NURS 309 Quiz 1 Preoperative Patients
A blind patient is to have a surgical procedure. She asks the nurse whether she will be able to sign her own consent form. What is the nurse's best response? A. "Yes, but your signature will need to have two witnesses." B. "No, but your next of kin can sign the consent form for you." C. "Yes, but you will need to make an X instead of signing your name." D. "No, but you can give instructions to sign for you to any responsible adult."
A. "Yes, but your signature will need to have two witnesses."
After a patient is prepared for surgery and before preoperative drugs are given and the patient is transported to surgery, which essential intervention can the nurse delegate to the unlicensed assistive personnel (UAP) at this time? A. Assist the patient to empty his or her bladder B. Help the patient remove all clothing C. Ask the patient is he or she wants to brush teeth D. Recheck the patient's identity
A. Assist the patient to empty his or her bladder
A nurse in the ambulatory preoperative unit identifies that a client is more anxious than most clients. What is the nurse's best intervention? A. Attempt to identify the client's concerns B. Reassure the client that surgery is routine C. Report the client's anxiety to the health care provider D. Provide privacy by pulling the curtain around the client
A. Attempt to identify the client's concerns
Which electrolyte laboratory result does the nurse report immediately to the anesthesiologist? A. Creatinine, 1.9 mg/dL (168 mcmol/L) B. Fasting glucose, 80 mg/dL (4.4 mmol/L) C. Potassium, 3.9 mEq/L (3.9 mmol/L) D. Sodium, 140 mEq/L (140 mmol/L)
A. Creatinine, 1.9 mg/dL (168 mcmol/L)
An appendectomy is being performed on a patient with appendicitis. What is the correct classification for this surgery? A. Curative B. Diagnostic C. Urgent D. Radical
A. Curative
An unidentified client 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? A. Ensure written consultation of two noninvolved physicians. B. Read the surgeon's consult to determine whether the client's condition is life-threatening. C. Sign the operative permit. D. Withhold surgery until the next of kin is notified
A. Ensure written consultation of two noninvolved physicians.
Which statement is true regarding the patient who has given consent for a surgical procedure? A. Information necessary to understand the nature of and reason for the surgery has been provided B. The length of stay in the hospital has been preapproved by the managed care provider C. Information about the surgeon's experience has been provided D. The nurse has provided detailed information about the surgical procedure
A. Information necessary to understand the nature of and reason for the surgery has been provided
A patient with type I diabetes mellitus is scheduled for surgery at 0700. Which actions must the nurse perform for this patient before he goes to the operating room? SATA A. Modify the dose of insulin given based on the patient's blood glucose as ordered B. Complete the preoperative checklist before transfer to the surgical suite C. Teach the patient about foot care and properly fitted shoes D. Delegate obtaining the patient's fingerstick blood glucose and vital signs to the unlicensed assistive personnel (UAP) E. Check if the patient is wearing any jewelry and call security to secure valuables if necessary F. Place the patient on NPO status for the period ordered by the physician
A. Modify the dose of insulin given based on the patient's blood glucose as ordered B. Complete the preoperative checklist before transfer to the surgical suite D. Delegate obtaining the patient's fingerstick blood glucose and vital signs to the unlicensed assistive personnel (UAP) E. Check if the patient is wearing any jewelry and call security to secure valuables if necessary F. Place the patient on NPO status for the period ordered by the physician
During preoperative screening,, the nurse discovers that the patient is allergic to shellfish. What is the nurse's best first action? A. Notifies the surgeon B. Develops a plan to keep the patient safe C. Obtains an order for a shellfish-free diet D. Asks the patient if any other family members have the same allergy
A. Notifies the surgeon
A client is admitted for surgery. Although not physically distressed, the client appears apprehensive and withdrawn. What is the nurse's best action? A. Orient the client to the unit environment B. Have a copy of hospital regulations available C. Explain that there is no reason to be concerned D. Reassure the client that the staff is available to answer questions
A. Orient the client to the unit environment
