MedSurg Chapter 16

A client will be undergoing palliative surgery. The client's daughter asks what this means. What is the nurse's best response? a. "The surgery will relieve the symptoms but will not cure your father." b. "There are fewer risks with this type of surgery." c. "There is no guarantee of the outcome of the surgery." d. "The surgery must be performed immediately to save your father's life."

a. "The surgery will relieve the symptoms but will not cure your father."

Four clients are scheduled for surgery. Which client does the nurse determine is at highest risk for postsurgical complications? a. 89-year-old scheduled for a knee replacement b. 40-year-old requiring gallbladder surgery c. 19-year-old requiring a laparoscopy d. 10-year-old admitted for a tonsillectomy

a. 89-year-old scheduled for a knee replacement

The nurse reviews a client's laboratory results before surgery and notes a fasting blood glucose of 120 mg/dL, a prothrombin time (PT) of 25 seconds, and potassium (K+) of 3.8 mEq/L. Which action by the nurse is best? a. Ask the surgeon for additional laboratory studies. b. Administer a potassium supplement of 20 mEq. c. Increase the IV infusion of D5W to 100 mL/hr. d. Record laboratory results on the preoperative assessment.

a. Ask the surgeon for additional laboratory studies.

A client is brought to the emergency department (ED) after a motorcycle accident. The client has suffered a ruptured spleen. What is the immediate priority? a. Emergent surgery to control bleeding b. Aggressive pain control c. Calling the family members d. Assessment of neurologic status

a. Emergent surgery to control bleeding

Which action is most appropriate during a preoperative chart review? a. Ensure that the consent form is signed, dated, and witnessed. b. Call the surgeon if the client has any food allergies. c. Make sure all marks are washed off the surgical site. d. Make sure the client understands the procedure.

a. Ensure that the consent form is signed, dated, and witnessed.

The nurse is caring for an older adult client with a history of chronic lung disease who will be undergoing surgery the following day. When postoperative care is planned, which potential problem is the highest priority for this client? a. Maintaining oxygenation b. Tolerating activity c. Anxiety and fear d. Hypovolemia

a. Maintaining oxygenation

The nurse has just completed preoperative teaching with a client who will be having surgery the following day. Which statement by the client indicates that additional teaching is needed? a. "When I brush my teeth before surgery, I will be sure to spit out the water." b. "I will go to the bathroom as soon as I receive all my preoperative medications." c. "I will remember to wear my glasses tomorrow instead of my contact lenses." d. "I won't have to worry about putting my makeup on tomorrow morning."

b. "I will go to the bathroom as soon as I receive all my preoperative medications."

Twenty minutes after a client has received a preoperative injection of atropine and midazolam (Versed), the client tells the nurse that he must be allergic to the medication because his mouth is dry and his heart seems to be beating faster than normal. What is the nurse's priority action? a. Document the findings. b. Assess the client's pulse and blood pressure. c. Administer diphenhydramine (Benadryl). d. Explain to the client that these symptoms are expected.

b. Assess the client's pulse and blood pressure.

A client is brought to the hospital unconscious and needs emergency surgery. The client's only family member cannot come to the hospital before the surgery. Which is the best option for obtaining informed consent for the client's emergent surgery? a. Proceed with surgery and have the family member sign the consent as soon as possible. b. Contact the family member by phone and obtain verbal consent with two witnesses. c. Obtain written consultation with two surgeons that the surgery is needed. d. Have the hospital administrator appoint a temporary legal guardian.

b. Contact the family member by phone and obtain verbal consent with two witnesses.

What recently learned information about a client who is scheduled to have surgery within the next 2 hours is the nurse certain to communicate to the surgical team? a. An allergy to cats b. Hearing problem c. Consumption of a glass of wine 12 hours ago d. Taking 2000 mg of vitamin C each day

b. Hearing problem

A client undergoing preoperative assessment informs the nurse that he takes medication for high blood pressure and for asthma. What is the nurse's best action? a. Tell the client not to take the medication on the day of surgery. b. Notify the surgeon and the anesthesiologist. c. Document the information in the client's record. d. Tell the client to take medications preoperatively with a sip of water.

b. Notify the surgeon and the anesthesiologist.

