Fundi's Ch. 30 Prep U

A client is undergoing surgery for an appendectomy. This would be considered what type of surgery? A. diagnostic surgery B. emergency surgery C. elective surgery D. palliative surgery

B. emergency surgery

The nurse knows the term perioperative phase refers to care given to the client: A. immediately before an operative procedure. B. before, during, and after the operative phase. C. immediately after the operative phase. D. from the start of surgery until its conclusion.

B. before, during, and after the operative phase.

In the postoperative phase of abdominal surgery, the client reports severe abdominal pain. In the second postoperative day, the client's bowel sounds are absent. What does the nurse suspect? A. hernia development B. paralytic ileus C. normal response D. abdominal infection

B. paralytic ileus

A nurse from the ambulatory surgical center is preparing discharge instructions for a client who has had pelvic surgery. Which criterion would the client need to demonstrate to ensure that she is ready for discharge? A. exhibit no bleeding B. verbalize absence of pain C. eat without nausea D. void normally

D. void normally

A nurse is teaching an older adult client to use an incentive spirometer following hip replacement surgery when the client asks why using this machine is necessary. How will the nurse respond? A. The exercise helps prevent pneumonia. B. This exercise keeps you from getting bronchitis. C. The exercise keeps you from getting asthma. D. This exercise prevents deep vein thrombosis.

A. The exercise helps prevent pneumonia.

Which factor is most important in the nurse's decision on assessment data, outcomes, and the monitoring needs of a client in preparing for surgery? A. Type of surgery B. Client's support system C. Age of client D. Type of anesthesia

A. Type of surgery

An operating room nurse is bringing a client to the nurse in the postanesthesia care unit (PACU). Which information would the operating room nurse provide during a hand-off report? Select all that apply. A. length of surgery B. performance of time-out before surgery C. medications given in operating room D. all personnel present in operating room E. drains inserted in surgery

A. length of surgery C. medications given in operating room E. drains inserted in surgery

As a circulating nurse caring for a 45-year-old man undergoing left knee arthroscopic exploratory surgery, which task ensures that the team is on the same page and will perform the procedure on the right client and at the right site? A. procedural pause (time-out) B. preoperative checklist C. informed consent D. operative site marking

A. procedural pause (time-out)

The nurse recognizes that palliative surgery is performed for what purpose? A. to lessen the intensity of an illness B. to make or confirm a diagnosis C. to restore function to tissue that is traumatized D. to remove a part of the body that is diseased

A. to lessen the intensity of an illness

The nurse needs to evaluate the effectiveness of a preoperative teaching session with a client scheduled for abdominal surgery. Which client statement indicates the need for further clarification? A. "I will splint my incision while I cough." B. "While my pneumatic compression device is on, I don't need to do leg exercises." C. "Every 2 hours while I am awake, I will take deep breaths and cough." D. "I will sit up in bed before using my incentive spirometer."

B. "While my pneumatic compression device is on, I don't need to do leg exercises."

A nurse caring for a client postoperatively notes that the dressing on the client's incision was recently clean and dry but is now saturated with a large amount of fresh blood. What intervention should be taken by the nurse in this situation, along with notifying the primary care provider? A. Reinforce the dressing. B. Change the dressing. C. Remove the dressing. D. Leave dressing as is.

A. Reinforce the dressing.

The nurse is assessing clients for postoperative complications. What is the most commonly assessed postanesthesia recovery emergency? A. Respiratory obstruction B. Cardiac distress C. Dehydration D. Wound infection

A. Respiratory obstruction

The preoperative nurse is teaching a client about deep-breathing exercises. The client asks, "Why do I need to learn about this?" Which response by the nurse is correct? A. "After surgery, deep-breathing exercises help to remove anesthetic gases and mucus and improve oxygen supply to body tissues." B. "These techniques will prevent trapped air from accumulating in your lungs." C. "If you learn how to perform these exercises correctly, you will not need supplemental oxygen during surgery." D. "These types of exercises help distract you from the postoperative pain."

A. "After surgery, deep-breathing exercises help to remove anesthetic gases and mucus and improve oxygen supply to body tissues."

