SI peri-, intra, post operative

On the day of surgery, a client with DM who take insulin on a sliding scale is tobe NPO and all medications withheld. The client's 0600 glucose level is 300 mg/dL.The nurse should: A. Withhold all medications B. Administer the insulin dose dictated by the sliding scale C. Call the physician for specific prescriptions based on the glucose level D. Notify the surgery department

C

The nurse is performing a preoperative assessment for a patient scheduled fora surgical procedure. What is the rationale for the nurse's careful documentation ofthe patient's current medication list? A. Some medications may alter the patient's perceptions about surgery B. Many anesthetics alter renal and hepatic function, causing toxicity of other drugs. C. Some medications may interact with anesthetics, altering the potency and effect of the drugs. D. Routine medications are withheld the day of surgery, requiring dosage and schedule adjustments after surgery.

C

The nurse is preparing to start an IV infusion and has raised the HOB. After thenurse applies gloves to insert an IV catheter, the client begins to rub her eyes wipeaway nasal drainage. Which of the following should the nurse do first?A. Distract the client's attention B. Assess the client for pain C. Remove the IV catheter and assess the client's VS D. Lower the HOB

C

When assessing a patient's surgical dressing on the first postoperative day, thenurse notes new, bright-red drainage about 5 cm in diameter. What is the priorityaction by the nurse? A. Recheck in 1 hour for increased drainage. B. Notify the surgeon of a potential hemorrhage. C. Assess the patient's blood pressure and heart rate. D. Remove the dressing and assess the surgical incision.

C

When attempting to check the pupils of a client scheduled to receive generalanesthesia, the nurse notices that the client has trouble tilting the head back.Which of the following is the primary concern related to this finding? A. The client has limited movement of his neck B. The client is at risk for post-op neck pain C. The client is at risk for difficult intubation D. The ability to assess the client's pupils is limited

C

When reviewing the preoperative forms, the nurse notices that the informedconsent form is not present or signed. What is the best action for the nurse to take? A. Have the patient sign the consent form. B. Have the family sign the form for the patient. C. Call the surgeon to obtain consent for surgery. D. Teach the patient about the surgery and get verbal permission.

C

When the nurse asks the client who is to have abdominal surgery today if theclient understands the procedure, the client replies, "No, not really; I talked aboutseveral different things with my surgeon, and I am just not sure." The nurse should: A. Teach the client all the details of the planned procedure B. Utilize a second witness when the client signs for consent C. Notify the surgeon of the client's expressed lack of understanding D. Administer the prescribed preop narcotics and/or sedatives

C

The client has a latex allergy. What should the nurse teach the client to dobefore having surgery? Select all that apply. A. Determine that there will a be a latex-safe environment for surgery B. Report symptoms experienced with the latex allergy C. Notify the HCP at the surgery center D. Wear a stainless steel medical alert bracelet into the surgical suite E. Ask to have the surgery at a hospital

ABC

The nurse is positioning a patient after a surgical procedure. What is the bestposition unless contraindicated, for this patient to be placed in to preventrespiratory complications? A.Supine B. Lateral C. Semi-Fowler's D.High-Fowler's

B

The nurse is working on a surgical floor and is preparing to receive apostoperative patient from the postanesthesia care unit (PACU). What should thenurse's initial action be upon the patient's arrival? A. Assess the patient's pain. B. Assess the patient's vital signs. C. Check the rate of the IV infusion. D. Check the physician's postoperative orders.

B

A patient is admitted to the postanesthesia care unit (PACU) after abdominalsurgery. Which assessment, if made by the nurse, is the best indicator of respiratorydepression? A. Increased carbon dioxide pressure B. Decreased oxygen saturation C. Increased respiratory rate D.Frequent premature ventricular contractions (PVCs)

A

Before surgery, a client states that she is afraid of surgery because her cousindied in surgery when having her tonsils removed. What is the nurse's bestresponse? A. Reassure the client that technology has changed over the last 10 years B. Have the client perform deep breathing exercises to decrease her anxiety before surgery C. Explain to the client that it is normal to be afraid D. Ask the client if anyone else in her family has had trouble when they had surgery

D

Five minutes after receiving a preoperative sedative medication by IV injection,a patient asks to get up to go to the bathroom to urinate. What is the mostappropriate action for the nurse to take? A. Offer the patient to use a urinal or bedpan after explaining the need to maintain safety. B. Assist the patient to the bathroom and stay next to the door to assist patient back to bed whendone. C. Allow the patient to go to the bathroom since the onset of the medication will be more than 5minutes. D. Ask the patient to hold the urine for a short period since a urinary catheter will be placed in the operating room.

