Deck 20: Nursing Management: Preoperative Care

Question 1

Which following class of preoperative medications is administered to increase the patients' gastric pH and decrease gastric volume?

A) Narcotics
B) Benzodiazepines
C) Anticholinergics
D) Histamine H₂-receptor antagonists

Answer 1

Histamine H₂-receptor antagonists

Question 2

According to the Canadian Anesthesiologists' Society,what is the minimum preoperative fasting time period for intake of clear fluids?

A) 30 minutes
B) 1 hour
C) 2 hours
D) 4 hours

Answer 2

2 hours

Question 3

What does appropriate preoperative teaching for a patient scheduled for abdominal surgery include?

A) How to care for the wound
B) How to breathe deeply and cough
C) What medications will be used during surgery
D) What drains and tubes will be present after surgery

Answer 3

How to breathe deeply and cough

Question 4

During a preoperative assessment,which of the following reported allergies does the nurse recognize as a risk for latex allergy in the patient?

A) Iodine
B) Penicillin
C) Dairy products
D) Bananas

Question 5

The nurse visits the patient to have him sign the operative permit as directed in the physician's preoperative orders.The patient tells the nurse that the physician has not really told him what is involved in the surgical procedure.What should the nurse do?

A) Ask family members whether they have discussed the surgical procedure with the physician.
B) Explain what the planned surgical procedure entails before having the patient sign the consent form.
C) Have the patient sign the form,and tell him the physician will visit him before surgery to explain the procedure.
D) Delay the patient's signature on the consent form,and notify the physician that the informed-consent process is not complete.

Question 6

During the preoperative interview,a patient scheduled for an elective hysterectomy to treat benign tumours of the uterus tells the nurse that she does not know whether she can go through with the surgery because she knows she will die in surgery,as her mother did.What is the most appropriate response?

A) "Tell me more about what happened to your mother."
B) "Have you discussed these feelings with anyone else?"
C) "I am sure surgical techniques have improved since your mother had surgery."
D) "Think positively! Positive thoughts have been shown to influence a positive surgical outcome."

Question 7

Which of the following should be the nurse's preoperative consideration when the patient states that she takes a garlic pill every day?

A) Garlic may cause inflammation of the liver.
B) Garlic may inhibit platelet activity.
C) Garlic may increase bleeding.
D) Garlic may increase pulse rate.

Question 8

Sarah,46 years old,is in the preoperative assessment area awaiting surgery.She is wringing her hands and perspiring,and she has a worried affect.The nurse's communication with Sarah is based on the knowledge that the most prevalent fear of patients awaiting surgery is which of the following?

A) Pain
B) Altered body image
C) Potential for death
D) Results of the procedure

Question 9

An 82-year-old man is admitted to the hospital the evening before a prostatectomy for cancer of the prostate.He is alert and oriented but has difficulty seeing and hearing.His wife is at his bedside and answers most questions directed to the patient.What should the nurse do to accomplish preoperative teaching with the patient?

A) Use printed materials for instruction because the patient does not hear well.
B) Direct the teaching toward the wife because she is the obvious support and caregiver for the patient.
C) Provide additional time for the patient to understand preoperative instructions and carry out procedures.
D) Ask the patient's wife to wait in the hall in order to focus on preoperative teaching with the patient himself.

Question 10

During the preoperative assessment of a patient scheduled for a cholecystectomy at an outpatient centre,the patient tells the nurse that she uses St.John's wort to keep her spirits up.Why should the nurse notify the anaesthesiologist about this use of St.John's wort?

A) It may increase the risk of bleeding.
B) It may prolong the effects of anaesthetics.
C) It may cause serious elevations in blood pressure.
D) It may depress the immune system response,delaying healing.

Question 11

As the nurse prepares a patient the morning of surgery,the patient refuses to remove her wedding ring.What should the nurse do?

A) Tape the ring securely to the finger.
B) Note the presence of the ring on the preoperative checklist form.
C) Insist that the patient remove the ring,and take it to the facility's safe.
D) Tell the patient that the health facility cannot be responsible if something happens to her finger or the ring.

Question 12

Why is it especially important for the nurse to determine the patient's current use of medications during the preoperative assessment?

A) These medications may alter the patient's perceptions about surgery.
B) Anaesthetics alter renal and hepatic function,causing toxicity by other drugs.
C) Other medications may cause interactions with anaesthetics,altering the potency and effect of the drugs.
D) Routine medications are usually withheld the day of surgery,requiring dosage and schedule adjustments.

Question 13

A 36-year-old woman has been admitted to the hospital for knee surgery.Which of the following information that was obtained by the nurse during the preoperative assessment should be reported to the surgeon before surgery is performed?

A) Lack of knowledge about postoperative pain control
B) Knowledge of the possibility of an early,unplanned pregnancy
C) History of a postoperative infection following a prior cholecystectomy
D) Concern that she will be physically limited in caring for her children for a period postoperatively

Question 14

Which of the following is the meaning of the suffix -ostomy?

A) Excision or removal
B) Creation of opening into
C) Incision or cutting into
D) Repair and reconstruction

Question 15

How would the nurse document the preoperative rating of physical status for a patient who has a history of controlled asthma?

A) Healthy patient with no systemic disease
B) Mild systemic disease without functional limitations
C) Severe systemic disease associated with functional limitations
D) Severe systemic disease that is an ongoing threat to life

Question 16

A 74-year-old man is to have a left inguinal hernia repair at the outpatient surgical clinic.Preoperatively,what is it most important for the nurse to determine?

A) The patient has had outpatient surgery in the past.
B) The patient's medical plan covers outpatient surgery.
C) The patient plans to stay overnight at the surgical centre.
D) A family member or friend is available for transportation and care at home.

Question 17

A patient with diabetes that is well controlled with insulin injections has been on nothing by mouth (NPO)status since midnight before having a mastectomy.The nurse notes that there are no preoperative orders regarding the patient's daily insulin dose.What is the most appropriate nursing action?

A) Withhold any insulin dose because none is ordered and the patient is on NPO status.
B) Call the physician to clarify whether insulin should be given and at what dosage.
C) Give the patient half of her usual daily insulin dose because she will not be eating in the morning.
D) Give the patient her usual daily insulin dose because the stress of surgery will increase her blood glucose level.