping the patient warm D)Keeping the patient hydrated

C)Keeping the patient warm

The nurse is caring for an 82-year-old female patient in the PACU. The woman begins to awaken and responds to her name, but is confused, restless, and agitated. What principle should guide the nurses subsequent assessment? A)Postoperative confusion in older adults is an indication of impaired oxygenation or possibly a stroke during surgery. B)Confusion, restlessness, and agitation are expected postoperative findings in older adults and they will diminish in time. C)Postoperative confusion is common in the older adult patent, but it could also indicate a significant blood loss. D)Confusion, restlessness, and agitation indicate an underlying cognitive deficit such as dement

C)Postoperative confusion is common in the older adult patent, but it could also indicate a significant blood loss.

A patient is scheduled for a bowel resection in the morning and the patients orders include a cleansing enema tonight. The patient wants to know why this is necessary. The nurse should explain that the cleansing enema will have what therapeutic effect? A)Preventing aspiration of gastric contents B)Preventing the accumulation of abdominal gas postoperatively C)Preventing potential contamination of the peritoneum D)Facilitating better absorption of medication

C)Preventing potential contamination of the peritoneum

The nurse is caring for a 79-year-old man who has returned to the postsurgical unit following abdominal surgery. The patient is unable to ambulate and is now refusing to wear an external pneumatic compression stocking. The nurse should explain that refusing to wear external pneumatic compression stockings increases his risk of what postsurgical complication? A)Sepsis B)Infection C)Pulmonary embolism D)Hematoma

C)Pulmonary embolism

The nurse is caring for a patient on the medical surgical unit postoperative day 5. During each patient assessment, the nurse evaluates the patient for infection. Which of the following would be most indicative of infection? A)Presence of an indwelling urinary catheter B)Rectal temperature of 99.5F (37.5C) C)Red, warm, tender incision D)White blood cell (WBC) count of 8,000/mL

C)Red, warm, tender incision

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 patient do? A)Sit in a chair for 10 minutes prior to ambulating. B)Drink plenty of fluids to increase circulating blood volume. C)Stand upright for 2 to 3 minutes prior to ambulating. D)Perform range-of-motion exercises for each joint

C)Stand upright for 2 to 3 minutes prior to ambulating.

The ED nurse is caring for an 11-year-old brought in by ambulance after having been hit by a car. The Childs parents are thought to be en route to the hospital but have not yet arrived. No other family members are present and attempts to contact the parents have been unsuccessful. The child needs emergency surgery to save her life. How should the need for informed consent be addressed? A)A social worker should temporarily sign the informed consent. B)Consent should be obtained from the hospitals ethics committee. C)Surgery should be done without informed consent. D)Surgery should be delayed until the parents arrive

C)Surgery should be done without informed consent.

The nurse is checking the informed consent for a 17-year-old who has just been married and expecting her first child. She is scheduled for a cesarean section. She is still living with her parents and is on her parents health insurance. When obtaining informed consent for the cesarean section, who is legally responsible for signing? A)Her parents B)Her husband C)The patient D)The obstetrician

C)The patient

The nurse is caring for a patient after abdominal surgery in the PACU. The patients blood pressure has increased and the patient is restless. The patients oxygen saturation is 97%. What cause for this change in status should the nurse first suspect? A)The patient is hypothermic. B)The patient is in shock. C)The patient is in pain. D)The patient is hypoxic

C)The patient is in pain.

In anticipation of a patients scheduled surgery, the nurse is teaching her to perform deep breathing and coughing to use postoperatively. What action should the nurse teach the patient? A)The patient should take three deep breaths and cough hard three times, at least every 15 minutes for the immediately postoperative period. B)The patient should take three deep breaths and exhale forcefully and then take a quick short breath and cough from deep in the lungs. C)The patient should take a deep breath in through the mouth and exhale through the mouth, take a short breath, and cough from deep in the lungs. D)The patient should rapidly inhale, hold for 30 seconds or as long as possible, and exhale slow

C)The patient should take a deep breath in through the mouth and exhale through the mouth, take a short breath, and cough from deep in the lungs.

The PACU nurse is caring for a patient who has been deemed ready to go to the postsurgical floor after her surgery. What would the PACU nurse be responsible for reporting to the nurse on the floor? Select all that apply. A)The names of the anesthetics that were used B)The identities of the staff in the OR C)The patients preoperative level of consciousness D)The presence of family and/or significant others E)The patients full name

C)The patients preoperative level of consciousness D)The presence of family and/or significant others E)The patients full name

The nurse is preparing a patient for surgery prior to her hysterectomy without oophorectomy. The nurse is witnessing the patients signature on a consent form. Which comment by the patient would best indicate informed consent? A)I know Ill be fine because the physician said he has done this procedure hundreds of times. B)I know Ill have pain after the surgery but they'll do their best to keep it to a minimum. C)The physician is going to remove my uterus and told me about the risk of bleeding. D)Because the physician isn't taking my ovaries, Ill still be able to have children

C)The physician is going to remove my uterus and told me about the risk of bleeding.

