Medsurg II Chapter 17 – Preoperative Nursing Management – Flashcards
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The nurse expects informed consent to be obtained for insertion of: a) A nasogastric tube b) An intravenous catheter c) A gastrostomy tube d) An indwelling urinary catheter
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A gastrostomy tube
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The surgical unit nurse is developing a postoperative plan of care. In which client's plan of care would the nurse document interventions of coughing and deep breathing, gastrointestinal assessment, and effective regulation of temperature? a) A client having a knee replacement and regional anesthesia b) A client having lower extremity muscle repair and spinal anesthesia c) A client with spinal stenosis and a regional nerve blockade d) A client with gastrointestinal surgery and general anesthesia
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A client with gastrointestinal surgery and general anesthesia
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A physically fit 86-year-old is scheduled for right knee replacement. What factor in this client makes him at increased risk for surgery? a) Age b) Ability to metabolize medication c) Nutritional status d) Type of surgery
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Age
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When assessing a postoperative client, the nurse is correct to relate which surgical risk factor that would decrease if the surgical client maintained a blood glucose level under 150 mg/dL? a) Liver dysfunction b) Respiratory complications c) Wound healing d) Nutrient deficiencies
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Wound healing
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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) Explain that the client cannot go into the operating room with jewelry on. b) Medicate the client and then remove the ring. c) Tell the physician and anesthesiologist. d) Place gauze under and over the ring and apply adhesive tape over it.
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Place gauze under and over the ring and apply adhesive tape over it.
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When the patient is encouraged to concentrate on a pleasant experience or restful scene, the cognitive coping strategy being employed by the nurse is a) optimistic self-recitation. b) progressive muscular relaxation. c) distraction. d) imagery.
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imagery
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You are caring for a client 6 hours post surgery. You observe that the client voids urine frequently and in small amounts. You know that this most probably indicates what? a) Urinary infection b) Calculus formation c) Urine retention d) Requirement of intermittent catheterization
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Urine retention
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Patients who have received corticosteroids preoperatively are at risk for which type of insufficiency? a) Parathyroid b) Adrenal c) Thyroid d) Pituitary
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Adrenal
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An example of a curative surgical procedure is a) a biopsy. b) a face-lift. c) the placement of gastrostomy tube. d) the excision of a tumor.
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the excision of a tumor.
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When a patient recites, "I know all will go well," what is the cognitive coping strategy he or she is using? a) Distraction b) Music therapy c) Optimistic self-recitation d) Imagery
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Optimistic self-recitation
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Once the operating team has assembled in the room, the circulating nurse calls for a "time out." What action should the nurse take during the time out? a) Confirm that informed consent has been obtained. b) Check that all surgical personnel are properly attired. c) Review the scheduled procedure, site, and client. d) Ensure that sufficient surgical supplies are available.
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Review the scheduled procedure, site, and client.
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A patient with a history of alcoholism and scheduled for an urgent surgery asks the nurse, "Why is everyone so concerned about how much I drink?" What is the best response by the nurse? a) "The amount of alcohol you drink will determine the amount of pain medication you will need postoperatively." b) "It is important for us to know how much and how often you drink to help prevent surgical complications." c) "It is a required screening question for all patients having surgery." d) "We can have counselors available after surgery; if it is determined you need help for your drinking."
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"It is important for us to know how much and how often you drink to help prevent surgical complications."
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Which health care profession has the ultimate responsibility to provide appropriate information regarding a nonemergent surgery? a) Certified nurse's aide b) Nurse c) Physician d) Case manager
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Physician
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The nurse is educating a community group regarding types of surgery. A member of the group asks the nurse to describe a type of surgery that is curative. What response by the nurse is true? a) The excision of a tumor b) A biopsy c) The placement of gastrostomy tube d) A face-lift
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The excision of a tumor
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When the indication for surgery is without delay, the nurse recognizes that the surgery will be classified as a) elective. b) emergency. c) required. d) urgent.