A nurse is teaching a client about the rationale for fasting from food and fluids prior to surgery. What condition does this measure attempt to avoid? A. Aspiration B. Bowel alterations C. Respiratory distress D. Infection

A. Aspiration

The nurse is caring for a postoperative client. During the past hour, there is 20 mL of dark, concentrated amber urine. Which actions should the nurse choose? Select all that apply. A. Assess skin turgor and mucous membranes. B. Examine intake and output, including estimated blood loss from the operative report. C. Determine if the indwelling urinary catheter is kinked. D. Calculate if the overall average urine output is 30 mL/hr. E. Obtain vital signs and compare to baseline measurements.

A. Assess skin turgor and mucous membranes. B. Examine intake and output, including estimated blood loss from the operative report. C. Determine if the indwelling urinary catheter is kinked. E. Obtain vital signs and compare to baseline measurements

A nurse is monitoring a client post cardiac surgery. What action would help to prevent cardiovascular complications for this client? A. Implement leg exercises and turn the client in bed every 2 hours. B. Position the client in bed with pillows placed under his knees to hasten venous return. C. Keep the client from ambulating until the day after surgery. D. Keep the client cool and uncovered to prevent elevated temperature.

A. Implement leg exercises and turn the client in bed every 2 hours.

A client in the immediate postoperative period begins to report nausea and begins vomiting. Which is the priority nursing action? A. Make client NPO and auscultate bowel sounds B. Provide an emesis basin at the bedside C. Document the characteristics of emesis D. Administer an antiemetic medication

A. Make client NPO and auscultate bowel sounds

The nurse is developing a plan of care for a client who had a splenectomy. The outcome is prevention of surgical site infection. Which interventions should be included in the client's plan of care? Select all that apply. A. Monitor white blood cell count. B. Reposition client frequently. C. Assess vital signs. D. Use asepsis with dressing change. E. Maintain hydration. F. Monitor bowel sounds.

A. Monitor white blood cell count. C. Assess vital signs. D. Use asepsis with dressing change. E. Maintain hydration.

A nurse caring for clients in a PACU assesses a client who is displaying signs and symptoms of shock. What is the priority nursing intervention for this client? A. Place the client in a flat position with legs elevated 45 degrees. B. Remove extra coverings on the client to keep temperature down. C. Do not administer any further medication. D. Place the client in the prone position.

A. Place the client in a flat position with legs elevated 45 degrees.

The nurse is caring for a client who returned from the postanesthesia care unit 3 hours ago. The surgical dressing was dry and intact upon arrival to the postoperative unit, but now it is saturated with fresh blood. Which actions should the nurse take first? A. Reinforce the dressing with more bandages until the bleeding stops. B. Remove the dressing and inspect the wound. C. Measure vital signs. D. Draw a circle around the drainage and note the time.

A. Reinforce the dressing with more bandages until the bleeding stops.

The nurse educates a client about what to expect after abdominal surgery. How will the nurse explain the progression of a client's diet in the postoperative period? A. You may eat anything you want following surgery. B. Food and liquids will be held in the immediate postoperative period. C. You will receive a diet high in vitamin B. D. In the immediate postoperative period, you will receive a soft diet high in carbohydrates.

B. Food and liquids will be held in the immediate postoperative period.

The nurse has admitted a client to the postoperative unit following a bowel resection and is providing postoperative health education on coughing and deep breathing. What does the nurse explain to the client about why these actions are important? A. If you continue to breathe shallowly or cough ineffectively, this can lead to acute respiratory distress syndrome. B. If you continue to breathe shallowly or cough ineffectively, this can lead to atelectasis and pneumonia. C. If you continue to breathe shallowly or cough ineffectively, this can lead to dizziness, falling, or an inability to ambulate because of shortness of breath. D. If you continue to breathe shallowly or cough ineffectively, this can lead to deep vein thrombosis (DVT) by preventing poor oxygen exchange in the cardiac and peripheral circulatory system.

B. If you continue to breathe shallowly or cough ineffectively, this can lead to atelectasis and pneumonia.

The nurse is preparing a client for coronary artery bypass graft cardiac surgery. Which interventions should the nurse provide during the preoperative phase? Select all that apply. A. Assess the midsternal and leg dressings. B. Instruct the client how to use the incentive spirometer. C. Prep the skin of the chest and legs with surgical prep. D. Measure the legs for graduated compression stockings. E. Explain what to expect after the surgery.

B. Instruct the client how to use the incentive spirometer. D. Measure the legs for graduated compression stockings. E. Explain what to expect after the surgery.

