Deck 12: Nursing Care of Patients Having Surgery

Question 1

The nurse is caring for a patient who is to have a nephrectomy. The patient states that the surgeon said that this surgery is considered a "curative procedure." Which of these responses would be appropriate by the nurse?

A)"No, it is considered diagnostic surgery."
B)"Yes, it can be classified as a curative procedure."
C)"No, it is an exploratory procedure."
D)"It is considered palliative surgery."

Answer 1

"Yes, it can be classified as a curative procedure."

Question 2

The nurse is caring for a patient who had an abdominal hysterectomy and reports pain from gas postoperatively. Which of the following actions should the nurse take?

A)Offer a hot beverage.
B)Provide an extra blanket.
C)Apply an abdominal binder.
D)Help the patient ambulate.

Answer 2

Help the patient ambulate.

Question 3

The nurse is to witness an adult patient's consent for a knee arthroscopy. Which of these is essential for the nurse to confirm before witnessing the consent?

A)What type of job the patient has
B)When the patient last ate or drank
C)Who is driving the patient home
D)Which is the operative knee

Answer 3

Which is the operative knee

Question 4

The nurse is caring for a preoperative patient. The patient asks, "What type of anesthesia causes a total loss of sensation and a complete loss of consciousness?" Which of these responses should the nurse give?

A)"Epidural anesthesia"
B)"Spinal anesthesia"
C)"Local anesthesia"
D)"General anesthesia"

Question 5

The nurse is caring for a patient who is scheduled for surgery. Which of these nursing actions should the nurse use to address the patient's psychological concerns?

A)Using correct, technical medical terminology in explanations
B)Providing privacy to allow the patient to ask questions
C)Instructing the patient to ask the surgeon all surgical questions
D)Providing information to a patient who says, "I do not want to know"

Question 6

The nurse is contributing to the plan of care for a surgical patient. The nurse recognizes that the most common human response to the stress associated with surgery is which of the following?

A)Anxiety
B)Depression
C)Delirium
D)Fear

Question 7

The nurse is caring for a patient 23 hours after abdominal surgery. Which of the following patient data collection findings would require the nurse to take action?

A)Hypoactive bowel sounds in four quadrants
B)Report of flatus
C)Lack of appetite
D)Abdominal distention

Question 8

The nurse answers a patient's call light and finds the patient sitting up in bed with a wound evisceration. What action should the nurse take first?

A)Place the patient in low Fowler's position.
B)Cover the wound with sterile saline-soaked towels.
C)Notify the physician immediately.
D)Apply gentle pressure over the wound.

Question 9

The nurse is caring for a patient who is NPO for scheduled surgery. The nurse notes that the patient has been on long-term oral steroid therapy and would have been scheduled for a dose of Prednisone 10 mg orally at 0600 if not NPO. Which of the following actions should the nurse take?

A)Notify the registered nurse.
B)Contact the pharmacy to obtain an intravenous equivalent dose.
C)Ask why the patient is taking steroid therapy.
D)Give the oral steroid with a small sip of water.

Question 10

The nurse is caring for a patient who has developed an increased temperature during the first 24 hours postoperatively. Which of these actions is a priority for the nurse to take?

A)Providing passive range of motion exercises
B)Encouraging coughing and deep breathing
C)Giving antipyretic medication
D)Restricting oral fluids

Question 11

The nurse is caring for a patient who had spinal anesthesia. Which of the following effects from spinal anesthesia may affect the safety of the patient when getting out of bed for the first time postoperatively?

A)Hypertension
B)Hypotension
C)Hyperventilation
D)Hypoventilation

Question 12

The nurse is caring for a patient who the night before surgery is withdrawn and sad. The patient says, "I am scared of this surgery." Which of the following would be the nurse's best response?

A)"It's normal to be scared. What is it that scares you?"
B)"I would be scared, too. You will make it through."
C)"Don't be so concerned. Everything will be all right."
D)"Be happy, because this surgery will help you."

Question 13

The nurse is to preoperatively administer 8 mg of morphine intramuscularly to a patient. The nurse has available morphine 10 mg/mL. How many milliliters should the nurse give?