A client receiving preoperative medication tells the nurse that she took all the following vitamins and herbs last night before going to bed. Which one does the nurse report to the surgical team as a priority? a. Valerian root b. St. John's wort c. Garlic d. Chamomile

c. Garlic

During the preoperative assessment, the client tells the nurse that he smokes three packs of cigarettes daily. Which action by the nurse is best? a. Call the surgeon to cancel the surgery. b. Have baseline laboratory studies drawn. c. Perform a respiratory assessment. d. Give a nebulizer treatment.

c. Perform a respiratory assessment.

A client voluntarily signed the operative consent form. What is the nurse's next action? a. Teach the client about the surgery. b. Have family members witness the signature. c. Sign under the client's name as a witness. d. Call for the physician to sign the form.

c. Sign under the client's name as a witness.

The nurse is caring for a client who will be undergoing emergency surgery as soon as possible. Which information is most important for the nurse to teach the client at this time? a. How the surgery will be performed b. Importance of early ambulation after surgery c. What to expect in the operating and recovery rooms d. Complications that may occur after surgery

c. What to expect in the operating and recovery rooms

A client tells the nurse that he has an advance directive with durable power of attorney for health care. The client asks how the advance directive will affect the surgery. What is the nurse's best response? a. "You will not be intubated during general anesthesia for the surgery." b. "There will be no effect on your surgery." c. "The surgical staff will resuscitate only if your heart stops during the operation." d. "If you are unable to make a decision, your designee will be asked."

d. "If you are unable to make a decision, your designee will be asked."

When the nurse brings a client's preoperative medications, the client responds, "I don't need that. I had a good night's sleep last night." What is the nurse's best response? a. "The doctor ordered this medication so you should take it." b. "I will make a note that you refused to take the medication." c. "I will ask your surgeon if you have to take the medication." d. "Let me teach you about your medications for surgery."

d. "Let me teach you about your medications for surgery."

The nurse is conducting preoperative assessments. Which client does the nurse teach about the possibility of developing a venous thromboembolism (VTE)? a. Client with a latex allergy b. Client with body mass index (BMI) of 19 c. Client with an international normalized ratio (INR) of 2.2 d. Client undergoing hip replacement surgery

d. Client undergoing hip replacement surgery

The nurse is completing preoperative teaching for a client, and it becomes apparent that the client does not understand the surgery that will be performed. What is the priority action for the nurse? a. Obtain informed consent from the client. b. Continue teaching the client about the surgery. c. Revise the teaching plan for the client. d. Notify the surgeon and document the finding.

d. Notify the surgeon and document the finding.

When examining an adult client's preoperative laboratory results, the nurse notes that the potassium level is 2.9 mEq/mL. What is the nurse's priority action? a. Document the finding. b. Alter the client's diet to include fruit. c. Increase the IV flow rate. d. Notify the surgeon.

d. Notify the surgeon.

The nurse applies antiembolism stockings to a client preoperatively. When the client says that they are uncomfortably tight, what is the nurse's best action? a. Remove the stockings for an hour to relieve the pressure. b. Pull the stockings down so that they are not constricting. c. Measure the client's calf to ensure that they are the correct size. d. Teach the client the purpose of wearing the stockings.

d. Teach the client the purpose of wearing the stockings.

The nurse is performing preoperative teaching with an older adult client who will be having colon resection surgery the following day. The surgeon has ordered bowel preparation the night before. Which action is a priority? a. Administer antibiotics with a sip of water. b. Encourage the client to drink plenty of juice. c. Teach the client to eat only low-fat foods the night before surgery. d. Tell the client not to get up and go to the bathroom alone.

d. Tell the client not to get up and go to the bathroom alone.