A

A patient is being prepared for a surgical procedure. What is the priorityintervention by the nurse prior to the start of the procedure according to theNational Patient Safety Goal (NPSG)? A. Identify patients at risk for suicide. B. Improved staff communication C. Patient, surgical procedure, and site are checked D. Prevention of infection

C

A patient requests that the nurse give his hearing aid to a family member so itwill not be lost in surgery. What is the appropriate action by the nurse?A. Give the hearing aid to the wife as he wishes. B. Tape the hearing aid to his ear to prevent loss. C. Encourage the patient to wear it for the surgery. D. Tell the surgery nurse that he has his hearing aid out.

C

A client has been unable to void since having abd surgery 7 hours ago. Thenurse should first: A. Encourage the client to increase oral fluid intake B. Insert an intermittent urinary catheter C. Notify the HCP D. Assist the client up to the toilet to attempt to void

D

Which intraoperative nursing responsibilities should be performed by thescrub nurse (select all that apply)? A. Documenting intraoperative care B. Keeping track of irrigation solutions for monitoring of blood loss C. Passing instruments and supplies to the surgeon by anticipating his or her needs D. Coordinating the flow and activities of members of the surgical team in the surgical suite. E. Performing the count of sponges, needles, and instruments used during the surgical procedure

BCE

A patient had surgery at an ambulatory surgery center. Which criteria supportthat this patient is ready for discharge (select all that apply.)? A. Comfortable after IV opioid 15 minutes ago B. Vital signs baseline or stable C. Wants to go to the bathroom at home D. Responsible adult taking patient home E. Minimal nausea and vomiting

BDE

Eight hours following bowel surgery, the nurse observes that the client's urineoutput has decreased from 50 to 20 ml/hr. The nurse should assess the clientfurther for which of the following? A. Bowel obstruction B. Adverse effect of opioid analgesics C. Hemorrhage D. HTN

C

The nurse is doing a preoperative assessment on a male patient who has type2 diabetes mellitus; weighs 146 kg; and is 5 feet 8, inches tall. Which patientassessment is a priority related to anesthesia? A. Has a body mass index of 48.8 kg/m2 B. Has a history of postoperative vomiting C. Has several seasonal allergies D. Has hemoglobin A1C of 8.5%

A

The perioperative nurse is reviewing the chart of a patient who is beingadmitted into the operating room for a laminectomy. What information obtainedfrom the chart review should the nurse discuss with the anesthesiologist? A. The patient's father developed an elevated temperature during a recent surgery. B. The patient's brother developed nausea after surgery with general anesthesia. C. The patient's mother developed contact dermatitis related to a latex allergy. D. The patient's grandmother developed hypothermia during a craniotomy

A

A patient asks a student nurse if his family member may accompany him tothe surgical area. What is the best response by the nurse? A. "Your family member may not enter the surgical area" B. "Your family can be with you in the preoperative holding area. C. "Your family can't be with you until the postanesthesia care unit. D. "Your family is only allowed in the conference room for preoperative teaching."

B

An older adult patient is undergoing coronary artery bypass graft (CABG)surgery and has just experienced intraoperative vomiting. The nurse shouldconsequently anticipate the use of which drug? A. Fentanyl B. Midazolam C. Meperidine D. Ondansetron

D

The patient donated a kidney, and early ambulation is included in the plan ofcare, but the patient refuses to get up and walk. What rationale should the nurseexplain to the patient for early ambulation? A. "Early walking keeps your legs limber and strong." B. "Early ambulation will help you be ready to go home." C. "Early ambulation will help you get rid of your syncope and pain." D. "Early walking is the best way to prevent postoperative complications."

D

The surgical team in the operating room performs a surgical time-out justbefore starting hip replacement surgery. Which action would be part of the surgicaltime-out? A. Assess the patient's vital signs and oxygen saturation level. B. Check the chart for a signed consent form for the procedure. C. Determine if the patient has any questions about the procedure D. Have the patient verify the procedure and the location of the surgery.

D

The nurse is assessing a client recovering from anesthesia. Which of thefollowing is an early indicator of hypoxemia? A. Somnolence B. Restlessness C. Chills D. Urgency

B

While performing preoperative teaching, the patient asks when he is no longerable to eat or drink. Based on the most recent practice guidelines established by theAmerican Society of Anesthesiologists, what is the best response by the nurse? A. "You may drink clear liquids up until she is moved to the OR." B. "You may drink clear liquids up to 2 hours before surgery." C. "Maintain NPO status until after breakfast." D. "Stay NPO after midnight."

B

While the perioperative nurse is transporting a patient to the operating roomfor general surgery, the patient states, "I am a Jehovah's Witness, and I am worriedabout blood transfusions." What would be the best response by the nurse to thispatient's statement? A. "I will make sure that you do not receive a blood transfusion during this surgery." B. "Would you like to sign the consent form just in case you need blood during surgery?" C. "Do you have someone I can contact in an emergency if you need a blood transfusion?" D. "Tell me what you would like done if it is determined that you need blood replacement duringsurgery."

D