PrepU ML Quiz Ch 17
A client is scheduled for a cholecystectomy. Which finding by the nurse is least likely to contribute to surgical complications? A. Osteoporosis B. Diabetes C. Pregnancy D. Urinary tract infection
A
A nurse is assessing a postoperative client with hyperglycemic blood glucose levels. Which client surgical risk factor would decrease if the surgical client maintained strict blood glycemic control? A. wound healing B. respiratory complications C. nutrient deficiencies D. liver dysfunction
A
A perioperative nurse is assigned to complete a preoperative assessment on a client who is scheduled for surgery for kidney stones the next day. What category of surgery does this procedure fall into? A. urgent B. required C. emergent D. elective
A
An elderly client is preparing to undergo surgery. The nurse participates in preoperative care knowing that which of the following is the underlying principle that guides preoperative assessment, surgical care, and postoperative care for older adults? A. Older adults have less physiologic reserve (or ability to regain physical equilibrium) than younger clients. B. Neurologic and musculoskeletal complications are the leading cause of postoperative morbidity and mortality for older adults. C. Aging processes reduce the chances that surgery will be successful for these clients. D. All older people face similar risks when undergoing surgeries.
A
As a nurse working in an ambulatory surgery center, you are admitting a client who is going to have a biopsy of a skin lesion. What is an important part of the preoperative process? A. Review preoperative instructions. B. Teach dressing changes. C. Give caregiver instructions. D. Give postoperative instructions.
A
For the client who is taking aspirin, it is important to stop taking this medication at least how many day(s) before surgery? A. 7 B. 1 C. 5 D. 3
A
In advance of a client's scheduled appendectomy, the nurse spends significant time explaining to the client what will happen, both before the procedure and after the procedure is complete. The primary reason the nurse puts so much effort into preoperative teaching is to: A. increase the likelihood of a successful recovery. B. absolve the hospital of legal responsibility should complications arise. C. minimize the time that will need to be spent on postoperative questions. D. decrease the client's participation and allow the family to take on the caregiver role.
A
Nursing assessment findings reveal that the client is afraid of dying during the surgical procedure. Which surgical team member would be most helpful in addressing the client's concern? A. Surgeon B. Anesthesiologist C. Registered nurse first assistant D. Circulating nurse
A
The nurse in the preoperative area has just medicated her client according to the anesthesiologist's orders. What is the nurse's priority action at this time? A. Place the side rails in the up position and make sure the call button is in reach. B. Take the client's vital signs. C. Have the family go to the waiting room. D. Take the client to the bathroom.
A
The nurse is educating a client scheduled for elective surgery. The client currently takes aspirin daily. What education should the nurse provide with regard to this medication? A. Stop taking the aspirin 7 days before the surgery, unless otherwise directed by your physician. B. Take half doses of the aspirin until 1 week after surgery. C. Aspirin should be increased until 3 days before surgery, then it should be discontinued until 3 days after surgery. D. Continue to take the aspirin as ordered.
A
The nurse is reviewing the pre-admission laboratory findings of the client scheduled for surgery. Which laboratory value would be of greatest concern to the nurse? A. potassium 6.2 mEq/L B. sodium 138 mEq/L C. white blood cell count 7.2 cells/mm D, calcium 9.8 mg/dL
A
The nurse recognizes that written informed consent is required for insertion of a(n): A. Peripherally-inserted central catheter. B. Oral airway. C. Urinary catheter. D. Nasogastric tube.
A
What is the blood glucose level goal for a diabetic client who will be having a surgical procedure? A. 80 to 110 mg/dL B. 250 to 300 mg/dL C. 150 to 240 mg/dL D. 300 to 350 mg/dL
A
Which client would the nurse recognize as having the greatest risk for complications during the intraoperative or postoperative period? A. The 35-year-old client with non-insulin dependent diabetes. B. The 47-year-old client who stopped smoking 2 years ago. C. The 28-year-old client who occasionally smoked marijuana in high school. D. The 72-year-old client who takes no routine medications.
A
Which would be considered to require an urgent surgical procedure? A. Acute gallbladder infection B. Severe bleeding C. Cataract D. Loose facial skin
A
A nurse is planning preoperative teaching for an older client. Which structural or functional changes in the older adult impact the surgical experience? Select all that apply. A. Increased fatty tissue prolongs elimination of anesthesia. B. Loss of collagen increases the risk of skin complications. C. Increased plasma proteins decrease the effects of anesthesia. D. Decreased ability to compensate for hypoxia increases the risk of an embolism. E. Enlarged liver, due to fatty deposits, alters the breakdown of anesthetic agents. F. Reduced tactile sensitivity can lead to assessment and communication problems.
