Exam 1 Chapter 17 Preop

You are the nurse working in an ambulatory surgery center. A teenage son of your clients ask you why so many people have surgery. What would be your best reply? "Many people have diagnostic or short therapeutic surgical procedures." "Lots of people have cancer and need tumors removed." "You know, we have a lot of sick people in the world." "Not everyone has to go to the hospital to have surgery anymore."

"Many people have diagnostic or short therapeutic surgical procedures."

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

Hypoglycemia

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? Answer the client's questions. Request that the surgeon come and answer the questions. Place the consent form in the client's medical record. Notify the nurse manager of the client's questions.

Request that the surgeon come and answer the questions.

A 79-year-old man is scheduled for surgical repair of an inguinal hernia. In light of this patient's age, the nurse will prioritize nursing interventions aimed at preventing: Overstimulation Skin breakdown Hyperglycemia or hypoglycemia Early ambulation

Skin breakdown

A nurse is teaching a client with chronic bronchitis about breathing exercises. Which instruction should the nurse include in the teaching? Make inhalation longer than exhalation. Exhale through an open mouth. Use diaphragmatic breathing. Use chest breathing.

Use diaphragmatic breathing.

When a client is encouraged to concentrate on a pleasant experience or restful scene, the client is using the cognitive coping strategy called imagery. optimistic self-recitation. distraction. progressive muscular relaxation.

imagery.

Which nursing statement would best decrease a client's anxiety before an emergency operative procedure? "You will be just fine; the operating room nurses will take good care of you." "It is best to take deep breaths and relax before the procedure." "Let me explain to you what will happen next." "We will keep your family informed of your progress."

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

A client has been transported to the operating room for emergent surgery. Which statement by the nurse best supports the need for emergent surgery? "The client was unresponsive, had a distended abdomen, and had unstable vital signs after a motor vehicle accident." "The client had epigastric abdominal pain, an elevated white blood count, and vomiting for 1 day." "The client had severe pain and a laceration to the face with minimal bleeding after being attacked by a dog 1 hour ago." "The client was tachycardic, had progressive weight loss, and experienced bouts of insomnia as a result of hyperthyroidism."

"The client was unresponsive, had a distended abdomen, and had unstable vital signs after a motor vehicle accident."

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? 2 weeks 4 weeks 7 to 10 days 2 to 3 days

7 to 10 days

What is the blood glucose level goal for a diabetic client who will be having a surgical procedure? 80 to 110 mg/dL 150 to 240 mg/dL 250 to 300 mg/dL 300 to 350 mg/dL

80 to 110 mg/dL

The nurse expects informed consent to be obtained for insertion of: An indwelling urinary catheter An intravenous catheter A gastrostomy tube A nasogastric tube

A gastrostomy tube

During the preoperative assessment, the nurse learns that the client has been taking prednisone. The nurse realizes that the client is at risk for: Cardiovascular collapse. Respiratory depression. Decreased blood pressure. Increased blood loss.

Cardiovascular collapse.

The client is scheduled for a biopsy for suspected cancer of the prostate. The nurse recognizes the purpose of this surgical procedure is: Curative Diagnostic Palliative Reparative

Diagnostic

What action by the nurse best encompasses the preoperative phase? Educating clients on signs and symptoms of infection Documenting the application of sequential compression devices (SCDs) Monitoring vital signs every 15 minutes Shaving the client using a straight razor

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. urgent. required. elective.

Emergency

A fractured skull would be classified under which category of surgery based on urgency? Elective Required Urgent Emergent

Emergent

You are admitting an insulin-dependent patient to the same-day surgical suite for carpal tunnel surgery. You know that this patient may be at risk for which metabolic disorder? Adrenal insufficiency Thyrotoxicosis Impaired acid base balance Hyperglycemia

Hyperglycemia

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. May have a sexually transmitted disease. Needs to change her position during intercourse. Is susceptible to the lubricant.

May have a latex allergy.

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? Aging processes reduce the chances that surgery will be successful for these clients. Older adults have less physiologic reserve (or ability to regain physical equilibrium) than younger clients. Neurologic and musculoskeletal complications are the leading cause of postoperative morbidity and mortality for older adults. All older people face similar risks when undergoing surgeries.

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? Pregnancy Diabetes Urinary tract infection Osteoporosis

Osteoporosis

Which health care profession has the ultimate responsibility to provide appropriate information regarding a nonemergent surgery? Nurse Physician Case manager Certified nurse's aide

Physician

You are physically preparing a client for surgery and instruct the person to remove any jewelry. The client refuses to remove a wedding band. What should you do in this situation with approval from your facility? Explain that the client cannot go into the operating room with jewelry on. Medicate the client and then remove the ring. Place gauze under and over the ring and apply adhesive tape over it. Tell the physician and anesthesiologist.