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emergency
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You are the nurse working in an ambulatory surgery center. A teenage son of your clients ask you why so many people have surgery. What would be your best reply? a) "Many people have diagnostic or short therapeutic surgical procedures." b) "Lots of people have cancer and need tumors removed." c) "You know, we have a lot of sick people in the world." d) "Not everyone has to go to the hospital to have surgery anymore."
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"Many people have diagnostic or short therapeutic surgical procedures."
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The nurse has just admitted a 12-year-old client who is going to have an above-the-knee amputation of their left leg due to osteosarcoma. The nurse knows that adequate preoperative teaching and learning is important for what reason? a) Client will have a shorter recovery period. b) Client will understand after surgery they will not have a left leg. c) Client will understand they have cancer. d) Client's family will understand their child will lose their leg in the surgery.
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Client will have a shorter recovery period.
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An obese patient is scheduled for open abdominal surgery. What priority education should the nurse provide this patient? a) Prevention of wound dehiscence b) Venous thromboembolism prevention c) Prevention of respiratory complications d) Wound care and infection prevention
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Prevention of respiratory complications
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Which question is most important for the nurse to ask the client when obtaining the preoperative admission history? a) "When is the last time you ate or drank?" b) "Did you bring a copy of your health care power of attorney?" c) "Who is here with you?" d) "Did you bring any valuables with you?"
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"When is the last time you ate or drank?"
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The nurse is evaluating the client's understanding of diet teaching aimed at promoting wound healing following surgery. The nurse would conclude teaching was ineffective if the client selects which of the following? a) Baked chicken, mashed potatoes, broccoli, and strawberries b) Cheeseburger, french fries, coleslaw, and ice cream c) Grilled salmon, rice pilaf, green beans, and cantaloupe d) Turkey breast, baked sweet potato, asparagus, and an orange
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Cheeseburger, french fries, coleslaw, and ice cream
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For the patient who is taking aspirin, it is important to stop taking this medication at least how many day(s) prior to surgery? a) 1 b) 3 c) 5 d) 7
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7
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When does the nurse understand the patient is knowledgeable about the impending surgical procedure? a) The patient discusses stress factors causing the patient to feel depressed. b) The patient participates willingly in the preoperative preparation. c) The patient expresses concern about postoperative pain. d) The patient verbalizes fears to family.
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The patient participates willingly in the preoperative preparation.
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A nurse is teaching a client with chronic bronchitis about breathing exercises. Which instruction should the nurse include in the teaching? a) Use chest breathing. b) Exhale through an open mouth. c) Use diaphragmatic breathing. d) Make inhalation longer than exhalation.
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Use diaphragmatic breathing.
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The nurse is caring for a client during an intra operative procedure. When assessing vital signs, which result indicates a need to alert the anesthesiologist immediately? a) Pulse rate of 110 beats/min b) Blood pressure of 104/62 mm Hg c) Temperature of 102.5° F d) Respiratory rate of 18 breaths/min
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Temperature of 102.5° F
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The nurse is reviewing the pre-admission laboratory findings of the client scheduled for surgery. Which of the following values would be of greatest concern to the nurse? a) Sodium 138 mEq/L b) Potassium 6.2 mEq/L c) Calcium 9.8 mg/dL d) White blood cell count 7.2 cells/mm
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Potassium 6.2 mEq/L
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An OR nurse needs to assist a patient to the Trendelenburg position. Which of the following is the correct position? a) On his back, with his legs and thighs flexed at right angles b) On his back, with his head lowered, so that the plane of his body meets the horizontal on an angle c) On his side, with his uppermost leg adducted and flexed at the knee d) Flat on his back with his arms next to his sides
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On his back, with his head lowered, so that the plane of his body meets the horizontal on an angle
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Which of the following is the appropriate response to the statement, "I'm so nervous about my surgery"? a) "Relax. Your recovery period will be shorter if you're less nervous." b) "You needn't worry. Your doctor has done this surgery many times before." c) "You seem nervous about your surgery." d) "Stop worrying. It only makes you more nervous."