A)0.25 mL
B)0.5 mL
C)0.8 mL
D)1.25 mL

Question 14

The nurse assists in preparing patients for surgery. Which of these patients would the nurse recognize as being in the best condition for surgery and at lower risk for complications?

A)A 23-year-old patient 30 pounds less than ideal weight
B)A 40-year-old patient who plans to quit smoking after surgery
C)A 55-year-old patient who is a marathon runner
D)A 66-year-old patient who is obese

Question 15

The nurse is contributing to the preoperative patient's plan of care. Which of these statements by the patient would alert the nurse to plan interventions to help prevent postoperative complications?

A)"I am 60 years old and in good health."
B)"This is my second surgery in 2 years."
C)"I have not had anything to eat or drink for 8 hours."
D)"I have chronic obstructive pulmonary disease."

Question 16

The nurse is caring for a postoperative patient. Which of these outcomes would be most important for the patient's postoperative nursing diagnosis of Pain related to new incision?

A)Patient reports pain using a pain scale.
B)Patient states alternative techniques to minimize pain.
C)Patient states normal coping techniques for pain.
D)Patient states pain relief is satisfactory.

Question 17

The nurse is caring for a patient who is to have a liver biopsy. The nurse recognizes that this is an example of which category of surgical procedures?

A)Diagnostic
B)Preventive
C)Curative
D)Palliative

Question 18

The nurse is caring for a postoperative patient who becomes restless, hypotensive, tachycardic, and tachypneic. Which nursing action should be given priority?

A)Notify the patient's family.
B)Ensure physician is informed.
C)Monitor vital signs.
D)Maintain a patent airway.

Question 19

The nurse is caring for a postoperative patient. When the patient is allowed to get out of bed for the first time postoperatively, which of these measures would be most effective to ensure patient safety?

A)Have the patient put on nonskid slippers before standing.
B)Ensure that two caregivers assist the patient to stand.
C)Dangle the patient at the bedside before standing is attempted.
D)Teach the patient to request help before rising.

Question 20

The nurse is caring for a postoperative patient who has a nursing diagnosis of ineffective airway clearance. Which of these outcomes would be most appropriate for this patient?

A)Observes demonstration of coughing and deep breathing exercises
B)Explains coughing and deep breathing exercises
C)Explains rationale for coughing and deep breathing exercises
D)Correctly demonstrates coughing and deep breathing exercises

Question 21

The home health nurse is visiting a patient recovering after an abdominal hysterectomy. Which of these actions should the home health nurse take before promoting patient intake of oral fluids?

A)Determine that the patient has passed flatus.
B)Ensure bowel sounds can be detected.
C)Check for the absence of pain.
D)Verify physician's order for intake.Multiple Response
Identify one or more choices that best complete the statement or answer the question.

Question 22

The nurse is assisting a postoperative patient to use an incentive spirometer. Which of these patient instructions are appropriate?

A)Inhale deeply until the target is reached.
B)Do not hold breath after inhaling.
C)Exhale five times before inhaling.
D)Exhale deeply until the target is reached.

Question 23

The nurse is reviewing the medication history of a preoperative patient who is NPO. The patient is noted to have been on long-term oral steroid therapy. What action should the nurse take?

A)Ensure that the physician is informed of the patient's history of steroid use.
B)Hold steroid medication while the patient is receiving nothing by mouth.
C)Administer the steroid medication topically.
D)Monitor vital signs and document.

Question 24

The nurse is caring for a postoperative patient at risk for deep vein thrombosis. Which of the following actions should the nurse recommend be included in the patient's plan of care? (Select all that apply.?

A)Ambulate the patient tid.
B)Massage the patient's legs daily.
C)Apply antiembolic stockings.
D)Place a pillow under the patient's knees.
E)Perform leg exercises 10 times hourly while awake.

Question 25

The nurse is assisting in the surgical holding area. The nurse understands that which of the following schedules are recommended for prophylactic antibiotics?

A)4 hours prior to surgery
B)1 hour prior to surgery
C)During surgery
D)Within the first 2 hours postoperatively

Question 26

The nurse is caring for a patient in the perianesthesia unit. What is the nurse's priority responsibility for the patient while in this unit?