A colostomy is scheduled to be done on a patient with Crohn's disease. What is the correct classification for this surgery? A. Palliative B. Minor C. Restorative D. Curative
A. Palliative
An older adult is scheduled for an elective surgical procedure. On assessment, the nurse notes brittle nails, dry flaky skin, muscle wasting, and dry sparse hair. The patient's BP is 82/48 and heart rate is 112/minute. How does the nurse interpret this assessment data? A. Poor fluid and nutrition status B. Improper care in the home C. Expected physiological changes of aging D. Depression related to aging processes
A. Poor fluid and nutrition status
The 79-year-old patient with type 2 diabetes is scheduled for surgery to remove his left great toe. Which risk factors for complications of surgery does the nurse assess in this patient? SATA A. Presence of chronic illness B. Problems with healing C. Absence of smoking history D. Dehydration E. Electrolyte imbalance F. Daily exercise routine
A. Presence of chronic illness B. Problems with healing D. Dehydration E. Electrolyte imbalance
Which are the focus areas for the Surgical Care Improvement Project (SCIP)? SATA A. Prevention of infection B. Prevention of respiratory complications C. Prevention of serious cardiac events D. Prevention of venous thromboembolism E. Prevention of acute kidney injury F. Maintenance of normothermia
A. Prevention of infection C. Prevention of serious cardiac events D. Prevention of venous thromboembolism F. Maintenance of normothermia
The nurse has given the ordered preoperative medications to the patient. What actions must the nurse take after administering these drugs? SATA A. Raise the side rails B. Place the call light within the patient's reach C. Ask the patient to sign the consent form D. Instruct the patient not to get out of bed E. Place the bed in its lowest position F. Tell the patient that he or she may become drowsy
A. Raise the side rails B. Place the call light within the patient's reach D. Instruct the patient not to get out of bed E. Place the bed in its lowest position F. Tell the patient that he or she may become drowsy
Which postoperative interventions will the nurse typically teach a patient to prevent complications following surgery? SATA A. Range-of-motion exercises B. Massaging of lower extremities C. Taking pain medications only when experiencing severe pain D. Incision splinting E. Deep-breathing exercises F. Use of incentive spirometry
A. Range-of-motion exercises D. Incision splinting E. Deep-breathing exercises F. Use of incentive spirometry
The nurse has received a patient in the holding area who is scheduled for a left femoral-popliteal bypass. What are the priority safety measures for this patient before surgery? SATA A. The operative limb is marked by the surgeon B. The patient is positively identified by checking the name and date of birth C. The patient is asked to confirm the marked operative limb D. The patient is identified by checking the name and room number E. The patient is instructed to verify any family members waiting F. The patient is kept on NPO status
A. The operative limb is marked by the surgeon B. The patient is positively identified by checking the name and date of birth C. The patient is asked to confirm the marked operative limb F. The patient is kept on NPO status
Which are implied with informed consent? SATA A. The patient understands the nature of and the reason for surgery B. The patient is informed of what type of anesthesia drugs will be used C. The patient understands who will do the surgery and who will be present during surgery D. The patient understands the risks associated with the surgical procedure and its potential outcomes E. The patient understands that blood and blood products must be available during surgery F. The patient is informed of all available options and the benefits and risks associated with each option
A. The patient understands the nature of and the reason for surgery C. The patient understands who will do the surgery and who will be present during surgery D. The patient understands the risks associated with the surgical procedure and its potential outcomes F. The patient is informed of all available options and the benefits and risks associated with each option
Which task would be best for the charge nurse to assign to the LPN/LVN working in the surgery admitting area? A. Provide preoperative teaching to a client who needs insertion of a tunneled central venous catheter. B. Insert a retention catheter in a client who requires a flap graft of a sacral pressure ulcer. C. Obtain the medical history from a client who is scheduled for a total hip replacement. D. Assess the client who is being admitted for an elective laparoscopic cholecystectomy.