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"You seem nervous about your surgery."
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The patient asks the nurse why food is withheld before surgery. What is the best response by the nurse? a) "Obstruction will occur if food or fluid is taken prior to surgery." b) "Infection may occur if food or fluid is taken prior to surgery." c) "Aspiration is a concern and can be a complication if food or fluid is taken close to the surgery time." d) "Distention is a severe complication if food or fluid is taken close to the surgery time."
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"Aspiration is a concern and can be a complication if food or fluid is taken close to the surgery time."
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The patient is NPO prior to having a colonoscopy. The patient is to take a daily blood pressure pill prior to the procedure. Until when may water be given prior to the procedure? a) Up to 6 hours before surgery b) Up to 4 hours before surgery c) Up to 8 hours before surgery d) Up to 2 hours before surgery
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Up to 2 hours before surgery
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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
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During the preoperative period
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A gunshot wound would be classified under which category of surgery based on urgency? a) Elective b) Urgent c) Required d) Emergent
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Emergent
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You are caring for a client during the immediate postoperative period. What signs and symptoms indicate that the client may be in shock? a) Pooling of secretions in the lungs b) Weak and rapid pulse rate c) Warm, dry skin d) Obstructed airway
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Weak and rapid pulse rate
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How does the nurse determine that the patient may have hidden fears about the impending surgical procedure? (Select all that apply.) a) The patient avoids communication with the nurse. b) The patient repeatedly asks questions that have previously been answered. c) The patient informs the nurse of problems with postoperative nausea in the past and that it was a bad experience. d) The patient talks incessantly. e) The patient tells the nurse of concerns with the outcome of the procedure.
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• The patient avoids communication with the nurse. • The patient repeatedly asks questions that have previously been answered. • The patient talks incessantly.
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The nurse discovers that the client did not sign the operative consent before receiving the preoperative medication. The appropriate nursing action is: a) For the nurse to sign the consent with verbal permission of the client b) To notify the surgeon c) To have the client's next of kin sign the consent d) To have the client sign the consent immediately
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To notify the surgeon
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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 is repairing a deformity from birth or disease process. b) The physician needs additional information to plan medical treatment. c) The client and physician are focusing on symptom relief not a cure. d) The client wishes to improve body structures and elects a procedure.
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The client and physician are focusing on symptom relief not a cure.
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A client will be undergoing an appendectomy tomorrow morning. The nurse spends significant time explaining to the client what will happen, including before and after the procedure is complete. What is the primary reason the nurse puts so much effort into preoperative teaching? a) It minimizes the time needed to be spent on postoperative questions. b) It decreases the client's participation and allows the family to take on the caregiver role. c) It absolves the hospital of legal responsibility should complications arise. d) It increases the likelihood of a successful recovery.
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It increases the likelihood of a successful recovery.
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The nurse concludes that teaching about pain management was effective when the client states: a) "I will need to learn how to give myself pain medication by injection for when I go home." b) "The pain from my incision will be very similar to my arthritis pain." c) "I will ask for pain medication when the pain becomes unbearable." d) "I will support my incision with my hands when I do my coughing and deep breathing exercises."
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"I will support my incision with my hands when I do my coughing and deep breathing exercises."
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Which of the following activities are nursing activities in the preoperative phase of care? Select all that apply. a) Beginning discharge planning b) Administering medications, fluid, and blood component therapy, if prescribed c) Ensuring that the sponge, needle, and instrument counts are correct d) Discussing and reviewing the advanced directive document e) Establishing an intravenous line
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• Discussing and reviewing the advanced directive document • Establishing an intravenous line • Beginning discharge planning
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A surgical patient has been transferred to the holding area. What nursing intervention(s) promote safe and effective nursing care? Select all that apply. a) Maintain an aseptic environment. b) Review the medical records. c) Verify the surgical site and mark it appropriately. d) Provide oral fluids to the patient. e) Apply grounding devices to the patient. f) Identify the patient using two identifiers.
