Deck 12: Nursing Care of Patients Having Surgery

Question 1

A patient scheduled for a nephrectomy states that the surgeon said this surgery is considered a "curative procedure." Which responses should the nurse make to the patient?

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

Answer 1

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

Question 2

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

Answer 2

Place the patient in low Fowler's position.

Question 3

The nurse is caring for a patient recovering from surgery.Which outcome should the nurse identify as being the most important to address the nursing diagnosis of Pain related to surgical incision?

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

Answer 3

Patient states pain relief is satisfactory.

Question 4

A patient who is NPO (nothing by mouth)for scheduled surgery has been on long-term oral steroid therapy and should receive a dose of Prednisone 10 mg by mouth at 0600.Which action should the nurse take?

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

Question 5

The nurse is planning to witness an adult patient's consent for a knee arthroscopy.What should the nurse confirm before witnessing the consent?

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

Question 6

A patient recovering from surgery becomes restless,has a drop in blood pressure,increase in heart rate,and is breathing at a rate of 30 per minute.Which action should the nurse take first?

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

Question 7

A patient is prescribed to receive morphine sulfate 8 mg intramuscularly (IM)prior to surgery.The medication available is 10 mg/mL.How many milliliters should the nurse give to the patient?

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

Question 8

The nurse is caring for a patient who had spinal anesthesia.Which effect from spinal anesthesia may influence the safety of the patient when getting out of bed for the first time after surgery?

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

Question 9

The nurse is caring for a patient who is scheduled fora liver biopsy.For which category of surgical procedures should the nurse plan care for this patient?

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

Question 10

The nurse identifies the diagnosis of ineffective airway clearance as appropriate for a patient recovering from surgery.Which outcome should the nurse identify for this patient?

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

Question 11

The nurse is caring for a patient recovering from surgery.When the patient is permitted to get out of bed for the first time postoperatively,which measure should the nurse take to ensure patient safety?

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

Question 12

A patient scheduled for surgery the next morning is withdrawn,sad and states a fear of the surgery.How should the nurse respond to this patient?

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

Question 13

A patient scheduled for surgery is to receive anesthesia that causes a total loss of sensation and a complete loss of consciousness.What term should the nurse use to document this patient's type of anesthesia?

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

Question 14

The nurse is assisting in the preparation of patients for surgery.Which patient should the nurse recognize as being in the best condition for surgery and at lower risk for complications?

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

Question 15

The nurse is contributing to the preoperative patient's plan of care.Which patient statement should 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 chronic obstructive pulmonary disease."
D) "I have not had anything to eat or drink for 8 hours."

Question 16

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

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

Question 17

The nurse is caring for a patient 23 hours after abdominal surgery.Which finding would require the nurse to take action?

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

Question 18

The nurse is contributing to the plan of care for a surgical patient.What should the nurse recognize as the most common human response to the stress associated with surgery?

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

Question 19

A patient recovering from an abdominal hysterectomy is experiencing abdominal gas pain.Which action should the nurse take?

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

Question 20

The nurse is caring for a patient who has developed an increased temperature during the first 24 hours postoperatively.Which action should the nurse take?

A) Restrict oral fluids.
B) Give antipyretic medication.
C) Encourage coughing and deep breathing.
D) Provide passive range of motion exercises.

Question 21

The nurse is assisting a patient recovering from surgery on the use of an incentive spirometer.Which patient instruction is appropriate?

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

Question 22

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

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

Question 23

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

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

Question 24

The nurse is caring for a patient in the post anesthesia care unit (PACU).What is the nurse's priority responsibility for the patient while in this unit?

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

Question 25

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

Question 26

The nurse is collecting data from a patient recovering from epidural anesthetic during surgery.What finding should the nurse make a priority to report?

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

Question 27

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

A) Check for the absence of pain.
B) Verify physician's order for intake.
C) Ensure bowel sounds can be detected.
D) Determine that the patient has passed flatus.

