Med-surg II Ch. 14
A patient is scheduled for abdominal surgery. Which operative stage is most suitable for inserting the patient's nasogastric tube?
After the induction of anesthesia
What is autologous blood?
Blood from the patient prior to surgery
A 78-year-old patient is about to undergo cardiac surgery. Which assessment data has the highest priority?
Blood glucose 218 mg/dL
A health care provider has ordered a potassium intravenous drip for a patient with a potassium level of 3.2 mEq/L. Which surgical procedure would the nurse most likely to administer this medication for?
Bowel resection
Which intervention by the nurse involves promoting surgical care improvement project (SCIP) core measures?
Discontinuing prophylactic antibiotics within one day of surgery time.
A patient is scheduled to have a total hysterectomy at 0930. Which is the most appropriate time to give the patient preoperative prophylactic antibiotics?
0915
The nurse is instructing a patient about the use of antiembolism stockings. Which statement by the patient indicates the need for further teaching?
"These stockings will prevent blood clots.!
When completing the preoperative assessment, which question should the nurse ask the patient?
"What medications are you currently taking?'
The nurse is preparing a patient for surgery, and is planning to administer propofol. Which responses given by the patient would lead to administration of an alternate drug? Select all that apply.
'I am allergic to eggs. 'I am allergic to peanuts. I am allergic to soy products.
Preoperatively, the nurse instructs a patient about reducing the risk of infection at the surgical site. Which statement made by the patient indicates a need for further teaching?
'I should avoid using soap when bathing on the day of surgery."
The nurse teaches expansion breathing exercises to a patient who is scheduled for chest surgery. Which statement made by the patient indicates the need for further teaching?
'I should exhale by moving my lower rib cage inward first, and then chest.'
A nurse is conducting a preoperative assessment for a patient who will have a coronary artery bypass graft. Which statement by the patient suggests understanding of the preoperative instructions?
'I took my metoprolol this morning with a sip of water!
Which of a nursing student's statements regarding informed consent prior to surgery indicates a need for further teaching?
'Informed consent does not designate who is performing the surgery or whether others will be present during procedure.
While gathering patient history during the preoperative phase, what statement would be most concerning pertaining to anesthesia?
'My mother spiked a fever right after her hip replacement.'
Which statement by the novice nurse best demonstrates an understanding of preoperative teaching?
'Please sign both consents for anesthesia and blood products.
The nurse is educating a family member of a patient who is having surgery. Which statement by the family member indicates a need for further teaching?
'The type of anesthesia used is what determines the length of the patient's stay in the postanesthesia unit (PACU)."
Which teaching by the nurse during the preoperatie perod best informs the patient regarding the primary purpose of the device shown in the image?
'This device will help you keep your lungs expanded after surgery.'
The nurse is providing patient education regarding external pneumatic compression devices. Which statement by the patient demonstrates effective teaching?
'You will apply these before my surgery.'
The nurse is providing preoperative care to a patient who is diagnosed with type I diabetes mellitus. Which order does the nurse anticipate implementing?
Administer a reduced dose of insulin.
The nurse cares for a patient who is scheduled for cardiovascular Which assessment finding is most surgery. important for the nurse to report to the primary health.care provider?
Absence of peripheral pulses
What symptom will the nurse observe in a preoperative patient with anxiety? Select all that apply.
Anger Crying Urinary frequency
Why are prophylactic antibiotics discontinued within 24 hours after a gastric surgery? Select all that apply.
Antimicrobial resistance Risk for clostridium infection Risk outweighs the benefits of the drug
A patient reports uncomfortable sensations such as itching, sweating, and heat when wearing sequential compression boots. Which intervention would help the patient reduce the uncomfortable sensations?
Apply antiembolism stockings.
The nurse is caring for a perioperative patient. How does the nurse intervene in managing the perioperative temperature of the patient?
By measuring the temperature within 15 minutes after anesthesia administration
After examining a patient's respiratory status, the nurse anticipates a chronic lack of oxygen. Which evaluation criterion leads the nurse to this conclusion?
Clubbing of fingertips
A patient with back pain is scheduled for spinal surgery. What examinations does the nurse anticipate in the preoperative order set for this patient? Select all that apply.
Computed tomography (CT) scan Magnetic resonance imaging (MRI)
Which condition of a patient with obesity is responsible for increasing the risk for poor wound healing? Select all that apply.
Decreased nutrients Fewer blood vessels Low amounts of collagen
Which information is most appropriate to communicate to the next shift nurse about a 74-year-old patient who is recovering from right hip surgery?
Decreàsed lung sounds
Which nursing action will help prevent fatigue in a patient diagnosed with a decrease in cardiac output?
Determining the patient's normal activity levels
Which clinical manifestations in a patient indicate poor fluid or nutritional status? Select all that apply.
Dull hair Brittle nails Muscle wasting Skin turgor changes
An unidentified patient from the emergency department requires immediate surgery, but he is not conscious and no one is with him. What must the nurse, who is verifying the informed consent, do?
Ensure written consultation of two noninvolved physicians.
Which drug is prescribed to a patient for stimulating red blood cell production prior to surgery?
Epoetin alpha
Which nursing intervention is appropriate for a preoperative patient with dry skin and less subcutaneous fat?
Teaching the patient to change position hours
The nurse is caring for a postoperative patient. Which instructions should the nurse provide to the patient for deep diaphragmatic breathing? Select all that apply.
Inhale and exhale as gently as possible. Take a deep breath through the nose and mouth.