A nurse teaches deep breathing exercises to a preoperative client. Which action should the nurse perform? A. Instruct the client to breathe in through the nose as deeply as possible and hold the breath for 10 seconds. B. Instruct the client to exhale gently and completely before inhaling. C. Instruct the client to place the palms of both hands along the upper posterior rib cage. D. Assist or place the client in a supine position for the exercises.

B. Instruct the client to exhale gently and completely before inhaling.

The healthy adult client is given an opioid prior to a surgical procedure. The nurse is completing the chart and notices the consent form was not signed by the client. Which of the following should the nurse do first? A. Immediately have the client sign the consent form. B. Notify the physician of the oversight. C. Ask the client if he still wants to proceed with the procedure. D. Have the client's family member sign the consent form.

B. Notify the physician of the oversight.

A nurse is assessing a client who is experiencing pulmonary embolus. What would be the priority nursing intervention for this client? A. Instruct the client to perform Valsalva maneuver. B. Place the client in semi-Fowler's position. C. Attempt to overhydrate the client with fluids. D. Assist the client to ambulate every 2 to 3 hours.

B. Place the client in semi-Fowler's position.

Which nursing action will assist in pain management for a client in the postoperative phase? A. Provide food and medication B. Relaxation techniques C. Dim lighting D. Client education

B. Relaxation techniques

The nurse is caring for a client who had a procedure under moderate sedation at the ambulatory surgical center. Which assessment finding indicates to the nurse that the client may be ready for discharge to home? A. The client is alert and oriented with a blood pressure 122/74 mm Hg and respirations 18 breaths/min, able to ambulate, is not nauseated or vomiting, reports a pain level of 5 on a 0-10 scale, and has no excessive bleeding or drainage. B. The client is alert and oriented with a blood pressure 118/70 mm Hg and respirations 18 breaths/minute, is able to ambulate, is not nauseated or vomiting, pain is controlled with medication, and has no excessive bleeding and drainage is as expected. C. The client is alert and oriented with a blood pressure 102/60 mm Hg and respirations 18 breaths/minute, is slightly dizzy, but not nauseated or vomiting, denies pain, and has no excessive bleeding or drainage. D. The client is alert and oriented with a blood pressure of 136/90 mmHg and respirations 18 breaths/minute, states mild nausea but no vomiting, pain under control with pain medication, able to void and pass gas, and has mild expected drainage.

B. The client is alert and oriented with a blood pressure 118/70 mm Hg and respirations 18 breaths/minute, is able to ambulate, is not nauseated or vomiting, pain is controlled with medication, and has no excessive bleeding and drainage is as expected.

When an older adult client is brought to the recovery room and presents with irregular, loud respirations, the nurse determines that this is most likely a result of: A. the effects of anesthesia. B. a partial airway obstruction. C. the type of surgery. D. the normal return of reflexes.

B. a partial airway obstruction.

Which client most likely requires special preoperative assessment and treatment as a result of the existing medication regimen? A. a woman who takes daily thyroid supplements to treat her longstanding hypothyroidism B. a woman who takes daily anticoagulants to treat atrial fibrillation C. a man who takes an angiotensin-converting enzyme (ACE) inhibitor because he has hypertension D. a man who regularly treats his rheumatoid arthritis with over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs)

B. a woman who takes daily anticoagulants to treat atrial fibrillation

A client has presented to a clinic for a preoperative consult, during which the client has expressed concern about having to fast before surgery. What should the nurse discuss with the client reflecting current standards by the American Society of Anesthesiologists related to fasting prior to surgery? A. fasting is still often recommended as medically unnecessary B. allowing clear liquids up to 2 hours before surgery with an order by the health care provider C. allowing eating and drinking until just prior to anesthetic being administered D. not eating or drinking anything after midnight the night before surgery

B. allowing clear liquids up to 2 hours before surgery with an order by the health care provider

Surgery can lead to hypothermia. Which client is at greatest risk for hypothermia? A. an adolescent having arthroscopic surgery B. an older adult man with a fractured hip C. a woman experiencing a cesarean birth D. a young adult with a fractured leg

B. an older adult man with a fractured hip

A nurse is employed in an operative setting. Which of these roles is within the registered nurse (RN) scope of practice? Select all that apply. A. administering inhalation anesthetics B. positioning the client on the operating table C. monitoring the client's vital signs D. counting sponges before and after surgery E. administering regional nerve blocks

