Question 1

When is it appropriate to ask a surgeon to clarify information for a patient who is undergoing surgery? (Select all that apply.)&#10;A) Before the informed consent has been signed&#10;B) When a patient is confused about the reason for the procedure&#10;C) When a patient understands the risks involved in a procedure&#10;D) If there is confusion about the procedure after the informed consent is signed&#10;E) After the surgery has been performed

Accepted Answer

Patients need to sign all consent forms before you administer any preoperative medications that alter the patient's consciousness.The primary responsibility for informing the patient rests with the surgeon and anesthesia care personnel.However,if the patient is confused or uncertain about a procedure,you are ethically obligated to contact the surgeon and/or anesthesia care provider so that further discussion and clarification are provided to meet the patient's needs.The patient always has the right to refuse surgery or treatment even after giving written consent.

Question 2

A nurse working in an ambulatory care surgery center is preparing to discharge a postoperative patient.The nurse knows that the convalescence period will occur:&#10;A) 1 to 2 hours after surgery.&#10;B) at home.&#10;C) once the patient has been monitored overnight in the hospital.&#10;D) 2 to 4 hours after surgery.

Accepted Answer

For a patient following ambulatory surgery,convalescence will occur at home,the immediate recovery period normally lasts only 1 to 2 hours.For a hospitalized patient the immediate postoperative period often lasts a few hours,with convalescence taking 1 or more days,depending on the extent of surgery and a patient's response.Patient who are admitted to stay overnight at the hospital are not classified as ambulatory care surgery center.

Question 3

The preoperative nurse who is providing patient teaching to a 49-year-old patient who is scheduled to undergo a right-side inguinal surgery repair.The nurse informs the patient that the American Society of Anesthesiologists recommend that patients undergoing surgery with a general anesthesia fast from meat and fried foods for how many hours before surgery?

A) 2
B) 4
C) 6
D) 8

8

Accepted Answer

The American Society of Anesthesiologists (ASA)provides recommendations on fluid and food intake before procedures requiring general anesthesia,regional anesthesia,or sedation/analgesia.The ASA recommendations include fasting from intake of clear liquids for 2 or more hours,and a light meal of toast and clear liquids for 6 hours.The patient also cannot have any meat or fried foods 8 hours before surgery,unless explicitly specified by the anesthesiologist or surgeon.

Question 4

The nurse is providing preoperative teaching for a patient regarding pain control after surgery.Which of the following statements is/are true regarding the use of postoperative analgesia? (Select all that apply.)

A) "Analgesics will not provide adequate relief if you wait until the pain becomes excruciating before using them."
B) "Pain control will help you recover from surgery quicker."
C) "You shouldn't be concerned about becoming addicted to your pain medications immediately after surgery."
D) "You will remain pain-free as long as you take your pain medications as prescribed."
E) "A PCA pump is commonly used to help patients control their pain."
F) "Take pain medication carefully as it will lengthen your recovery period."

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Accepted Answer

Analgesics will not provide adequate pain relief if the patient waits until the pain becomes excruciating before using or requesting an analgesic.Even though around-the-clock (ATC)analgesia is more effective,most patients still have analgesics ordered prn (as needed).Pain control is essential for a surgical patient to recover quickly.Encourage the patient to use analgesics as needed and not be fearful of any dependence on pain medications after surgery.Patient-controlled analgesia (PCA)is common and provides patients with control over pain.Explain to a patient how to operate a pump and the importance of administering medication as soon as pain becomes persistent.The patient also needs to know it takes time for a drug to act and that the drug will rarely eliminate all the discomfort.Pain medication will not lengthen the recovery period,it will shorten it.

Question 5

A patient with a ruptured abdominal aortic aneurysm needs to have major surgery.The nurse explains to the family that major surgery:&#10;A) is an excision or removal of a diseased body part.&#10;B) involves extensive surgery to reconstruct body parts.&#10;C) is not necessary but may prevent additional problems.&#10;D) is a surgical exploration that allows the physician or health care provider to confirm a diagnosis.

Accepted Answer

Major surgery involves extensive reconstruction or alteration in body parts; poses great risks to the patient's well-being.Urgent surgery is necessary for the patient's health and will possibly prevent additional problems from developing.Elective surgery is performed on a basis of the patient's choice.It is not always essential,and it is not always necessary for health.Diagnostic surgical exploration allows the physician or health care provider to confirm a diagnosis.