A)Monitoring urine output
B)Maintaining a patent airway
C)Assessing readiness for discharge
D)Administering pain medication

Question 27

The nurse is collecting data for a patient who had an epidural anesthetic during surgery. What finding by the nurse is a priority to report?

A)Patient reports a feeling of heaviness in the legs.
B)Patient experiences chills and shaking postoperatively.
C)Patient's blood pressure is 100/60 mm Hg.
D)Patient reports a feeling of numbness in the legs.

Question 28

The nurse is caring for a postoperative patient who 30 minutes prior to transfer from the perianesthesia unit (PACU) received an intravenous analgesic. Pain medication orders are for morphine 10 mg IM every 3 hours PRN. An hour after arrival on the nursing unit, the patient reports pain of 8 on a 0 to 10 pain scale. What action should the nurse take?

A)Explain that intramuscular analgesic cannot be given for another 1.5 hours.
B)Repeat same intravenous medication the patient received in the PACU.
C)Administer the intramuscular medication now and then every 3 hours as ordered.
D)Give the patient nonnarcotic analgesics.

Question 29

The nurse recommends early ambulation as ordered be included in the patient's plan of care. Which of the following can be prevented by early ambulation?

A)Increased peristalsis
B)Coughing
C)Thrombophlebitis
D)Impaired wound healing

Question 30

The nurse is caring for a preoperative patient. The patient asks the nurse what types of anesthesia cause a loss of sensation in a specific area of the body while the patient remains alert. Which of these responses should the nurse give? (Select all that apply.?

A)"Epidural anesthesia."
B)"General anesthesia."
C)"Local anesthesia."
D)"Spinal anesthesia."

Question 31

The practical/vocational nurse is preparing a patient for surgery who has asthma and is hard of hearing. Which of the following are within the scope of practice for the nurse? (Select all that apply.?

A)Provide emotional support.
B)Apply antiembolism devices as ordered.
C)Assist patient with insertion of hearing aids.
D)Reinforce registered nurse's instructions.
E)Send inhaler to surgery with patient.
F)Provide information for informed consent.

Question 32

The nurse is assisting during surgery when a patient develops malignant hyperthermia. Which of the following protocols would the nurse be prepared to assist with as directed?

A)Administer oxygen, and continue the anesthesia and surgery.
B)Immediately cease anesthesia and surgery, cool patient, and administer dantrolene sodium.
C)Switch to a different type of anesthetic agent to continue the surgery.
D)Warm the patient, administer fluids, and then continue surgery.

Question 33

The nurse is contributing to the intraoperative plan of care for a patient undergoing an appendectomy. Which of these would be an intraoperative outcome for this patient?

A)Verbalizes fears
B)Demonstrates leg exercises
C)Remains free from injury
D)States understanding of discharge instructions

Question 34

The nurse works on a preoperative unit. For which of the following conditions does the nurse recognize urgent surgery is needed?

A)Ruptured appendix
B)Hernia repair
C)Fracture repair
D)Aortic aneurysm

Question 35

The nurse is dangling a patient with an abdominal incision, when the incision suddenly eviscerates. What action should the nurse take after positioning the patient supine with flexed knees?

A)Cleanse the abdomen.
B)Apply an abdominal binder securely.
C)Apply sterile saline-moistened dressings.
D)Administer pain medication.

Question 36

The nurse is caring for a patient after ambulatory surgery. The patient's oxygen saturation must be above what level for the nurse to consider readiness for discharge?

A)70%
B)80%
C)85%
D)90%

Question 37

The nurse has reinforced preoperative teaching with a patient about coughing and deep breathing techniques. Which of the following statements by the client would indicate a correct understanding of the teaching? (Select all that apply.?

A)"I should cough and deep breathe 10 times every hour while awake."
B)"I should avoid deep breathing after surgery."
C)"I should take shallow breaths after surgery to prevent pain."
D)"I should cough and deep breathe beginning 2 days after my surgery."
E)"Coughing and deep breathing helps prevent respiratory problems."

Question 38

The intraoperative practical/vocational nurse is caring for a patient who is undergoing abdominal surgery with general anesthesia. What interventions should the nurse implement? (Select all that apply.?