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• Identify the patient using two identifiers. • Verify the surgical site and mark it appropriately. • Review the medical records.
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A client is placed on the operating room table for the surgical procedure. Which surgical team member is responsible for handing sterile instruments to the surgeon and assistants? a) Circulating nurse b) Scrub nurse c) Certified registered nurse anesthetist d) First assistant
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Scrub nurse
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When a person with a history of chronic alcoholism is admitted to the hospital for surgery, the nurse anticipates that the patient may show signs of alcohol withdrawal delirium during which time period? a) Up to 72 hours after alcohol withdrawal b) Up to 24 hours after alcohol withdrawal c) Immediately upon admission d) Upon awakening in the postanesthesia care unit
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Up to 72 hours after alcohol withdrawal
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A fractured skull would be classified under which category of surgery based on urgency? a) Required b) Urgent c) Emergent d) Elective
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Emergent
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The nurse concludes that further teaching about diaphragmatic breathing is needed when the client: a) Performs diaphragmatic breathing in a semi-Fowler's position b) Places the hands on the lower chest to feel the rise and fall with breathing c) Exhales forcefully with a short expiration d) Breathes in deeply through the nose and mouth
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Exhales forcefully with a short expiration
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A patient with uncontrolled diabetes is scheduled for a surgical procedure. What chief life-threatening hazard should the nurse monitor for? a) Dehydration b) Hypertension c) Hypoglycemia d) Glucosuria
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Hypoglycemia
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The nurse is conducting a preoperative assessment on a patient scheduled for gallbladder surgery. The patient reports having 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 nurse's best action? a) Wait 1 hour and complete the assessment again. b) Notify the primary physician about the assessment findings. c) Document the findings and continue the patient through the preoperative phase. d) Notify the surgeon to possibly delay the surgery.
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Notify the surgeon to possibly delay the surgery.
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The nurse is planning care for a client following abdominal surgery. Which outcome demonstrates a return of functioning to the gastrointestinal tract? a) The client is tolerating sips of water. b) The client states being hungry. c) The client is passing flatus. d) The client reports a small bowel movement.
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The client reports a small bowel movement.
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A nurse is witnessing a patient sign the consent form for surgery. After the patient signs the consent form, the patient starts asking questions regarding the risks and benefits of a surgical procedure. What action by the nurse is most appropriate? a) Request that the surgeon come and answer the questions. b) Answer the patient's questions. c) Place the consent form in the patient's medical record. d) Notify the nurse manager of the patient's questions.
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Request that the surgeon come and answer the questions.
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You are working in the preoperative area with a client going to surgery for a cholecystectomy. The client has histamine2-receptor antagonists ordered preoperatively. The client asks you why these medications are needed. What would be your best answer? a) "These medications slow motor activity." b) "These medications decrease the amount of anesthesia you will need." c) "These medications decrease anxiety before surgery." d) "These medications decrease gastric acidity and volume."
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"These medications decrease gastric acidity and volume."
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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) Verifies that operative consent is signed b) Develops a plan of care c) Provides psychological support d) Completes preoperative assessment
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Verifies that operative consent is signed
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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) Palliative b) Cosmetic c) Normative d) Causative e) Diagnostic
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• Cosmetic • Diagnostic • Palliative
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The nurse recognizes that written informed consent is required for insertion of a(n): a) Urinary catheter. b) Oral airway. c) Peripherally-inserted central catheter. d) Nasogastric tube.
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Peripherally-inserted central catheter.