B. Insert a retention catheter in a client who requires a flap graft of a sacral pressure ulcer.
Which statement best describes the preoperative period? SATA A. It begins when the patient makes the appointment with the surgeon to discuss the need for surgery B. It ends at the time of transfer to the surgical suite C. It is a time during which the patient's need for surgery is established D. It begins when the patient is scheduled for surgery E. It is a time during which the patient receives testing and education related to impending surgery F. It is a time when patients families receive discharge instructions
B. It ends at the time of transfer to the surgical suite D. It begins when the patient is scheduled for surgery E. It is a time during which the patient receives testing and education related to impending surgery
The patient is scheduled for same-day surgery for an uncomplicated cholecystectomy. Which surgical approach will most likely be used? A. Simple B. Minimally invasive C. Open D. Radical
B. Minimally invasive
A CBC, urinalysis, and x-ray examination of the chest are ordered for a client before surgery. The client asks why these tests are done. Which is the best reply by the nurse? A. "Don't worry; these tests are routine." B. "They are done to identify other health risks." C. "They determine whether surgery will be safe." D. "I don't know; your health care provider ordered them."
B. "They are done to identify other health risks."
The preoperative patient tells the nurse that she is afraid that she may experience a reaction if she must receive blood during or after her surgery. What is the nurse's best response to the patient's concern? A. "The likelihood that you will need a blood transfusion for your surgery is minimal, so do not worry about this." B. "You could donate some of your own blood (autologous donation) a few weeks before your surgery." C. "With today's technology and procedures, it is very unlikely that you would have a reaction to donated blood." D. "The nursing staff follows strict procedures to prevent such an event from ever happening."
B. "You could donate some of your own blood (autologous donation) a few weeks before your surgery."
While receiving a preoperative enema, a client starts to cry and says "I'm sorry you ave to do this messy thing for me." What is the nurse's best response? A. "I don't mind it." B. "You seem upset." C. "This is part of my job." D. "Nurses get used to this."
B. "You seem upset."
The nurse screens a preoperative patient for conditions that may increase the risk for complications during the perioperative period. Which conditions are possible risk factors? SATA A. Emotionally stable B. Age 67 C. Obesity D. Marathon runner E. Pulmonary disease F. Hypertension
B. Age 67 C. Obesity E. Pulmonary disease F. Hypertension
During the preoperative period, a patient receives surgery on the wrong extremity. To which agency must this occurrence be reported? A. Association of periOperative Registered Nurses (AORN) B. Centers for Medicare and Medicaid Services (CMS) C. The Joint Commission (TJC) D. American Society of Anesthesiologists (ASA)
B. Centers for Medicare and Medicaid Services (CMS)
As the nurse obtains informed consent, the client asks, "Now what exactly are they going to do to me?" What is the nurse's response? A. Contact the anesthesiologist. B. Contact the surgeon. C. Explain the procedure. D. Have the client sign the form.
B. Contact the surgeon.
A 75-year-old patient is having an exploratory laparotomy tomorrow. The wife tells the nurse that at night the patient gets up and walks around his room. What priority action does the nurse take after hearing this information? A. Notify the provider B. Develops a plan to keep the patient safe C. Obtains an order for sleep medication D. Tells the patient not to get out of bed at night
B. Develops a plan to keep the patient safe
A patient with an abdominal aortic aneurysm is having surgical repair. What is the correct classification for this surgery? A. Restorative B. Emergent C. Urgent D. Minor
B. Emergent
A patient who can barely ambulate with a walker at home is having a left total knee replacement. What is the most appropriate category for this surgery? A. Urgent B. Restorative C. Simple D. Palliative
B. Restorative
Which assessment data finding for a client scheduled for total knee replacement surgery is most important for the nurse to communicate to the surgeon and the anesthesia provider before the procedure? SATA A. The oxygen saturation is 97%. B. The serum potassium level is 3.0 mEq/L (3.0 mmol/L) C. The client took a total of 1300 mg of aspirin yesterday. D. The client requests to talk with a registered dietitian about weight loss. E. The client took a regularly scheduled antihypertensive drug with a sip of water 2 hours ago. F. After receiving the preoperative medications, the client tells the nurses that he lied on the assessment form and that he really is a current smoker.
B. The serum potassium level is 3.0 mEq/L (3.0 mmol/L) C. The client took a total of 1300 mg of aspirin yesterday. F. After receiving the preoperative medications, the client tells the nurses that he lied on the assessment form and that he really is a current smoker.