A)Assist physician as directed.
B)Assist with patient positioning.
C)Encourage leg exercises.
D)Assist the patient to change position in bed every 4 hours.
E)Monitor for unilateral swelling of the calf.
F)Participate in a time out before surgery begins.

Question 39

The nurse is caring for a patient after a hernia repair who reports pain of 4 on a 0 to 10 scale. The patient's orders include ibuprofen (Motrin) 400 mg orally every 6 hours prn for pain. Which of the following actions should the nurse take?

A)Start the ibuprofen on the second postoperative day.
B)Hold the ibuprofen due to risk of gastrointestinal (GI) upset.
C)Give the ibuprofen as ordered for pain.
D)Consult the physician for a stronger analgesic.

Question 40

The nurse is caring for a preoperative patient who expresses a fear of dying. What action should the nurse take?

A)Tell the patient everything will be all right.
B)Explain the national death rate from surgery.
C)Allow the patient time to express concerns.
D)Ask the family to comfort the patient.

Question 41

The nurse notes upon the patient's return to the surgical unit postoperatively that the surgical dressing covering the Penrose drain is dry and intact. Two hours later, the patient reports pain of 5 on a scale of 0 to 10 at the incisional site. The nurse checks the dressing and finds a 1 $\times$ 1 inch area of serosanguineous drainage on the dressing. What action should the nurse take? (Select all that apply.?

A)Monitor the drainage at the incisional site.
B)Notify the registered nurse immediately.
C)Review the analgesic administration record.
D)Culture the drainage on the dressing.
E)Apply pressure to the incisional site.

Question 42

The nurse is assisting in preparing the patient for surgery. Which surgical consent would the nurse recognize as being a legal consent? (Select all that apply.?

A)Consent signed by 36-year-old patient 1 hour after receiving lorazepam (Ativan).
B)Consent signed by 16-year-old patient for his or her own urgent surgery.
C)Consent signed by a foster mother for a 17-year-old patient.
D)Consent signed by a 60-year-old patient 1 hour before receiving morphine.
E)Consent signed by a 17-year-old for her infant's surgery.
F)Consent signed by a 28-year-old for his own elective surgery.

Question 43

The nurse is witnessing an adult patient's surgical consent. Which of the following would the nurse need to confirm before witnessing the surgical consent? (Select all that apply.?

A)The patient's next of kin
B)Whether the patient is informed about the surgery
C)If family members have questions related to the surgery
D)When the patient last ate or drank
E)The last time a sedative was administered

Question 44

The nurse is contributing to an education program for older adults who are preparing for joint replacement surgery. Which of the following interventions should the nurse use to enhance older patient learning? (Select all that apply.?

A)Conduct session in a room with bright, fluorescent lighting.
B)Utilize medical terminology to promote understanding.
C)Provide handouts with black print on white nonglare paper.
D)Convey positive attitude and self-care promotion for older adults.
E)Avoid repetition in presentation.

Question 45

The nurse is caring for a postoperative patient. When getting the patient out of bed for the first time postoperatively, which action should the nurse take to maintain safety? (Select all that apply.?

A)Have the patient stand with no assistance.
B)Assist the patient to stand in one motion.
C)Dangle the patient at the bedside.
D)Instruct the patient to place the nurse light on to get up.
E)Use two people to assist patient.

Question 46

The nurse provides recommendations for the plan of care for a patient scheduled to undergo a cholecystectomy. What is the best rationale for including preoperative teaching of deep breathing exercises to prevent postoperative complications for this patient? (Select all that apply.?

A)Anesthesia increases retention of respiratory secretions.
B)Anesthesia decreases production of respiratory secretions.
C)Location of incision contributes to decreased lung expansion.
D)Incisional pain promotes decreased lung expansion.

Question 47

The postoperative nurse is caring for a patient who had abdominal surgery with general anesthesia. What interventions should the nurse implement? (Select all that apply.?

A)Monitor first voiding after catheter removal.
B)Position carefully and pad bony prominences.
C)Encourage use of incentive spirometer as ordered.
D)Assist the patient to change position in bed every 4 hours.
E)Monitor for unilateral swelling of the calf.
F)Monitor pain level each hour that patient is awake.