A, B, D, F
The nurse is reviewing a preoperative informed consent when preparing the client for surgery. Which contents of the informed consent are required? Select all that apply. A. Potential risks B. Benefits of surgery C. Personnel present D. Description of alternatives E. Estimated time of procedure F. Explanation of procedure
A, B, D, F
A nurse knows that she must obtain a signed informed consent for which of the following procedures? Select all that apply. A. Arteriography B. Insertion of a peripheral intravenous line C. Insertion of a urethral catheter D. Paracentesis E. Open reduction of a fracture F. Cystoscopy
A, D, E, F
A client is preparing for a surgical procedure is taking corticosteroids for Crohn's disease. What is most important for the nurse to monitor during the operative experience with the client? A. hypoglycemia B. adrenal insufficiency C. obstruction D. surgical site infection
B
A client is scheduled for a surgical procedure. When planning the client's care, the nurse should consider that which of the following conditions will increase the client's risk of complications after surgery? A. history of osteoarthritis B. A history of diabetes C. A history of sensitivity to aspirin D. A history of chronic low back pain
B
A client is undergoing preoperative assessment. During admission paperwork, the client reports having enjoyed a hearty breakfast this morning to be ready for the procedure. What is the nurse's next action? A. Document what foods the client ate. B. Notify the surgeon. C. Cancel the surgery. D. Give the client plenty of water to aid digestion.
B
A fractured skull would be classified under which category of surgery based on urgency? A. Elective B. Emergent C. Urgent D. Required
B
A nurse is teaching a client with chronic bronchitis about breathing exercises. Which instruction should the nurse include in the teaching? A. Make inhalation longer than exhalation. B. Use diaphragmatic breathing. C. Use chest breathing. D. Exhale through an open mouth.
B
Clients who have received corticosteroids preoperatively are at risk for which type of insufficiency? A. Pituitary B. Adrenal C. Thyroid D. Parathyroid
B
In preparing the client for transfer to the operating room, which of the following actions by the nurse is inappropriate? A. Have the client void. B. Allow the client to wear dentures. C. Have client wear hospital gown. D. Remove all jewelry.
B
The nurse has provided preoperative instructions to a client scheduled for surgery at an ambulatory care center. Which statement, made by the client, would indicate that further instruction is needed? A. "My medical records will be sent to the ambulatory care center prior to my surgery." B. "The nurse will explain the details of the surgery before I sign a consent." C. "The physician will update my family after the procedure and provide specific discharge instructions." D. "If I do not follow the instructions, my surgery could be cancelled."
B
The nurse is caring for the client in the preoperative period and documenting rationale for a palliative surgical procedure. Which rationale is most appropriate? A. The physician needs additional information to plan medical treatment. B. The client and physician are focusing on symptom relief not a cure. C. The client wishes to improve body structures and elects a procedure. D. The physician is repairing a deformity from birth or disease process.
B
The perioperative nurse has a number of major responsibilities when a patient is admitted to a surgical unit or center. Which of the following is the most important function? A. Completes preoperative assessment B. Verifies that operative consent is signed C. Develops a plan of care D. Provides psychological support
B
When the indication for surgery is without delay, the nurse recognizes that the surgery will be classified as A. required. B. emergency. C. elective. D. urgent.
B
Which nursing statement would best decrease a client's anxiety before an emergency operative procedure? A. "We will keep your family informed of your progress." B. "Let me explain to you what will happen next." C. "It is best to take deep breaths and relax before the procedure." D. "You will be just fine; the operating room nurses will take good care of you."
B
Why is assessment of dentition important in the patient preparing to have a surgical procedure with general anesthesia? A. The patient may require referral to the dentist. B. Decayed teeth or dental prosthesis can become dislodged during intubation. C. The patient can sue if a tooth falls out during surgery. D. Oral hygiene is important for all patients.
B
Several of the clients at the clinic are preparing to have surgery within the next 2 weeks. They are completing preoperative paperwork today with their visit. What are some of the reasons that people might need to have surgery? Select all that apply. A. Normative B. Cosmetic C. Palliative D. Diagnostic E. Causative
B, C, D
A client is undergoing a surgical procedure to repair an ulcerated colon. Which client education topics will be discussed preoperatively? Select all that apply. A. the client's spouse's thoughts about the upcoming surgery B. cough and deep-breathing exercises C. the surgeon's fee and other hospital charges D. intravenous fluids and other lines and tubes E. postoperative pain control
B, D, E
The nurse assesses a client to determine if there is increased risk for complications intraoperatively or postoperatively. Which are general risk factors? Select all that apply. A. Ethnicity B. age C. gender D. physical condition E. nutritional status F. health status
B, D, E, F
A 17-year-old client is having same-day surgery. Solely during the intraoperative phase of perioperative care, the nurse: A. performs a complete assessment of the client. B. assesses how well the client is recovering from anesthesia. C. continuously monitors the sedated client. D. obtains a surgical consent from the client's mother.