The nurse is preparing the patient for surgery. Which common laboratory tests does the nurse anticipate being ordered? SATA A. Total cholesterol B. Urinalysis C. Electrolyte levels D. Uric acid E. Clotting studies F. Serum creatinine
B. Urinalysis C. Electrolyte levels E. Clotting studies F. Serum creatinine
The nurse completes the preoperative checklist on a client scheduled for general surgery. Which factor contributes the greatest risk for the planned procedure? A. Age 59 years B. General anesthesia complications experienced by the client's brother C. Diet-controlled diabetes mellitus D. Ten pounds (4.5 kg) over the client's ideal body weight
C. Diet-controlled diabetes mellitus
A 76-year-old patient is having bilateral cataract removal. What is the correct classification for this surgery? A. Major B. Cosmetic C. Elective D. Emergent
C. Elective
During a preoperative assessment, which statement by a client requires further investigation by the nurse to assess surgical risks? A. "I am taking vitamins." B. "I drink a glass of wine a night." C. "I had a heart attack 4 months ago." D. "I quit smoking 10 years ago."
C. "I had a heart attack 4 months ago."
The nurse is instructing a client about the use of antiembolism stockings. Which statement by the client indicates the need for further teaching? A. "I will take off my stockings one to three times a day for 30 minutes." B. "My stockings are too loose." C. "It's better if they are too tight rather than too loose." D. "These stockings help promote blood flow."
C. "It's better if they are too tight rather than too loose."
A client was originally scheduled for surgery at noon. The surgeon is delayed, and the surgery has been rescheduled for 3:00 p.m. How will the nurse plan to administer the preoperative prophylactic antibiotic? A. Give at noon as originally prescribed. B. Cancel orders, preoperative prophylactic antibiotics are given optionally. C. Adjust the administration time to be given within 1 hour before surgery. D. Hold the preoperative antibiotic so it can be administered immediately following surgery.
C. Adjust the administration time to be given within 1 hour before surgery.
Which drug may the surgeon allow the patient to take prior to surgery? A. Daily vitamin B. Stool softener C. Anti-seizure drug D. Daily baby aspirin
C. Anti-seizure drug
A preoperative patient is scheduled for surgery at 7:30 a.m. At 0600, the patient's vitals are BP 90/60, HR 110 and irregular, respirations 22/minute, and oral temperature 100.9F. The patient's oxygen saturation is 92% and he has a productive cough. What is the nurse's priority action at this time? A. Administer acetaminophen (Tylenol) with just a sip of water B. recheck the vital signs at 0700 C. Call and notify the surgeon immediately D. Have the patient cough and take some deep breaths
C. Call and notify the surgeon immediately
A male patient is having revision of a scar on his forehead from a third-degree burn. What is the correct classification for this surgery? A. Major B. Restorative C. Cosmetic D. Curative
C. Cosmetic
At 8:00 a.m., the registered nurse is admitting a client scheduled for sinus surgery to the outpatient surgery department. Which information given by the client is of most immediate concern to the nurse? A. An allergy to iodine and shellfish B. Being nauseated after a previous surgery C. Having a small glass of juice at 7:00 a.m. D. Expressing anxiety about the surgery
C. Having a small glass of juice at 7:00 a.m.
Which is the top priority for nurses during the preoperative period? A. Patient teaching B. Patient diagnostic testing C. Patient safety D. Patient care documentation
C. Patient safety
What client teaching will the nurse provide regarding postoperative leg exercises to minimize the risk for development of deep vein thrombosis after surgery? A. Only perform each exercise one time to prevent overuse. B. Begin exercises by sitting at a 90-degree angle on the side of the bed. C. Point toes of one foot toward bottom of bed; then point toes of same leg toward his or her face. Repeat several times; then switch legs. D. Bend knee and push heel of foot into the bed until the calf and thigh muscles contract. Repeat several times; then switch legs.
C. Point toes of one foot toward bottom of bed; then point toes of same leg toward his or her face. Repeat several times; then switch legs.
A preoperative client smokes a pack of cigarettes a day. What is the nurse's teaching priority for the best physical outcomes? A. Instruct the client to quit smoking. B. Teach about the dangers of tobacco. C. Teach the importance of incentive spirometry. D. Tell the client that smoking increases postoperative complications.
