Quiz 16: Care of Preoperative Patients

Medical Surgical-Nursing

Nursing
28
Questions
0
True/False
22
Choices
6
Essay
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Questions

Q1
Free

A client voluntarily signed the operative consent form. What is the nurses next action?

Multiple Choice
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A) Teach the client about the surgery.
B) Have family members witness the signature.
C) Sign under the clients name as a witness.
D) Call for the physician to sign the form.
Answer:
C) Sign under the clients name as a witness.

Explanation:

The nurses signature as a witness indicates that the consent form was signed by the client voluntarily. None of the other steps are necessary.

Q2
Free

The nurse is caring for an older adult client with a history of chronic lung disease who will be undergoing surgery the following day. When postoperative care is planned, which potential problem is the highest priority for this client?

Multiple Choice
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A) Maintaining oxygenation
B) Tolerating activity
C) Anxiety and fear
D) Hypovolemia
Answer:
A) Maintaining oxygenation

Explanation:

Breathing problems take priority over the other problems listed. This would be compounded in a client with any chronic lung disorder.

Q3
Free

The nurse is completing preoperative teaching for a client, and it becomes apparent that the client does not understand the surgery that will be performed. What is the priority action for the nurse?

Multiple Choice
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A) Obtain informed consent from the client.
B) Continue teaching the client about the surgery.
C) Revise the teaching plan for the client.
D) Notify the surgeon and document the finding.
Answer:
D) Notify the surgeon and document the finding.

Explanation:

The surgeon should be notified right away so that the client can be instructed about the surgery to be performed. The client cannot give informed consent unless he or she understands the procedure.

Q4

During the preoperative assessment, the client tells the nurse that he smokes three packs of cigarettes daily. Which action by the nurse is best?

Multiple Choice
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A) Call the surgeon to cancel the surgery.
B) Have baseline laboratory studies drawn.
C) Perform a respiratory assessment.
D) Give a nebulizer treatment.
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Q5

When the nurse brings a clients preoperative medications, the client responds, I dont need that. I had a good nights sleep last night. What is the nurses best response?

Multiple Choice
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A) The doctor ordered this medication so you should take it.
B) I will make a note that you refused to take the medication.
C) I will ask your surgeon if you have to take the medication.
D) Let me teach you about your medications for surgery.
Answer:

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Q6

A client receiving preoperative medication tells the nurse that she took all the following vitamins and herbs last night before going to bed. Which one does the nurse report to the surgical team as a priority?

Multiple Choice
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A) Valerian root
B) St. Johns wort
C) Garlic
D) Chamomile
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Q7

The nurse reviews a clients laboratory results before surgery and notes a fasting blood glucose of 120 mg/dL, a prothrombin time (PT) of 25 seconds, and potassium (K+) of 3.8 mEq/L. Which action by the nurse is best?

Multiple Choice
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A) Ask the surgeon for additional laboratory studies.
B) Administer a potassium supplement of 20 mEq.
C) Increase the IV infusion of D5W to 100 mL/hr.
D) Record laboratory results on the preoperative assessment.
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Q8

A client is brought to the emergency department (ED) after a motorcycle accident. The client has suffered a ruptured spleen. What is the immediate priority?

Multiple Choice
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A) Emergent surgery to control bleeding
B) Aggressive pain control
C) Calling the family members
D) Assessment of neurologic status
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Q9

The nurse has just completed preoperative teaching with a client who will be having surgery the following day. Which statement by the client indicates that additional teaching is needed?

Multiple Choice
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A) When I brush my teeth before surgery, I will be sure to spit out the water.
B) I will go to the bathroom as soon as I receive all my preoperative medications.
C) I will remember to wear my glasses tomorrow instead of my contact lenses.
D) I wont have to worry about putting my makeup on tomorrow morning.
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Q10

The nurse is performing preoperative teaching with an older adult client who will be having colon resection surgery the following day. The surgeon has ordered bowel preparation the night before. Which action is a priority?

Multiple Choice
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A) Administer antibiotics with a sip of water.
B) Encourage the client to drink plenty of juice.
C) Teach the client to eat only low-fat foods the night before surgery.
D) Tell the client not to get up and go to the bathroom alone.
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Q11

When examining an adult clients preoperative laboratory results, the nurse notes that the potassium level is 2.9 mEq/mL. What is the nurses priority action?

Multiple Choice
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A) Document the finding.
B) Alter the clients diet to include fruit.
C) Increase the IV flow rate.
D) Notify the surgeon.
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Q12

What recently learned information about a client who is scheduled to have surgery within the next 2 hours is the nurse certain to communicate to the surgical team?

Multiple Choice
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A) An allergy to cats
B) Hearing problem
C) Consumption of a glass of wine 12 hours ago
D) Taking 2000 mg of vitamin C each day
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Q13

A client will be undergoing palliative surgery. The clients daughter asks what this means. What is the nurses best response?

Multiple Choice
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A) The surgery will relieve the symptoms but will not cure your father.
B) There are fewer risks with this type of surgery.
C) There is no guarantee of the outcome of the surgery.
D) The surgery must be performed immediately to save your fathers life.
Answer:

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Q14

Twenty minutes after a client has received a preoperative injection of atropine and midazolam (Versed), the client tells the nurse that he must be allergic to the medication because his mouth is dry and his heart seems to be beating faster than normal. What is the nurses priority action?