C
A gunshot wound would be classified under which category of surgery based on urgency? A. Elective B. Required C. Emergent D. Urgent
C
A nurse is teaching a client about diaphragmatic breathing. What client action indicates that further teaching is needed? A. The client breathes in deeply through the nose and mouth. B. The client places the hands on the lower chest to feel the rise and fall with breathing. C. The client exhales forcefully with a short expiration. D. The client performs diaphragmatic breathing in a semi-Fowler's position.
C
A nurse is teaching a client about pain management after surgery. Which client statement indicates the teaching was effective? A. "The pain from my incision will be very similar to my arthritis pain." B. "I will ask for pain medication when the pain becomes unbearable." C. "I will support my incision with my hands when I cough and do my deep breathing exercises." D. "I will need to learn how to give myself pain medication by injection for when I go home."
C
A nurse is teaching a client with chronic bronchitis about breathing exercises. Which instruction should the nurse include in the teaching? A. Make inhalation longer than exhalation. B. Use chest breathing. C. Use diaphragmatic breathing. D. Exhale through an open mouth.
C
A nurse is witnessing a client sign the consent form for surgery. After signing the consent form, the client starts asking questions regarding the risks and benefits of a surgical procedure. What action by the nurse is most appropriate? A. Answer the client's questions. B. Place the consent form in the client's medical record. C. Request that the surgeon come and answer the questions. D. Notify the nurse manager of the client's questions.
C
A patient is scheduled for a reduction mammoplasty. What classification of surgery does the nurse understand that this is? A. Urgent B. Reconstructive C. Optional D. Required
C
A physically fit older adult is scheduled for right knee replacement. What factor for the client creates an increased risk for postoperative complications? A. type of surgery B. ability to metabolize medication C. current smoking history D. surgical site
C
At what point does the preoperative period end? A. When the decision is made to proceed with surgery B. When the client is admitted to the PACU C. When the client is transferred onto the operating table D. When the client signs the consent form
C
The nurse has administered preanesthetic medication. What action should the nurse take next? A. Review the client's list of home medications. B. Obtain the client's signature on the consent form. C. Place the client on bed rest with the side rails up. D. Educate the client on discharge instructions.
C
The nurse is aware that a religious group that refuses blood transfusions for religious reasons is: A. Methodists B. Catholics C. Jehovah's Witnesses D. Jews
C
The nurse is caring for a client needing emergency surgery. Which preoperative teaching is least important to prepare the client for surgery? A. Effective coughing and deep breathing B. Types of postoperative pain medication C. Post-discharge diet D. Knowledge of surgical procedure
C
The nurse is caring for a patient with liver disease who had a surgical procedure. When should the nurse alert the physician? A. When a serum globulin concentration reaches 2.8 g/dL B. When a serum albumin concentration is 5.0 g/dL C. When the patient's blood ammonia concentration reaches 180 mg/dL D. When a lactate dehydrogenase concentration is 300 units
C
The nurse is conducting a health history of a preoperative client. The client shares that she experienced vaginal itching and burning and labial swelling after her partner tried a new brand of condoms. The nurse suspects that the client: A. Is susceptible to the lubricant. B. May have a sexually transmitted disease. C. May have a latex allergy. D. Needs to change her position during intercourse.
C
The nurse recognizes that which of the following clients is at least risk for perioperative complications? A. A 32-year-old African-American woman who takes prednisone B. A 76-year-old Asian man who takes clopidogrel C. A 65-year-old Caucasian man who has a history of arthritis D. A 45-year-old African-American man recently diagnosed with type 2 diabetes
C
You are physically preparing a client for surgery and instruct the person to remove any jewelry. The client refuses to remove a wedding band. What should you do in this situation with approval from your facility? A. Tell the physician and anesthesiologist. B. Medicate the client and then remove the ring. C. Place gauze under and over the ring and apply adhesive tape over it. D. Explain that the client cannot go into the operating room with jewelry on.
C
A client having a surgical procedure takes aspirin 325 mg daily for prevention of platelet aggregation. When should the client stop taking the aspirin before the surgery? A. 2 weeks B. 4 weeks C. 2 to 3 days D. 7 to 10 days
D
A client is scheduled to have surgery to address a cleft palate. What type of surgery would the nurse be preparing this client for? A. prophylactic B. corrective C. diagnostic D. reconstructive
D
A client is undergoing thoracic surgery. What priority education should the nurse provide to assist in preventing respiratory complications? A. Deep breathing and coughing exercises should be completed every 8 hours. B. Pain medication should be taken before completing deep breathing and coughing exercises. C. Deep breathing and coughing exercises may be used as relaxation techniques. D. Splint the incision site using a pillow during deep breathing and coughing exercises.