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Completing your preoperative assessment, you mentally rehearse your client's needs to determine if there is increased risk for complications intra operatively or postoperatively. Which of the following are general risk factors? Select all that apply. a) Ethnicity b) Gender c) Age d) Nutritional status e) Physical condition f) Health status
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• Age • Nutritional status • Physical condition • Health status
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Which of the following nursing activities would not be part of the preoperative phase of care? Select all that apply. a) Administering medications, fluid, and blood component therapy, if prescribed b) Establishing an intravenous line c) Ensuring that the sponge, needle, and instrument counts are correct d) Beginning discharge planning e) Discussing and reviewing the advanced directive document
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• Ensuring that the sponge, needle, and instrument counts are correct • Administering medications, fluid, and blood component therapy, if prescribed
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What action by the nurse best encompasses the preoperative phase? a) Shaving the patient using a straight razor b) Educating the patients on signs and symptoms of infection c) Monitoring vital signs every 15 minutes d) Documenting the application of sequential compression devices (SCD)
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Educating the patients on signs and symptoms of infection
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A patient is undergoing thoracic surgery. What priority education should the nurse provide to assist in preventing respiratory complications? a) Pain medication should be taken before completing deep breathing and coughing exercises. b) Deep breathing and coughing exercises should be completed every 8 hours. 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.
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Splint the incision site using a pillow during deep breathing and coughing exercises.
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A patient having a surgical procedure takes aspirin 325 mg daily for prevention of platelet aggregation. When should the patient stop taking the aspirin before the surgery? a) 2 to 3 days b) 2 weeks c) 7 to 10 days d) 4 weeks
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7 to 10 days
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Regarding the surgical patient, which one of the following phases refers to the period of time that constitutes the surgical experience? a) Postoperative b) Intraoperative c) Perioperative d) Preoperative
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Perioperative
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The nurse is caring for a client needing emergency surgery. Which preoperative teaching should be omitted to prepare the client for surgery? a) Effective coughing and deep breathing b) Frequency of postoperative vital signs c) Knowledge of surgical procedure d) Types of postoperative pain medication
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Frequency of postoperative vital signs
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During a procedure, a client's temperature begins to rise rapidly. This is likely the result of which of the following complications? a) Malignant hyperthermia b) Hypothermia c) Infection d) Fluid volume excess
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Malignant hyperthermia
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What is the blood glucose level goal for a diabetic patient who will be having a surgical procedure? a) 150 to 240 mg/dL b) 80 to 110 mg/dL c) 250 to 300 mg/dL d) 300 to 350 mg/dL
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80 to 110 mg/dL
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The nurse assesses an older adult patient who complains of dimmed vision. What does this alert the nurse to plan for? a) Probable cataract extractions b) A safe environment c) Restrictions of the patient's unassisted mobility activities d) Referral to an ophthalmologist
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A safe environment
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A 17-year-old male client is having same-day surgery to remove a neuroma from his foot. Which of the following nursing interventions would occur during the intra operative phase of peri operative care? a) The nurse assesses how well the client is recovering from anesthesia. b) The nurse obtains a surgical consent from the client's mother. c) The nurse continuously monitors the sedated client. d) The nurse performs a complete assessment of the client.
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The nurse continuously monitors the sedated client.
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Which nursing statement would best decrease a client's anxiety before an emergency operative procedure? a) "It is best to take deep breaths and relax before the procedure." b) "Let me explain to you what will happen next." c) "You will be just fine; the operating room nurses will take good care of you." d) "We will keep your family informed of your progress."
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"Let me explain to you what will happen next."
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A patient is scheduled to have a cholecystectomy. Which of the nurse's finding is least likely to contribute to surgical complications? a) Pregnancy b) Osteoporosis c) Diabetes d) Urinary tract infection
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Osteoporosis
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A client taking chlorpromazine (Thorazine) is preparing to undergo surgery. Which of the following complications does the surgical team need to prepare to deal with before anesthetics are administered? a) Hypotension b) Apnea from respiratory paralysis c) Seizures d) Cardiovascular collapse
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Hypotension
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You are caring for a client preoperatively who is very anxious and fearful about their surgery. You know that this client's anxiety can cause problems with the surgical experience. What type of problems can this client have because of their anxiety and fear? a) Anxious clients need psychological counseling after surgery. b) Anxiety and fear can affect a client positively during and after surgery. c) Anxious clients have a poor response to surgery and are prone to complications. d) Anxiety and fear increases the need for anesthesia and postoperative medications.
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Anxious clients have a poor response to surgery and are prone to complications.