Question 6

A patient with a ruptured abdominal aortic aneurysm needs to have major surgery.The family asks the nurse what type of anesthesia the patient will receive.The best response is which of the following?&#10;A) Local anesthesia&#10;B) Regional anesthesia&#10;C) Moderate sedation&#10;D) General anesthesia

Accepted Answer

General anesthesia is administered during major procedures requiring extensive tissue manipulation or any time analgesia,muscle relaxation,immobility,and control of the autonomic nervous system are required.Local anesthesia involves loss of sensation at the desired surgical site by inhibiting peripheral nerve conduction.It is used during minor procedures performed in ambulatory surgery.Regional anesthesia results in loss of sensation in an area of the body by anesthetizing sensory pathways.This type of anesthesia is accomplished by injecting a local anesthetic along the pathway of a nerve from the spinal cord.Administration techniques include peripheral nerve blocks and spinal,epidural,and caudal blocks.A patient requires careful monitoring during and immediately after regional anesthesia for return of sensation and movement distal to the regional anesthesia.Intravenous moderate sedation/analgesia or conscious sedation is routinely used for diagnostic or therapeutic procedures (e.g.,colonoscopy or certain laparoscopies)that do not require complete anesthesia but simply a decreased level of consciousness.

Question 7

The nurse instructs the postoperative patient to perform leg exercises every hour in order to do which of the following?&#10;A) Maintain muscle tone.&#10;B) Increase venous return.&#10;C) Exercise fatigued muscles.&#10;D) Assess range of joint motion.

Accepted Answer

The number one priority in a surgical setting is to prevent deep vein thrombosis (DVT)complications.By increasing venous return there is less stasis therefore decreasing the risk of DVT.Early measures directed at preventing venous stasis are aimed at preventing DVT during convalescence.On the surgical nursing unit,begin these interventions as soon as possible.Encourage patients to perform leg exercises at least every hour while awake unless contraindicated by surgery.Maintaining muscle tone,exercising fatigued muscles,and assessing range of joint motion are all reasons to perform leg exercises.

Question 8

A 44-year-old patient with breast cancer who is scheduled to undergo a right-side mastectomy.Ideally when should preoperative teaching begin?&#10;A) As soon as she is diagnosed with breast cancer&#10;B) One week before surgery&#10;C) The day before surgery&#10;D) The day of surgery

Accepted Answer

Preoperative teaching is most useful when started the week before admission and reinforced immediately before surgery.Teaching performed when the patient is less anxious will result in more effective learning.Anxiety and fear are barriers to learning.

Question 9

The operating room environment is deliberately kept cool.When the nurse assesses the patient in the post anesthesia care unit,the patient is shivering.The nurse needs to understand that shivering may do which of the following?

A) Be a side effect of anesthesia.
B) Indicate a problem of the hypothalamus.
C) Indicate the beginning of the infectious process.
D) Be a normal response to stabilize blood pressure.

Accepted Answer

The operating room environment is cool,and the patient's depressed level of body function results in a lowering of metabolism and fall in body temperature.When patients begin to awaken,they often complain of feeling cold and uncomfortable.Shivering is not always a sign of hypothermia,but rather a side effect of certain anesthetic agents.If a patient develops a fever,notify the surgeon immediately.The chances of the shivering being a problem with the hypothalamus,indicating infection (such as fever with sepsis)are very low in this case.

Question 10

The perioperative nurse is admitting a patient for an elective surgery.She questions the patient about issues with anesthesia,to assess the patient for malignant hyperthermia.Which of the following is a late sign of malignant hyperthermia?

A) High CO2 levels
B) Tachycardia
C) Elevated temperature
D) Tachypnea

Accepted Answer

Malignant hyperthermia is a life-threatening complication.Early signs of malignant hyperthermia include high levels of CO?,tachypnea,and tachycardia.Elevated temperature occurs in the late stages.

Question 11

All patients undergoing surgery need to have preoperative preparation.When physically preparing the patient,the most appropriate action for the nurse to take is which of the following?&#10;A) Leaving all of the patient's jewelry in place&#10;B) Removing the patient's makeup and nail polish&#10;C) Providing the patient with sips of water for a dry mouth&#10;D) Removing the patient's hearing aid before transport to the operating room

Accepted Answer

The answer of All patients undergoing surgery need to have...

Question 12

The nurse working on a medical/surgical floor knows that pulmonary embolisms can be a deadly complication after surgery.Which of the following patients is most likely to develop a pulmonary embolism?&#10;A) 45-year-old patient after bariatric surgery&#10;B) 23-year-old patient with pneumonia&#10;C) 13-year-old patient after appendectomy&#10;D) 57-year-old patient after cholecystectomy

Accepted Answer

The answer of The nurse working on a medical/surgical floor...