Multiple Choice
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A) Document the findings.
B) Assess the clients pulse and blood pressure.
C) Administer diphenhydramine (Benadryl).
D) Explain to the client that these symptoms are expected.
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Q15

A client undergoing preoperative assessment informs the nurse that he takes medication for high blood pressure and for asthma. What is the nurses best action?

Multiple Choice
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A) Tell the client not to take the medication on the day of surgery.
B) Notify the surgeon and the anesthesiologist.
C) Document the information in the clients record.
D) Tell the client to take medications preoperatively with a sip of water.
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Q16

Which action is most appropriate during a preoperative chart review?

Multiple Choice
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A) Ensure that the consent form is signed, dated, and witnessed.
B) Call the surgeon if the client has any food allergies.
C) Make sure all marks are washed off the surgical site.
D) Make sure the client understands the procedure.
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Q17

The nurse is caring for a client who will be undergoing emergency surgery as soon as possible. Which information is most important for the nurse to teach the client at this time?

Multiple Choice
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A) How the surgery will be performed
B) Importance of early ambulation after surgery
C) What to expect in the operating and recovery rooms
D) Complications that may occur after surgery
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Q18

A client tells the nurse that he has an advance directive with durable power of attorney for health care. The client asks how the advance directive will affect the surgery. What is the nurses best response?

Multiple Choice
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A) You will not be intubated during general anesthesia for the surgery.
B) There will be no effect on your surgery.
C) The surgical staff will resuscitate only if your heart stops during the operation.
D) If you are unable to make a decision, your designee will be asked.
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Q19

A client is brought to the hospital unconscious and needs emergency surgery. The clients only family member cannot come to the hospital before the surgery. Which is the best option for obtaining informed consent for the clients emergent surgery?

Multiple Choice
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A) Proceed with surgery and have the family member sign the consent as soon as possible.
B) Contact the family member by phone and obtain verbal consent with two witnesses.
C) Obtain written consultation with two surgeons that the surgery is needed.
D) Have the hospital administrator appoint a temporary legal guardian.
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Q20

Four clients are scheduled for surgery. Which client does the nurse determine is at highest risk for postsurgical complications?

Multiple Choice
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A) 89-year-old scheduled for a knee replacement
B) 40-year-old requiring gallbladder surgery
C) 19-year-old requiring a laparoscopy
D) 10-year-old admitted for a tonsillectomy
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Q21

The nurse is conducting preoperative assessments. Which client does the nurse teach about the possibility of developing a venous thromboembolism (VTE)?

Multiple Choice
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A) Client with a latex allergy
B) Client with body mass index (BMI) of 19
C) Client with an international normalized ratio (INR) of 2.2
D) Client undergoing hip replacement surgery
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Q22

The nurse applies antiembolism stockings to a client preoperatively. When the client says that they are uncomfortably tight, what is the nurses best action?

Multiple Choice
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A) Remove the stockings for an hour to relieve the pressure.
B) Pull the stockings down so that they are not constricting.
C) Measure the clients calf to ensure that they are the correct size.
D) Teach the client the purpose of wearing the stockings.
Answer:

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Q23

[Multiple Response] The nurse is assessing a client before surgery. Which assessments contraindicate the client having surgery as scheduled? (Select all that apply.)
a. Potassium level of 2.8 mEq/L
b. International normalized ratio (INR) of 4
c. Prothrombin time (PTT) of 30 seconds
d. Calcium level of 8.8 mEq/dL
e. Positive pregnancy test
f. Platelet count of 150,000

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Q24

[Multiple Response] Which medications does the nurse correctly administer preoperatively? (Select all that apply.)
a. Hydroxyzine (Atarax, Vistaril) for sedation
b. Lorazepam (Ativan) for anxiety
c. Hydromorphone (Dilaudid) to decrease postoperative secretions
d. Metoclopramide (Reglan) to increase stomach emptying
e. Aspirin to decrease blood clotting postoperatively
f. Cimetidine (Tagamet) to prevent infection

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Q25

[Multiple Response] The nurse is conducting preoperative teaching with a client who will be undergoing pelvic surgery. What teaching is essential for this client? (Select all that apply.)
a. Wearing elastic stockings and using pneumatic compression devices are essential after surgery.
b. Extended bedrest will help you heal after this type of surgery.
c. Coughing and deep breathing will help to decrease postoperative complications.
d. Turning and moving your legs after surgery will help prevent clots from forming.
e. You will need to have your abdomen shaved before surgery.
f. You cannot wear your hearing aid into the surgical suite.

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Q26

[Multiple Response] What data are essential for the nurse to assess on a client who is scheduled for surgery? (Select all that apply.)
a. Use of tobacco
b. Current medications
c. Use of herbal or over-the-counter therapy
d. Mental status examination
e. Power of attorney
f. Allergies g. Date of last tetanus shot

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Q27

[Multiple Response] What data are essential for the nurse to assess on a client who is scheduled for surgery? (Select all that apply.)
a. Use of tobacco
b. Current medications
c. Use of herbal or over-the-counter therapy
d. Mental status examination
e. Power of attorney
f. Allergies g. Date of last tetanus shot

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Q28

[Multiple Response] The nurse is preparing to transfer a client to the operating room for surgery. Put the interventions in order for the nurse to perform. (List in order of priority.)
a. Take a full set of vital signs.
b. Have the client go to the bathroom to void.
c. Ask the client to state his or her name and check the ID band.
d. Administer ordered preoperative sedation.

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