Chapter 17 Prep U 310

What is the blood glucose level goal for a diabetic cli]ent who will be having a surgical procedure

80 to 110 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

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

Adrenal

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

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

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

Let me explain to you what will happen next

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

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

The nurse is reviewing the pre-admission laboratory findings of the client scheduled for surgery. Which laboratory value would be of greatest concern to the nurse

Potassium 6.2 mEq/L

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

When does the nurse understand the patient is knowledgeable about the impending surgical procedure

The patient participates willingly in the preoperative preparation

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

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

7 days

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

7-10 days

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

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

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

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

Emergency

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

Emergent

A client with a skull fracture after falling from a ladder requires surgery. The nurse should anticipate transporting the client to surgery during what time frame

Immediately

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

Moving the client swiftly

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

Which health care profession has the ultimate responsibility to provide appropriate information regarding a nonemergent surgery

Physician

The nurse in the preoperative area has just medicated her client according to the anesthesiologist's orders. What is the nurse's priority action at this time

Place the side rails in the up position and make sure the call button is in reach

When is the ideal time to discuss preoperative teaching

Preadmission visit

A client is scheduled for elective surgery. To prevent the complications of hypotension and cardiovascular collapse, the nurse should report the use of which medication

Prednisone

A client is scheduled to have surgery to address a cleft palate. What type of surgery would the nurse be preparing this client for

Reconstructive

The nurse is educating a client scheduled for elective surgery. The client currently takes aspirin daily. What education should the nurse provide with regard to this medication

Stop taking the aspirin 7 days before the surgery, unless otherwise directed by your physician

The nurse is educating clients who require surgery for various ailments about the perioperative experience. What education provided by the nurse is most appropriate

Three phases of surgery and safety measures for each phase

Sudden withdrawal of which of the following may result in seizures

Tranquilizers

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

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?

The nurse assesses an older adult patient who complains of dimmed vision. What does this alert the nurse to plan for

A safe environment

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

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 Health status Age Physical condition

A client is undergoing thoracic surgery. What priority education should the nurse provide to assist in preventing respiratory complications

Pain medication should be taken before completing deep breathing and coughing exercises

Which nutrient plays an important role in normal blood clotting

Vitamin K

The nurse is completing a preoperative assessment. The nurse notices the client is tearful and constantly wringing their hands. The client states, "I'm really nervous about this surgery. Do you think it will be ok" What is the nurse's best response

What are your concerns

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

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

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 patient is scheduled for a surgical procedure. For which surgical procedure should the nurse prepare an informed consent form for the surgeon to sign

An open reduction of a fracture