Question 28

The nurse is assisting in the surgical holding area.When should the nurse administer a prophylactic antibiotic to a patient?

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

Question 29

The nurse recommends early ambulation as ordered to be included in the plan of care for a patient recovering from surgery.Which adverse effect is the nurse planning to prevent by early ambulation?

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

Question 30

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

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

Question 31

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

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

Question 32

The nurse is assisting during surgery when a patient develops malignant hyperthermia.Which protocol should the nurse prepare to assist with as directed?

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

Question 33

A patient recovering from hernia repair surgery 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 action should the nurse take?

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

Question 34

The nurse works on a preoperative unit.For which conditions should the nurse recognize that urgent surgery is needed?

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

Question 35

A patient recovering from surgery received an IV analgesic in the post-anesthesia care unit.Upon arrival to the medical-surgical care area one hour later the patient rates pain as being 8 on a scale of 0 to 10.The patient is prescribed morphine 10 mg IM injection every 3 hours PRN.What should the nurse do?

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

Question 36

The nurse is caring for a patient after ambulatory surgery.Which oxygen saturation level should the nurse use as evidence that the patient is ready for discharge?

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

Question 37

A patient recovering from surgery in the post-anesthesia care unit begins to thrash in bed and pull at the endotracheal tube and IV lines.For which health problem should the nurse provide care for this patient?

A) Delusions
B) Sundowning
C) Hallucinations
D) Emergency delirium

Question 38

A patient scheduled for surgery expresses a fear of dying.What action should the nurse take?

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

Question 39

While dangling a patient in preparation for ambulation after surgery the abdominal incision suddenly eviscerates.What action should the nurse take after positioning the patient supine with flexed knees?

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

Question 40

A patient with chronic obstructive pulmonary disease is scheduled for total hip replacement.What should the nurse instruct the patient about smoking before the surgery?

A) Do not smoke for 24 hours before the surgery.
B) Do not smoke for 3 to 4 weeks before the surgery.
C) Abstain from smoking for 3 to 4 hours before the surgery.
D) Limit smoking to 1 or 2 cigarettes per day before the surgery.

Question 41

The nurse is reinforcing teaching provided to a patient to learn how to get out of bed independently at home after surgery.What should the nurse emphasize in this teaching? (Select all that apply.)

A) Hold breath while sitting.
B) Place the hands flat against the bed.
C) Turn onto the side without a pillow between the knees.
D) Sit for a few minutes to avoid dizziness and falling.
E) Push up while swinging the legs into a sitting position.

Question 42

A patient scheduled for surgery asks if any changes should be made to the diet before the operation occurs.What nutrients should the nurse suggest the patient ingest prior to the operative procedure? (Select all that apply.)

A) Zinc
B) Protein
C) Vitamin C
D) Vitamin E
E) Magnesium

Question 43

After surgery a patient's 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 and the dressing has a 1 ´ 1 inch area of serosanguineous drainage on the dressing.What actions should the nurse take? (Select all that apply.)

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

Question 44

The nurse provides recommendations for the plan of care for a patient scheduled to undergo a cholecystectomy.Why should the nurse include preoperative teaching of deep breathing exercises to prevent postoperative complications for this patient? (Select all that apply.)

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

Question 45

The nurse is witnessing an adult patient's surgical consent.What should the nurse confirm before witnessing the surgical consent? (Select all that apply.)

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

Question 46

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

Question 47

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

Question 48

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

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

Question 49

The nurse is reviewing discharge instructions with a patient recovering from procedural sedation and analgesia for a surgical procedure.What should the nurse emphasize in this teaching? (Select all that apply.)

A) The patient will not eat for 24 hours.
B) An adult must drive the patient home.
C) An adult must be home to provide a safe environment.
D) The patient will not sign legal documents for 24 hours.
E) The patient will not drive or operate heavy machinery for 24 hours.

Question 50

A patient recovering from surgery 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 responses should the nurse give? (Select all that apply.)

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

Question 51

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

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

Question 52

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

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