Question 13

A 56-year-old nondiabetic patient is undergoing orthopedic surgery.The perioperative nurse is monitoring the blood glucose level.What is the main rationale for monitoring his blood glucose level during surgery?

A) She does not want the patient to develop an embolism.
B) Research shows a strong relationship between wound infections and hyperglycemia.
C) She knows that normal glucose levels promote platelet production.
D) She is monitoring to prevent embolism.

Accepted Answer

The answer of A 56-year-old nondiabetic patient is undergoing orthopedic...

Question 14

The nurse is conducting preoperative teaching with the patient and family.The nurse teaches the patient the proper use of the incentive spirometer.The nurse knows that the patient understands the need for this intervention when the patient states,"I use this device to:

A) help my cough reflex."
B) expand my lungs after surgery."
C) increase my lung circulation."
D) keep me from coughing."

Accepted Answer

The answer of The nurse is conducting preoperative teaching with...

Question 15

A patient is awaiting surgery.The nurse's best rationale for assessing vital signs is to do which of the following?&#10;A) Assess the patient's anxiety level.&#10;B) Determine the patient's basal temperature.&#10;C) Establish a baseline for vital signs comparisons.&#10;D) Assess for any changes that may indicate infection.

Accepted Answer

The answer of A patient is awaiting surgery.The nurse's best...

Question 16

A patient asks a nurse to explain the differences between general anesthesia and regional anesthesia.What is the correct response relating to general anesthesia?&#10;A) &#34;General anesthesia inhibits peripheral nerve conduction.&#34;&#10;B) &#34;Under general anesthesia all sensation and consciousness is lost.&#34;&#10;C) &#34;Under general anesthesia there is a loss of sensation in a specific area of the body.&#34;&#10;D) &#34;General anesthesia is routinely used for procedures that only require a decreased level of consciousness.&#34;

Accepted Answer

The answer of A patient asks a nurse to explain...

Question 17

Which of the following patients is most at risk for hypovolemic shock after emergency surgery?&#10;A) 14-year-old adolescent with gastroenteritis&#10;B) 59-year-old patient with pneumonia&#10;C) 12-year-old patient with H1N1 flu&#10;D) 28-year-old patient with a fractured ankle

Accepted Answer

The answer of Which of the following patients is most...

Question 18

Intraoperatively,the circulating nurse observes a member of the surgical team breach aseptic technique.As a result of this incident the postoperative patient can be at risk for which of the following?&#10;A) Paralytic ileus&#10;B) Malignant hyperthermia&#10;C) Development of infection&#10;D) Alteration in pulmonary hygiene

Accepted Answer

The answer of Intraoperatively,the circulating nurse observes a member of...

Question 19

A 45-year-old woman has been admitted for surgery to remove a cancerous abdominal tumor.She has been on chemotherapy and recently radiotherapy to shrink the tumor without success.To best facilitate wound healing,when is the best time for her to undergo surgery?

A) During the radiotherapy treatments
B) Immediately after the radiotherapy treatments
C) 2 to 3 weeks after radiotherapy treatments
D) 4 to 6 weeks after radiotherapy treatments

Accepted Answer

The answer of A 45-year-old woman has been admitted for...

Question 20

A 57-year-old patient who is being admitted for an appendectomy.The patient is a 2-pack-a-day smoker,has a history of diabetes,and is 20 pounds overweight.Which of the following potential postoperative complications should be the nurse's highest concern for prevention?

A) Atelectasis
B) Negative nitrogen balance
C) Delayed wound healing
D) Hyperthermia

Accepted Answer

The answer of A 57-year-old patient who is being admitted...

Question 21

A student nurse has been assigned to a 67-year-old patient who is undergoing thoracic surgery to remove a tumor.As part of the preoperative teaching,the student nurse discusses the importance of coughing.Which of the following statements is true regarding why postoperative coughing is important? (Select all that apply.)

A) "Coughing assists in removing retained mucus in the airways."
B) "It won't hurt to cough with adequate pain control."
C) "You can splint your incision when coughing to minimize pain."
D) "Deep breathing and coughing will remove anesthesia gases from your lungs."
E)"Deep breathing involves fast, shallow, breaths and then one big breath."
F) "Coughing is not encouraged because of the potential or dehiscence at the surgical site."

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The answer of A student nurse has been assigned to...

Deck 39: Surgical Patient