The nurse in the ED is caring for a man who has returned to the ED 4 days after receiving stitches for a knife wound on his hand. The wound is now infected, so the stitches were removed, and the wound is cleaned and packed with gauze. The ED doctor plans to have the man return tomorrow to remove the packing and resuture the wound. You are aware that the wound will now heal by what means? A)Late intention B)Second intention C)Third intention D)First intention

C)Third intention

The dressing surrounding a mastectomy patients Jackson-Pratt drain has scant drainage on it. The nurse believes that the amount of drainage on the dressing may be increasing. How can the nurse best confirm this suspicion? A)Describe the appearance of the dressing in the electronic health record. B)Photograph the patients abdomen for later comparison using a smartphone. C)Trace the outline of the drainage on the dressing for future comparison. D)Remove and weigh the dressing, reapply it, and then repeat in 8 hou

C)Trace the outline of the drainage on the dressing for future comparison.

The nurse is caring for a patient who is experiencing pain and anxiety following his prostatectomy. Which intervention will likely best assist in decreasing the patients pain and anxiety? A)Administration of NSAIDs rather than opioids B)Allowing the patient to increase activity C)Use of guided imagery along with pain medication D)Use of deep breathing and coughing exercise

C)Use of guided imagery along with pain medication

The nurse is caring for a trauma victim in the ED who will require emergency surgery due to injuries. Before the patient leaves the ED for the OR, the patient goes into cardiac arrest. The nurse assists in the successful resuscitation and proceeds to release the patient to the OR staff. When can the ED nurse perform the preoperative assessment? A)When he or she has the opportunity to review the patients electronic health record B)When the patient arrives in the OR C)When assisting with the resuscitation D)Preoperative assessment is not necessary in this case

C)When assisting with the resuscitation

A patient is admitted to the ED complaining of severe abdominal pain, stating that he has been vomiting coffee-ground like emesis. The patient is diagnosed with a perforated gastric ulcer and is informed that he needs surgery. When can the patient most likely anticipate that the surgery will be scheduled? A)Within 24 hours B)Within the next week C)Without delay because the bleed is emergent D)As soon as all the days elective surgeries have been completed

C)Without delay because the bleed is emergent

The nurse is caring for a 78-year-old female patient who is scheduled for surgery to remove her brain tumor. The patient is very apprehensive and keeps asking when she will get her preoperative medicine. The medicine is ordered to be given on call to OR. When would be the best time to give this medication? A)As soon as possible, in order to alleviate the patients anxiety B)As the patient is transferred to the OR bed C)When the porter arrives on the floor to take the patient to surgery D)After being notified by the OR and before other preoperative preparations

D)After being notified by the OR and before other preoperative preparations

The recovery room nurse is admitting a patient from the OR following the patients successful splenectomy. What is the first assessment that the nurse should perform on this newly admitted patient? A)Heart rate and rhythm B)Skin integrity C)Core body temperature D)Airway patency

D)Airway patency

The nurse is planning patient teaching for a patient who is scheduled for an open hemicolectomy. The nurse intends to address the topics of incision splinting and leg exercises during this teaching session. When is the best time for the nurse to provide teaching? A)Upon the patients admission to the postanesthesia care unit (PACU) B)When the patient returns from the PACU C)During the intraoperative period D)As soon as possible before the surgical procedure

D)As soon as possible before the surgical procedure

The nursing instructor is talking with a group of medical surgical students about deep vein thrombosis (DVT). A student asks what factors contribute to the formation of a DVT. What would be the instructors best response? A)There is a genetic link in the formation of deep vein thrombi. B)Hypervolemia is often present in patients who go on to develop deep vein thrombi. C)No known factors contribute to the formation of deep vein thrombi; they just occur. D)Dehydration is a contributory factor to the formation of deep vein thrombi

D)Dehydration is a contributory factor to the formation of deep vein thrombi

The nurse is admitting a patient to the medical surgical unit from the PACU. What should the nurse do to help the patient clear secretions and help prevent pneumonia? A)Encourage the patient to eat a balanced diet that is high in protein. B)Encourage the patient to limit his activity for the first 72 hours. C)Encourage the patient to take his medications as ordered. D)Encourage the patient to use the incentive spirometer every 2 hours