B. positioning the client on the operating table C. monitoring the client's vital signs D. counting sponges before and after surgery

Who is legally responsible for obtaining the client's informed consent for a surgical procedure? A. the registered nurse B. the surgeon C. the admissions clerk D. any licensed person

B. the surgeon

The nurse assists a client to turn in the bed. The client has just returned from abdominal surgery. How does the nurse instruct the client? A. "Wait for assistance before moving in bed." B. "Change your position frequently." C. "Use a pillow to splint the incision." D. "Raise the head of the bed before turning."

C. "Use a pillow to splint the incision."

The licensed practical nurse (LPN) is observed by the registered nurse (RN) engaging in the reinforcement of teaching related to therapeutic deep breathing and coughing with a client who is recovering from abdominal surgery. Which statement by the RN best supports the LPN's role in the implementation of this intervention? A. "Let me know whether the client reported any pain during the implementation of this respiratory intervention." B. "Advocating for the client's recovery is an important role LPNs engage in when providing client care." C. "You served as a good role model while showing the client the proper technique for this intervention." D. "Be sure to chart your evaluation of the effectiveness of this postoperative intervention on the client's respiratory status."

C. "You served as a good role model while showing the client the proper technique for this intervention."

A nurse is assigned to be the circulating nurse during a surgical procedure. The nurse would be responsible for which activity? A. Providing sponges and drains to the surgical team in the operating room B. Preparing the sterile tables in the operating room before surgery C. Anticipating the needs of other members of the surgical team D. Coordinating care activity

C. Anticipating the needs of other members of the surgical team

The acute care nurse is preparing a client for surgery. Which action is essential to complete before transferring the client to surgery? A. Mark the client's skin to indicate the location of the surgery. B. Remove graduated compression stockings. C. Assure that diagnostic testing has been completed and results are available. D. Place the client in a side-lying position.

C. Assure that diagnostic testing has been completed and results are available.

A nurse is caring for an older adult client who had surgery for the removal of a cataract in the left eye. Which issue would prevent the client from being discharged on the day of surgery? A. Voiding on a regular basis B. Inability to see from left eye C. Inability to ambulate D. Alert and oriented ×4

C. Inability to ambulate

The preoperative nurse is reviewing the chart of a client whose surgery is scheduled to begin in the next 15 minutes and notices that the consent form is not signed. The nurse contacts the surgeon who states, "We have already reviewed this procedure extensively, so ask the client to sign the consent form and I will verify it in the operating room." Which action by the nurse is appropriate? A. Send the client to the operating room and inform the staff that the consent form needs to be signed. B. Ask the operating room staff to delay the procedure until the consent is signed. C. Keep the client in the preoperative area and inform the surgeon that it is the health care provider's responsibility to obtain consent for surgery. D. Ask the client to sign the consent; witness the signature and inform the operating room staff of the modification in the procedure.

C. Keep the client in the preoperative area and inform the surgeon that it is the health care provider's responsibility to obtain consent for surgery.

A nurse administers anticholinergics to a client as a postoperative medication. What condition does this medication help to prevent? A. Cardiovascular complications B. Nausea C. Laryngospasm D. Shock

C. Laryngospasm

A nurse is giving preoperative information to a client scheduled for outpatient surgery. What are recommended education guidelines? Select all that apply. A. Continue with all medications routinely taken. B. Wear clothing without buttons or zippers. C. List allergies and be sure the operating staff is aware of these. D. Have someone available for transportation home after recovery from anesthesia. E. Notify the surgeon's office if a cold or infection develops before surgery.

C. List allergies and be sure the operating staff is aware of these. D. Have someone available for transportation home after recovery from anesthesia. E. Notify the surgeon's office if a cold or infection develops before surgery.

A client had an open cholecystectomy (gallbladder removal) 36 hours earlier, and the nurse's assessment this morning confirms that the client has not yet had a bowel movement since prior to surgery. How should the nurse best respond to this assessment finding? A. Contact the physician to come assess the client. B. Immediately administer a cleansing enema. C. Monitor the client closely and promote fluid intake. D. Increase the rate of the client's intravenous infusion.

