Preoperative Mastery Review
they remove fluid from the surgical site
Which explanation would the nurse review with the patient before an operation regarding the placement of drains?
After induction of anesthesia (the purpose is to decompress or empty the stomach during surgery)
For patients having abd surgery, in which operative stage would a nasogastric tube be inserted?
clubbing of fingers
Which evaluation criterion leads the nurse to suspect that a patient has a chronic lack of oxygen?
the court
A patient is scheduled for abd surgery, but the patient is unable to give consent and has no family. Who can appoint a legal guardian for the patient?
Signs of delirium tremens
A patient is to undergo right total hip replacement after falling at home and reports that the last drink of alcohol was 3 days ago. Which assessment would be most concerning to the nurse in the pre op stage?
no eating, drinking, or smoking before surgery
A patient scheduled for a 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?
notify the surgeon and anticipate a cardio consult
A patient who is scheduled for back surgery has a medical history that includes GERD. During transport to the operating room, the patient reports burning chest pain rated as 8 on a pain scale of 0- 10. Which nursing action is most appropriate?
getting written consultation from two other HCPs before surgery
A patient who was involved in a motor vehicle accident arrives at the ER and requires immediate surgery to stop massive internal hemorrhaging. The patient is unconscious, and no family or spouse is present. Which action would the nurse anticipate?
the surgeon and the patient confirm and mark the site
Before surgery on a specific limb, which practice is supported by the joint commissions national patient safety goals regarding site prep?
I had a heart attack 4 months ago
During a pre op assessment, which statement by a patient requires further investigation by the nurse to assess surgical risks?
I have dull achy pain in my right calf
For the patient who is scheduled to undergo a total hip replacement, which complaint requires further evaluation by the nurse?
seizures hypertension cardiac disease respiratory disease
For which pre existing conditions may meds be allowed with a sip of water before surgery?
10-20 mg/dL
Normal BUN level for adults less than 60 years old
136-145 mEq/L
Normal sodium range for adults
palliative
Which category of surgery is an ileostomy creation?
altered response to anesthesia
The nurse at the hospital is preparing a patient with a history of alcoholism for knee replacement surgery. Which potential complication is this patient more likely to encounter during surgery?
dull hair brittle nails muscle wasting skin turgor changes
Which clinical manifestation in a patient indicates poor fluid or nutritional status?
Asking open ended questions related to any previous surgeries
The nurse is assessing a patient wo is scheduled for surgery and observes dilated pupils, tachycardia, and increased respiration. Which nursing action is most likely to reveal the presence of emotional stress in the patient?
You will apply these before my surgery (often applied before surgery and are used throughout the perioperative process to prevent venous thromboembolism VTE and deep vein thrombosis DVT. They help circulate blood from the lower extremities so that blood flow does not stagnate and ultimately clot)
The nurse is providing patient education regarding external pneumatic compression devices. Which statement by the patient demonstrates effective teaching?
potassium 3.3 mEq/dL
The nurse is reviewing lab data for a 56 yr old man who is scheduled to have surgery in 2 hours. Which result would require the nurse to notify the physician immediately?
incentive spirometry
This device will help you keep your lungs expanded after surgery
Teach the patient how to use incentive spirometer
When performing pre op teaching for a patient who smokes a pack of cigarettes a day, which instruction is priority?
teach the patient to splint the incision site when turning in bed
Which action would the nurse take for a patient preoperatively who is having abd surgery?
contact the surgeon (the nurse is not responsible for providing detailed info about the surgical procedure. The nurse's role is to clarify facts that have been presented by the HCP and dispel myths that the patient or family may have heard about the surgical experience)
Which action would the nurse take if, after informed consent is obtained, the patient asks, "Now what exactly are they going to do to me?"
use electric clippers or a chemical depilatory for hair removal
Which action would the nurse take to reduce the chances of infection during skin prep for a patient scheduled for abd surgery?
Latex
Which allergy would the nurse assess the patient for if the patient has a known allergy to bananas?
absence of peripheral pulses
Which assessment finding would the nurse report to the primary HCP when caring for a patient who is scheduled for cardio surgery?
decreased nutrients fewer blood vessels low amounts of collagen
Which condition related to obesity and excessive fatty tissue is associated with an increased risk for poor wound healing?
decreased nutrients fewer blood vessels low amounts of collagen
Which conditions related to obesity and excessive fatty tissue is associated with an increased risk for poor wound healing?
blood from the patient before surgery
Which definition of autologous blood is accurate?
Scanty
Which descriptor of urination is associated with the term oliguria?
Creatinine 1.9 mg/dL (normal range is 0.7-1.3 mg/dL)
Which electrolyte lab result in a pre op patient would the nurse report immediately to the anesthesiologist?