C. Teach the importance of incentive spirometry.
Which statement best describes the collaborative roles of the nurse and surgeon when obtaining the informed consent? A. The nurse is responsible for having the informed consent form on the chart for the healthcare provider (HCP) to witness B. The nurse may serve as a witness that the patient has been informed by the HCP before surgery is performed C. The nurse may serve as a witness to the patient's signature after the HCP has the consent form signed before preoperative sedation is given and before surgery is performed D. The nurse has no duties regarding the consent form if the patient has signed the informed consent form for the HCP, even if the patient then asks additional questions about the surgery
C. The nurse may serve as a witness to the patient's signature after the HCP has the consent form signed before preoperative sedation is given and before surgery is performed
The nurse is educating a client who is about to undergo cardiac surgery with general anesthesia. Which statement by the client indicates the need for further instruction? A. "I will wake up with a tube in my throat." B. "I will have a bandage on my chest." C. "My family will not be able to see me right away." D. "Pain medication will take away my pain."
D. "Pain medication will take away my pain."
A patient scheduled for surgery has a history of myocardial infarction 6 weeks ago. Which classification will this patient meet preoperatively based on the ASA Physical Status Classification system? A. ASA class I B. ASA class II C. ASA class III D. ASA class IV
D. ASA class IV
What should the nurse do initially when obtaining consent for surgery? A. Describe the risks involved in the surgery B. Explain that obtaining the signature is routine for any surgery C. Witness the client's signature which the nurse's signature will document D. Determine whether the client's knowledge level is sufficient to give consent
D. Determine whether the client's knowledge level is sufficient to give consent
A female patient is having a biopsy of a nodule found in the right breast. Which classification identifies this surgery? A. Urgent B. Minor C. Cosmetic D. Diagnostic
D. Diagnostic
A diabetic client who is scheduled for vascular surgery is admitted on the day of surgery with several orders. Which order does the nurse accomplish first? A. Use electric clippers to cut hair at the surgical site. B. Start an infusion of lactated Ringer's solution at 75 mL/hr. C. Administer one-half of the client's usual lispro insulin dose. D. Draw blood for glucose, electrolyte, and complete blood count values.
D. Draw blood for glucose, electrolyte, and complete blood count values.
What principle must a nurse consider when caring for a client with a closed wound drainage system? A. Gravity causes fluid to flow down a pressure gradient B. Fluid flow rate is determined by the diameter of the lumen C. Siphoning causes fluids to flow from one level to a lower level D. Fluids flow from an area of higher pressure to one of lower pressure
D. Fluids flow from an area of higher pressure to one of lower pressure
The nurse is providing preoperative care for a client who will have an arthroscopy of the left knee. As part of the Joint Commission National Patient Safety Goals (NPSG), what will the nurse be required to do? A. Ensure that the correct procedure is noted in the client's history. B. Remind the surgeon that the client will have a left knee arthroscopy. C. Verify with the client that a left knee arthroscopy will be performed. D. Mark the left knee site with the client awake and the surgeon present.
D. Mark the left knee site with the client awake and the surgeon present.
Colostomy surgery is categorized as what type of surgery? A. Cosmetic B. Curative C. Diagnostic D. Palliative
D. Palliative
A client had extensive, prolonged surgery. Which electrolyte level should the nurse monitor most closely? A. Sodium B. Calcium C. Chloride D. Potassium
D. Potassium
An older client's adult child tells the nurse that the client does not want life support. What does the nurse do first? A. Call the legal department to draft the paperwork. B. Document this in the chart. C. Thank the person and do nothing else. D. Talk to the client.
D. Talk to the client.
A 47-year-old patient is having surgery to remove kidney stones. What is the correct classification for this surgery? A. Restorative B. Emergent C. Palliative D. Urgent
D. Urgent
A client is being prepared for gastrointestinal surgery and undergoes a bowel preparation. This preoperative procedure is done to A. decrease expected blood loss during surgery. B. eliminate any risk of infection. C. ensure that the bowel is sterile. D. reduce the number of intestinal bacteria.
D. reduce the number of intestinal bacteria.