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A postoperative client is moving from the bed to a chair when blood drips from the dressing. The nurse assesses the incision and notes evisceration. What does the nurse do first? a) Have the client lay quietly on back and call the physician. b) Place a pressure dressing over the opening and secure. c) Moisten sterile gauze with normal saline and place on any organ. d) Place a dry, sterile dressing over the protruding organs.
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Moisten sterile gauze with normal saline and place on any organ.
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When planning care for a client in the postoperative period, prioritize nursing diagnoses in the sequence from highest to lowest priority? a) Anxiety b) Impaired Gas Exchange c) Risk for Infection d) Altered Comfort e) Fluid Volume Deficit
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• Anxiety • Impaired Gas Exchange • Risk for Infection • Altered Comfort • Fluid Volume Deficit
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Sudden withdrawal of which of the following may result in seizures? a) Tranquilizers b) Thiazide diuretics c) Monoamine-oxidase inhibitors d) Steroids
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Tranquilizers
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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) Registered nurse first assistant b) Anesthesiologist c) Surgeon d) Circulating nurse
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Surgeon
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The potential effects of prior medication therapy must be evaluated before surgery. Which of the following drug classifications may cause respiratory depression from an associated electrolyte imbalance during anesthesia? a) Diuretics b) Corticosteroids c) Anticoagulants d) Insulin
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Diuretics
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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) Needs to change her position during intercourse. b) Is susceptible to the lubricant. c) May have a sexually transmitted disease. d) May have a latex allergy.
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May have a latex allergy.
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Which of the following medications may increases the hypotensive action of anesthesia? a) Prednisone (Deltasone) b) Hydrochlorothiazide (HydroDUIRIL) c) Chlorpromazine (Thorazine) d) Warfarin (Coumadin)
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Chlorpromazine (Thorazine)
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The nurse is aware that which of the following helps to stimulate T-cell response: a) Zinc b) Vitamin D c) Arginine d) Biotin
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Arginine
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Which health care profession has the ultimate responsibility to provide appropriate information regarding a nonemergent surgery? a) Case manager b) Physician c) Certified nurse's aide d) Nurse
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Physician
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The nurse is aware that which of the following nutrients promotes normal blood clotting? a) Magnesium b) Vitamin K c) Vitamin C d) Zinc
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Vitamin K
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When caring for a patient with alcoholism, when should the nurse assess for symptoms of alcoholic withdrawal? a) About 24 hours postoperatively b) On the second or third day c) Within the first 12 hours d) 4 days after a surgical procedure
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On the second or third day
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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) Develops a plan of care b) Completes preoperative assessment c) Provides psychological support d) Verifies that operative consent is signed
answer
Verifies that operative consent is signed
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An intravenous anesthetic that, in large doses, has a powerful respiratory depressant effect sufficient to cause apnea and cardiovascular depression is: a) Ketalar b) Pentothal c) Versed d) Amidate
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Pentothal Thiopental sodium (Pentothal) is commonly used for induction anesthesia. It may cause laryngospasm. Large doses can cause apnea and cardiovascular depression.
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A perioperative nurse is assigned to complete a preoperative assessment on a patient who is scheduled for surgery for kidney stones. The nurse knows that the surgery is scheduled the following day and would therefore be classified as: a) Emergent b) Required c) Urgent d) Elective
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Urgent
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The nurse recognizes that which of the following clients is at least risk for perioperative complications? a) A 45-year-old African-American man recently diagnosed with type 2 diabetes b) A 65-year-old Caucasian man who has a history of arthritis c) A 76-year-old Asian man who takes clopidogrel (Plavix) d) A 32-year-old African-American woman who takes prednisone
answer
A 65-year-old Caucasian man who has a history of arthritis
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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) "The nurse will explain the details of the surgery before I sign a consent." b) "The physician will update my family after the procedure and provide specific discharge instructions." c) "If I do not follow the instructions, my surgery could be cancelled." d) "My medical records will be sent to the ambulatory care center prior to my surgery."