CT scan or MRI (helps to identify the exact location of the patients problem)
Which examination would the nurse anticipate in the pre op order set for a patient scheduled for spinal surgery?
reduces the potential for infection
Which explanation supports the use of electric clippers and depilatories to remove hair at the surgical site?
to deliver a general anesthetic
Which explanation would the nurse review with the patient before an operation as the primary need for vascular access?
obesity cancer smoking age 40 or older
Which factor can increase a post op patients risk for venous stasis leading to thromboembolism?
presence of cardiac problems alcohol and illicit substance use age related changes in kidney and liver function
Which factor can increase the risk for anesthesia related complications?
diet controlled Diabetes mellitus
Which factor increases the risk for surgical complications?
diabetes cardiac disease antihypertensive drugs age older than 65 years
Which factor may increase the risk for surgical or post op complications?
shellfish
Which food is contraindicated in patients with povidone-iodine allergy?
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
Which info must be provided to the patient when obtaining informed consent for surgery?
ensuring the correct hair removal process
Which intervention by the nurse involves promoting surgical care improvement project core measures?
padding bony prominences
Which intervention by the nurse is most appropriate to ensure skin integrity in an older adult who is scheduled for surgery?
instructing the patient to avoid visiting friends 24 hours before surgery
Which intervention in the plan of care for a pre op patient who is experiencing anxiety needs revision?
Monitor intake and output of fluids
Which intervention would the nurse implement specifically for a patient scheduled for surgery who has a history of renal impairment?
total knee replacement
Which is an example of an elective surgery?
9:15AM
Which is the most appropriate time to give the pre op prophylactic antibiotic to a patient who is scheduled to have surgery at 9:30am?
matching tag (given to the patient to wear or bring to the surgical area before surgery. Helps to ensure that patients receive their own blood)
Which item is provided by the blood collection center to the patient after autologous blood donation?
urinalysis electrolyte levels hemoglobin level blood type screen
Which lab and or diagnostic test is routinely carried out before any surgery is performed?
leg length
Which measurement is essential when determining anti embolic stocking size for a patient?
providing detailed information about the surgery to be performed
Which nursing action related to informed consent for a surgical procedure would need correction?
determining the patients normal activity levels
Which nursing action will help prevent fatigue in a patient diagnosed with a decrease in cardiac output?
teaching the patient about coughing and deep breathing exercises
Which nursing intervention would assist a patient in reducing pulmonary complications post op?
teaching the patient to change position every 2 hours
Which nursing intervention would be included in the plan or care for a pre op patient with dry skin and less subcutaneous fat?
pulmonary complications
Which occurrence is likely to develop in the patient whose pre op chest x-ray is abnormal if the surgery were to proceed?
Povidone-iodine
Which other substance may a patient be allergic to in conjunction with a shellfish allergy?
It expels secretions it prevents atelectasis it keeps the lungs clear it prevents pneumonia
Which point would be included in a teaching plan when explaining to a pre op patient the reasons to perform coughing and splinting?
arthroscopy
Which procedure is an example of a minimally invasive surgery?
it protects the patient from unwanted procedures
Which purpose of having a patient sign an informed consent form before surgery is accurate?
What meds are you currently taking?
Which question would the nurse ask the patient when completing the preoperative assessment?
reduces the number of intestinal bacteria
Which rationale is accurate regarding the need for bowel prep before GI surgery?
patient self determination act (PSDA)
Which regulation or act gives patient the right to a living will or durable power of attorney?
Verify that the consent form is signed serve as a witness to the signature dispel myths about the surgical experience
Which responsibility is associated with the nurse in the informed consent process?
please sign both consent forms for anesthesia and blood products
Which statement by the nurse demonstrates an understanding of pre op care?
informed consent enables a patient to understand the risks associated with the use of anesthesia
Which statement regarding informed consent before surgery is accurate?
It grants patients the right to have advanced directives documents such as a living will or durable power of attorney are mandated The PSDA grants patients the right to provide legally binding instructions to HCPs about their wishes regarding treatment
Which statement regarding the Patient Self Determination Act is true?
Iron folic acid vitamin C Vitamin B12
Which supplement is often prescribed to a patient before surgery to increase RBC formation?
ileostomy creation
Which surgery is an example of a surgical procedure performed to relieve symptoms of a disease?
appendectomy
Which surgical procedure is categorized under curative surgery?
anger crying urinary frequency
Which symptom might the nurse observe in a pre op patient with anxiety?
potent laxatives
Which therapy would be the safest to assist the patient in evacuating the bowels before hemorrhoids' surgery?
splinting pain management incentive spirometry lower extremity exercises
Which topic is included in pre op patient teaching?