The nurse is reviewing a plan of care for a preoperative patient who is experiencing anxiety. Which of the plan's interventions needs revision?
Instructing the patient to avoid visiting friends 24 hours before surgery
During the perioperative phase, a patient is advised to perform coughing and splinting. What may be the reasons behind this practice? Select all that apply.
It expels secretions. It prevents atelectasis. It keeps the lungs clear. It prevents pneumonia.
Which statements regarding the Patient Self-Determination Act (PSDA) are true? Select all that apply.
It grants patients the right to have advance directives (ADs). Documents such as a living will durable of attorney are mandated. The PSDA grants patients the right to provide legally binding instructions to health care providers about their wishes regarding treatment.
What is the purpose of having a patient sign an informed consent form before surgery?
It protects the patient from unwanted procedures.
Which explanation supports the use of electrical clippers and depilatories to remove hair at the surgical site?
It reduces the potential for infection.
Which religious group's members will typically not accept blood transfusions because of their religious convictions?
Jehovah's Witnesses
What should the nurse assess for in a patient whose potassium levels are high?
Kidney impairment
A patient has an allergy to bananas. To which other allergy may the patient be susceptible?
Latex
A patient has developed a pulmonary embolism. Which measurement is essential when ordering an antiembolism stocking size for the patient?
Leg length
During autologous donation, the patient's own blood is used during or after surgery if it is needed. What is provided by the blood collection center to the patient after autologous blood donation?
Matching tag
Which preoperative drug is administered to a patient when rapid emptying of stomach is needed?
Metoclopramide
A patient scheduled for surgery at the ambulatory health care clinic is asked to maintain 'NPO status' after midnight, on the night before surgery. What does the instruction about NPO status indicate?
No food should be consumed after midnight, on the night before surgery.
The nurse is caring for a patient who is scheduled for back surgery. The patient's medical history includes gastroesophageal reflux disease (GERD). During transport to the operating room, the patient complains of burning chest pain which he rates as '8' on a pain scale of 0 to 10. Which nursing action is most appropriate?
Notify the surgeon and anticipate a cardiology'consult
Colostomy surgery is categorized as what type of surgery?
Palliative
A nurse is preparing an 82-year-old patient to undergo a graft for an abdominal aortic aneurysm. Which assessment is important for the nurse to report to the surgeon?
Patient reports correct month and day, but not year.
The nurse is reviewing laboratory data for a 56-year-old male who is scheduled to undergo left lower lobectomy in two hours. Which result would require the nurse to notify the physician immediately?
Potassium 3.3 mEq/dL
A patient with hemorrhoids is being prepared for surgery the next day. Which therapy can help the patient in evacuating the bowels?
Potent laxatives
A patient has an allergy to shellfish. Which other substance may the patient be allergic to in conjunction with the shellfish allergy?
Povidone-iodine
Which factors can increase the risk for anesthesia-related complications? Select all that apply.
Presence of cardiac problems Alcohol and illicit substance use Age related changes in kidney and liver function
Before obtaining informed consent, the surgeon explains sufficient information about the surgical procedure to the patient. Which action related to informed consent, performed by the nurse, would need correction?
Providing detailed information about the surgery to be performed
A patient's preoperative chest x-ray is abnormal. What occurrence is likely to develop in the patient if surgery were to proceed?
Pulmonary complications
A patient is being prepared for gastrointestinal surgery and undergoes a bowel preparation. Why is this preoperative procedure done?
Reduce the number of intestinal bacteria
A patient is scheduled for emergency abdominal The surgery. patient is unable to give consent and has no family. Who can appoint a legal guardian for the patient?
The court
What is the primary reason for the placement of drains in the perioperative patient?
Removing fluid from the surgical site
Which condition is called oliguria?
Scanty urination
A patient is scheduled for a cholecystectomy. For which pre- existing conditions may medication be allowed with a sip of water before surgery? Select all that apply.
Seizures Hypertension Cardiac disease Respiratory disease
Which food is contraindicated in patients with povidone-iodine allergy?
Shellfish
The nurse who is caring for a patient preoperatively determines that the patient is at risk for cardiac failure based on what laboratory result?
Sodium level of 158 mmol/L
An older patient's adult child tells the nurse that the patient does not want life support. What does the nurse do first?
Talk to the patient.
Which postoperative nursing intervention is most important to perform to reduce the risk of deformities in older patients?
Teach the patient about turning and positioning techniques.
The nurse is attending to a patient who had an appendectomy. What nursing intervention does the nurse perform for this patient?
Teaches the patient to splint the wound when turning in bed.
Which information must be provided to the patient when obtaining informed consent for surgery? Select all that apply.
The reason for and nature of the surgery The risks associated with the use of anesthesia The available options and their possible risks The risks associated with the surgical procedure and its potential outcomes
What is the primary reason for establishing vascular access in the preoperative patient?
To deliver a general anesthetic
Which is an example of an elective surgery?
Total knee replacement
A 46-year-old female who was involved in a high-speed, head- on motor vehicle accident arrives at the emergency department by ambulance. The patient sustained multiple fractures and requires immediate surgery to stop massive internal hemorrhaging. The patient is unconscious and no family or spouse is present. Which action does the nurse anticipate?
Transporting the patient directly to surgery
A patient is scheduled for surgery. Which laboratory and/or diagnostic tests are routinely carried out before any surgery is performed? Select all that apply.
Urinalysis Electrolyte levels Hemoglobin level Blood type and screen