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"The nurse will explain the details of the surgery before I sign a consent."
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The nurse is physically preparing a client for surgery. What area does the nurse know needs to be addressed before the client is taken to the operating room? a) Elimination b) Medication c) Support system d) Activity
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Elimination
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Which client would the nurse recognize as having the greatest risk for complications during the intraoperative or postoperative period? a) The 72-year-old client who takes no routine medications. b) The 28-year-old client who occasionally smoked marijuana in high school. c) The 35-year-old client with non-insulin dependent diabetes. d) The 47-year-old client who stopped smoking 2 years ago.
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The 35-year-old client with non-insulin dependent diabetes.
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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) All older people face similar risks when undergoing surgeries. b) Aging processes reduce the chances that surgery will be successful for these clients. c) Older adults have less physiologic reserve (or ability to regain physical equilibrium) than younger clients. d) Neurologic and musculoskeletal complications are the leading cause of postoperative morbidity and mortality for older adults.
answer
Older adults have less physiologic reserve (or ability to regain physical equilibrium) than younger clients.
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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
answer
A blood urea nitrogen level of 42 mg/dL A blood urea nitrogen level of 42 mg/dL (significantly elevated) is an indicator of renal failure
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When is the ideal time to discuss preoperative teaching a) Preadmission visit b) Prior to entering the pre-op area c) When the patient is comfortable and sedated d) Day of surgery
answer
Preadmission visit
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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) Have the family go to the waiting room. c) Take the client's vital signs. d) Take the client to the bathroom.
answer
Place the side rails in the up position and make sure the call button is in reach.
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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) Give caregiver instructions. c) Teach dressing changes. d) Give postoperative instructions.
answer
Review preoperative instructions.
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There are four stages of general anesthesia. Select the stage during which the OR nurse knows not to touch the patient (except for safety reasons) because of possible uncontrolled movements. a) Stage III: surgical anesthesia b) Stage I: beginning anesthesia c) Stage II: excitement d) Stage IV: medullary depression
answer
Stage II: excitement
question
A client who is scheduled for knee surgery is anxious about the procedure, saying, "You hear stories on the news all the time about doctors working on the wrong body part. What if that happens to me?" What can you tell this client to help alleviate his concerns? a) The client will be involved in the verification process prior to surgery. b) The surgical team performs a "time-out" prior to surgery to conduct a final verification. c) The surgeon on his team has never been involved in such a mix-up. d) He can be involved in marking his knee, the site for the surgery.
answer
• He can be involved in marking his knee, the site for the surgery. • The surgical team performs a "time-out" prior to surgery to conduct a final verification. • The client will be involved in the verification process prior to surgery.
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Which of the following would be considered an urgent surgical procedure? a) Cosmetic surgery b) Cataract c) Severe bleeding d) Acute gallbladder infection
answer
Acute gallbladder infection
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You are providing preoperative care to a 51-year-old male client who is anxious about his total hip replacement surgery. "What if I can never walk again? I don't want to end up like my father!" What are some ways you might help alleviate his anxiety? Select all that apply. a) Review the client's postoperative goals following the procedure. b) Listen empathetically to the client's concerns about the procedure. c) Make sure the client understands what will happen during surgery. d) Offer the client a sedative to help him relax and feel more comfortable. e) Remind the client that the chances of something going wrong are statistically low. f) Ask the client if he would like to speak with a clergyperson.
answer
• Make sure the client understands what will happen during surgery. • Listen empathetically to the client's concerns about the procedure. • Review the client's postoperative goals following the procedure. • Ask the client if he would like to speak with a clergyperson.
question
A patient is scheduled for a reduction mammoplasty. What classification of surgery does the nurse understand that this is? a) Reconstructive b) Optional c) Urgent d) Required
answer
Optional
question
The client is scheduled for a biopsy for suspected cancer of the prostate. The nurse recognizes the purpose of this surgical procedure is: a) Palliative b) Reparative c) Diagnostic d) Curative
answer
Diagnostic