D
A client refuses to remove her wedding band when preparing for surgery. What is the best action for the nurse to take? A. Notify the surgeon to cancel surgery. B. Remove the ring once the client is sedated. C. Discuss the risk for infection caused by wearing the ring. D. Allow the client to wear the ring and cover it with tape.
D
A nurse evaluates the potential effects of a client's medication therapies before surgery. Which drug classification may cause respiratory depression from an associated electrolyte imbalance during anesthesia? A. anticoagulants B. corticosteroids C. insulin D. diuretics
D
A patient with renal failure is scheduled for a surgical procedure. When would surgery be contraindicated for this patient due to laboratory results? A. A creatine kinase level of 120 U/L B. A serum creatinine level of 0.9 mg/dL C. A urine creatinine level of 1.2 mg/dL D. A blood urea nitrogen level of 42 mg/dL
D
An anxious client being prepared for surgery is encouraged to concentrate on a pleasant experience or restful scene. What cognitive coping strategy would the nurse document as being used? A. Optimistic self-recitation B. Progressive muscular relaxation C. Distraction D. Imagery
D
At which time does the nurse realize that it is best to begin teaching about care needed during the postoperative period? A. Following the surgical procedure B. Upon arrival to the surgical unit C. At the time of discharge instructions D. During the preoperative period
D
During the preoperative assessment, the client mentions allergies to avocados, bananas, and hydrocodone. What is the priority action by the nurse? A. Notify the dietary department. B. Notify the physician regarding postoperative pain medications. C. Notify the nurse manager to follow up on the procedure. D. Notify the surgical team to remove all latex-based items.
D
Following diagnostic testing, a patient requires a cholecystectomy. This surgical procedure would be categorized as which of the following? A. Required B. Elective C. Emergent D. Urgent
D
Sudden withdrawal of which of the following may result in seizures? A. Monoamine-oxidase inhibitors B. Thiazide diuretics C. Steroids D. Tranquilizers
D
The nurse assesses an older adult patient who complains of dimmed vision. What does this alert the nurse to plan for? A. Restrictions of the patient's unassisted mobility activities B. Referral to an ophthalmologist C. Probable cataract extractions D. A safe environment
D
The nurse expects informed consent to be obtained for insertion of: A. A nasogastric tube B. An indwelling urinary catheter C. An intravenous catheter D. A gastrostomy tube
D
The nurse is aware that the amino acid, arginine, A. Is important for normal blood clotting B. Is essential for antibody formation C. Is involved in capillary formation D. Stimulates T-cell response
D
The nurse is conducting a preoperative assessment on a client scheduled for gallbladder surgery. The client reports a frequent cough producing green sputum for 3 days and denies fever. Upon auscultation, the nurse notes rhonchi throughout the right lung, with an occasional expiratory wheeze. Respiratory rate is 20, temperature is 99.8 (taken orally), heart rate is 87, and blood pressure is 124/70. What is the best action by the nurse? A. Notify the primary physician about the assessment findings. B. Document the findings and continue moving the client through the preoperative phase. C. Wait 1 hour and complete the assessment again. D. Notify the surgeon to possibly delay the surgery.
D
The nurse is educating clients who require surgery for various ailments about the perioperative experience. What education provided by the nurse is most appropriate? A. Expected pain levels and narcotic medications used to treat the pain B. Risks and benefits of the surgical procedures C. Intraoperative techniques used to perform the surgery D. Three phases of surgery and safety measures for each phase
D
The nurse recognizes that the client most at risk for mortality associated with surgery is the: A. Client with controlled diabetes B. Client with controlled hypertension C. Client who is obese D. Client with chronic alcoholism
D
What action by the nurse best encompasses the preoperative phase? A. Shaving the client using a straight razor B. Documenting the application of sequential compression devices (SCDs) C. Monitoring vital signs every 15 minutes D. Educating clients on signs and symptoms of infection
D
When caring for a patient with alcoholism, when should the nurse assess for symptoms of alcoholic withdrawal? A. About 24 hours postoperatively B. Within the first 12 hours C. 4 days after a surgical procedure D. On the second or third day
D
A client is preparing to undergo a curative surgical procedure. Which of the following is the type of surgery the client could be having? Select all that apply. A. Mammoplasty B. Skin biopsy C. Insertion of a gastrostomy tube D. Removal of a tumor E. Removal of a diseased appendix
D, E