Place gauze under and over the ring and apply adhesive tape over it

When is the ideal time to discuss preoperative teaching Preadmission visit Day of surgery Prior to entering the pre-op area When the patient is comfortable and sedated

Preadmission visit

Once the operating team has assembled in the room, the circulating nurse calls for a "time out." What action should the nurse take during the time out? Ensure that sufficient surgical supplies are available. Check that all surgical personnel are properly attired. Review the scheduled procedure, site, and client. Confirm that informed consent has been obtained.

Review the scheduled procedure, site, and client.

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. Pain medication should be taken before completing deep breathing and coughing exercises. Deep breathing and coughing exercises should be completed every 8 hours. Deep breathing and coughing exercises may be used as relaxation techniques.

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? Anesthesiologist Circulating nurse Registered nurse first assistant Surgeon

Surgeon

The nurse is preparing a patient for surgery. The patient is to undergo a hysterectomy without oophorectomy, and the nurse is witnessing the patient's signature on a consent form. Which comment by the patient would best indicate informed consent? "I know I'll be fine because the health care provider said he has done this procedure hundreds of times." "I know I'll have pain after the surgery." "The health care provider is going to remove my uterus and told me about the risk of hemorrhage." "Because the health care provider isn't taking my ovaries, I'll still be able to have children."

The health care provider is going to remove my uterus and told me about the risk of hemorrhage."

When does the nurse understand the patient is knowledgeable about the impending surgical procedure? The patient participates willingly in the preoperative preparation. The patient discusses stress factors causing the patient to feel depressed. The patient expresses concern about postoperative pain. The patient verbalizes fears to family.

The patient participates willingly in the preoperative preparation.

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? Completes preoperative assessment Develops a plan of care Verifies that operative consent is signed Provides psychological support

Verifies that operative consent is signed

When assessing a postoperative client, the nurse is correct to relate which surgical risk factor that would decrease if the surgical client maintained a blood glucose level under 8.3 mmol/L? Nutrient deficiencies Respiratory complications Wound healing Liver dysfunction

Wound healing

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. performs a complete assessment of the client. obtains a surgical consent from the client's mother. assesses how well the client is recovering from anesthesia.

continuously monitors the sedated client. performs a complete assessment of the client. obtains a surgical consent from the client's mother. assesses how well the client is recovering from anesthesia.

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 type of surgery ability to metabolize medication surgical site

current smoking history

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? corticosteroids diuretics insulin anticoagulants

diuretics

A nurse is assessing a postoperative client with hyperglycemic blood glucose levels. Which post-surgical risk factor would decrease if the surgical client maintained strict blood glycemic control? nutrient deficiencies respiratory complications wound healing liver dysfunction

liver dysfunction

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 gender health status Ethnicity

nutritional status age physical condition health status

In which phase of perioperative care will the nurse prepare the client's skin, encourage the client to void, and remove the client's dentures? preoperative postoperative intraoperative transoperative

preoperative

A nurse is assessing a postoperative client with hyperglycemic blood glucose levels. Which post-surgical risk factor would decrease if the surgical client maintained strict blood glycemic control? nutrient deficiencies respiratory complications wound healing liver dysfunction

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? "If I do not follow the instructions, my surgery could be cancelled." "The nurse will explain the details of the surgery before I sign a consent." "My medical records will be sent to the ambulatory care center prior to my surgery." "The physician will update my family after the procedure and provide specific discharge instructions."

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

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 Upon arrival to the surgical unit Following the surgical procedure At the time of discharge instructions

During the preoperative period

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. No action is needed, because the client takes warfarin on a continuing basis. Put a note on the preoperative checklist before sending the client into surgery. Tell the client to inform the circulating nurse before the anesthesia is administered.

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

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. minimize the time that will need to be spent on postoperative questions. decrease the client's participation and allow the family to take on the caregiver role. absolve the hospital of legal responsibility should complications arise.

increase the likelihood of a successful recovery.

A surgical client has been transferred to the holding area. What nursing intervention(s) promote safe and effective nursing care? Select all that apply. Identify the client using two identifiers. Verify the surgical site has been marked per institutional policy Maintain an aseptic environment. Review the medical records. Apply grounding devices to the client. Provide oral fluids to the patient.

Identify the client using two identifiers. Verify the surgical site has been marked per institutional policy Review the medical records.