C. Monitor the client closely and promote fluid intake.

A client states having a latex allergy. Which action does the nurse take to communicate this allergy to hospital staff caring for the client? A. Place a sign on the client's bed. B. Obtain latex-free gloves for the client's room. C. Note the allergy on the client's record. D. Inform the client to tell the anesthesiologist.

C. Note the allergy on the client's record.

A nurse is providing education to a client having same-day surgery. Which statement would be accurate regarding this type of surgery? A. Same-day surgery must be performed in a hospital setting. B. Older adult clients are generally not permitted to have same-day surgery. C. Some major surgeries can be done as same-day surgery. D. Clients without a strong support system are not candidates for same-day surgery.

C. Some major surgeries can be done as same-day surgery.

A nurse is caring for a postoperative client and preparing to apply a pneumatic compression device. How does the nurse explain the device to the client prior to application? A. The device fills with air supporting the legs during ambulation so blood flow will not pool in the legs and feet, thus preventing blood clots, and squeezes the legs, which increases blood flow through the veins of the legs. B. The device fills with air and squeezes the arms, which increases blood flow through the veins of the arms and helps to prevent blood clots. C. The device fills with air and squeezes the legs, which increases blood flow through the veins of the legs and helps to prevent blood clots. D. The device fills with air and squeezes the legs which increase blood flow through the veins of the legs and should be worn in bed and while ambulating to help prevent blood clots.

C. The device fills with air and squeezes the legs, which increases blood flow through the veins of the legs and helps to prevent blood clots.

The nurse has been waiting until after the administration of a toddler's anesthesia before removing the child's clothing and applying monitoring equipment. Doing these actions after the administration of anesthesia will: A. provide more accurate baseline vital signs. B. enhance thermoregulation. C. prevent anxiety. D. minimize blood loss.

C. prevent anxiety.

The nurse is preparing a client for surgery and asks if the client has an advance directive. The client asks "What is an advance directive?" What is the nurse's best response? A "We are not sure if you will wake up after surgery, so the advance directive will let us know your wishes just in case." B. "An advance directive is a living will. Some people already have one when they come to the hospital." C. "When you are going to have surgery, the hospital likes to have you fill out all paperwork needed beforehand." D. "An advance directive will communicate your wishes for health care postoperatively in case you are unable to do so."

D. "An advance directive will communicate your wishes for health care postoperatively in case you are unable to do so."

Which methods would the nurse anesthetist use when administering regional anesthesia to surgical clients? Select all that apply. A. Inhalation B. Intravenous C. Oral route D. Spinal block E. Epidural block F. Nerve block

D. Spinal block E. Epidural block F. Nerve block

The nurse is caring for a client who had abdominal surgery yesterday and is reluctant to cough and perform deep breathing. Which strategy will most likely increase the client's willingness to cough and perform deep breathing? A. Remind the client of the serious complications that can result from ineffective coughing and deep breathing. B. Administer respiratory treatments to encourage coughing. C. Assist the client to a side-lying position to cough. D. Teach the client how to splint the abdomen while coughing.

D. Teach the client how to splint the abdomen while coughing.

A nurse is reviewing postoperative protocols with the client, including an explanation and a demonstration of how to use an incentive spirometer. How does the nurse know that the teaching on the use of the incentive spirometer was effective? A. The client explains the procedure should be completed first thing in the morning before rising from the bed. B. The client repeats the explanation and instructions in one's own words to demonstrate understanding. C. After taking a deep breath, the client demonstrates how to exhale into the mouthpiece while in the semi-Fowler position. D. The client completes a return demonstration and inhales with lips tightly sealed around the mouthpiece while sitting upright in bed.

D. The client completes a return demonstration and inhales with lips tightly sealed around the mouthpiece while sitting upright in bed.

The nurse has delegated to the unlicensed assistive personnel (UAP) the application of antiembolism stockings to a client who had an endarterectomy earlier in the day. Which UAP action requires the nurse to immediately intervene? A. cleanses hands with alcohol-based hand rub B. elevates the legs 15 minutes after applying stockings C. measures calf circumference D. massages legs prior to application

D. massages legs prior to application

When preparing a client who has diabetes mellitus for surgery, the nurse should be aware of what surgical risk associated with this disease? A. respiratory depression from anesthesia B. altered metabolism and excretion of drugs C. fluid and electrolyte imbalance D. slow wound healing

D. slow wound healing