D)Encourage the patient to use the incentive spirometer every 2 hours

The nurses aide notifies the nurse that a patient has decreased oxygen saturation levels. The nurse assesses the patient and finds that he is tachypnic, has crackles on auscultation, and his sputum is frothy and pink. The nurse should suspect what complication? A)Pulmonary embolism B)Atelectasis C)Laryngospasm D)Flash pulmonary edema

D)Flash pulmonary edema

The nurse is providing teaching about tissue repair and wound healing to a patient who has a leg ulcer. Which of the following statements by the patient indicates that teaching has been effective? A)Ill make sure to limit my intake of protein. B)Ill make sure that the bandage is wrapped tightly. C)My foot should feel cool or cold while my legs healing. D)Ill eat plenty of fruits and vegetables

D)Ill eat plenty of fruits and vegetables

The nurse is creating the care plan for a 70-year-old obese patient who has been admitted to the postsurgical unit following a colon resection. This patients age and increased body mass index mean that she is at increased risk for what complication in the postoperative period? A)Hyperglycemia B)Azotemia C)Falls D)Infection

D)Infection

The PACU nurse is caring for a male patient who had a hernia repair. The patients blood pressure is now 164/92 mm Hg; he has no history of hypertension prior to surgery and his preoperative blood pressure was 112/68 mm Hg. The nurse should assess for what potential causes of hypertension following surgery? A)Dysrhythmias, blood loss, and hyperthermia B)Electrolyte imbalances and neurologic changes C)A parasympathetic reaction and low blood volumes D)Pain, hypoxia, or bladder distention

D)Pain, hypoxia, or bladder distention

The nurse is caring for a hospice patient who is scheduled for a surgical procedure to reduce the size of his spinal tumor in an effort to relieve his pain. The nurse should plan this patient care with the knowledge that his surgical procedure is classified as which of the following? A)Diagnostic B)Laparoscopic C)Curative D)Palliative

D)Palliative

A 90-year-old female patient is scheduled to undergo a partial mastectomy for the treatment of breast cancer. What nursing diagnosis should the nurse prioritize when planning this patients postoperative care? A)Risk for Delayed Growth and Development related to prolonged hospitalization B)Risk for Decisional Conflict related to discharge planning C)Risk for Impaired Memory related to old age D)Risk for Infection related to reduced immune function

D)Risk for Infection related to reduced immune function

The nurse is doing preoperative patient education with a 61-year-old male patient who has a 40-pack per year history of cigarette smoking. The patient will undergo an elective bunionectomy at a time that fits his work schedule in a few months. What would be the best instruction to give to this patient? A)Reduce smoking by 50% to prevent the development of pneumonia. B)Stop smoking at least 6 weeks before the scheduled surgery to enhance pulmonary function and decrease infection. C)Aim to quit smoking in the postoperative period to reduce the chance of surgical complications D)Stop smoking 4 to 8 weeks before the scheduled surgery to enhance pulmonary function and decrease infection.

D)Stop smoking 4 to 8 weeks before the scheduled surgery to enhance pulmonary function and decrease infection.

The nurse admitting a patient who is insulin dependent to the same-day surgical suite for carpal tunnel surgery. How should this patients diagnosis of type 1 diabetes affect the care that the nurse plans? A)The nurse should administer a bolus of dextrose IV solution preoperatively. B)The nurse should keep the patient NPO for at least 8 hours preoperatively. C)The nurse should initiate a subcutaneous infusion of long-acting insulin. D)The nurse should assess the patients blood glucose levels vigilantly

D)The nurse should assess the patients blood glucose levels vigilantly

An adult patient is in the recovery room following a nephrectomy performed for the treatment of renal cell carcinoma. The patients vital signs and level of consciousness stabilized, but the patient then complains of severe nausea and begins to retch. What should the nurse do next? A)Administer a dose of IV analgesic. B)Apply a cool cloth to the patients forehead. C)Offer the patient a small amount of ice chips. D)Turn the patient completely to one side

D)Turn the patient completely to one side

The nurse is caring for a patient in the postoperative period following an abdominal hysterectomy. The patient states, I don't want to use my pain meds because they'll make me dependent and I wont get better as fast. Which response is most important when explaining the use of pain medication? A)You will need the pain medication for at least 1 week to help in your recovery. What do you meanyou feel you wont get better faster? B)Pain medication will help to decrease your pain and increase your ability to breath. Dependency is a risk with pain medication, but you are young and wont have any problems. C)Pain medication can be given by mouth to prevent the risk of dependency that you are worried about. The pain medication has not been shown to affect your risk of a slowed recovery. D)You will move more easily and heal more quickly with decreased pain. Dependence only occurs when it is administered for an extended period of time

D)You will move more easily and heal more quickly with decreased pain. Dependence only occurs when it is administered for an extended period of time