Deck 28: Preoperative and Postoperative Care

Question 1

The nurse admits the patient to the postanesthesia care unit (PACU)after hand surgery.The patient is groggy but can respond after receiving conscious sedation and regional anesthesia.Which action by the nurse is priority?

A) Position the head to maintain a patent airway.
B) Elevate the affected hand higher than the level of the heart.
C) Monitor the circulatory status in the operative hand.
D) Measure the core body temperature.

Answer 1

Position the head to maintain a patent airway.

Question 2

The patient asks why preoperative application of compression stockings has been ordered.Which response by the nurse is most appropriate?

A) "They help to prevent any chance of blood clots after surgery."
B) "They are measured from behind the knee to the heel."
C) "They are connected to a pump that compresses different parts of the leg at different times to help the circulation in your legs after surgery."
D) "They put continual light pressure on your legs to improve venous return after surgery."

Answer 2

"They put continual light pressure on your legs to improve venous return after surgery."

Question 3

The nurse assesses a patient before knee surgery.Which assessment finding reported by the nurse will most likely require the surgery to be delayed?

A) A 10-year history of smoking a pack of cigarettes per day
B) A reddened, swollen, and painful calf
C) An upper respiratory infection last month
D) A low-normal serum hemoglobin level

Answer 3

A reddened, swollen, and painful calf

Question 4

The nurse plans assignments for the staff in an ambulatory surgery center.Which assignment can the nurse delegate to nursing assistive personnel (NAP)?

A) Bring the preoperative medications prepared by the nurse to the patient.
B) Administer a preoperative enema to the patient.
C) Instruct the patient to arrange for a ride home and a companion after surgery.
D) Reinforce preoperative teaching related to the patient's postoperative diet.

Question 5

The nurse assesses the patient and determines that he may be at risk for altered peripheral tissue perfusion.Which activity should the nurse include in patient teaching to prevent decreased perfusion to his extremities while he is on bed rest?

A) Avoid any fluids by mouth until the patient begins passing gas.
B) Flex and rotate the ankles several times every hour while awake.
C) Rest quietly to allow the maximum action of the opioid analgesics.
D) Stay positioned on either side with pillows between the legs.

Question 6

While being prepared for surgery,the patient tells the nurse that he didn't take the ordered antibiotics in preparation for the surgery.What initial action should the nurse take?

A) Document what the patient just said.
B) Order the missed medication but in a parenteral form.
C) Notify the patient's surgeon.
D) Ask the patient why he didn't take it.

Question 7

The nurse admits a male patient for ambulatory surgery.The patient tells the nurse that he skipped breakfast but drank a cup of coffee and some juice.Which does the nurse implement next?

A) Asks the patient to estimate the fluid volume
B) Instructs the patient to dress and return home
C) Notifies the anesthesiologist and surgeon
D) Changes or delays surgery for several hours

Question 8

The patient is prepared for shoulder surgery and tells the preoperative nurse that the scar will be invisible after the surgery.Which action should the nurse take at this time?

A) Tell the patient that this surgery always leaves a scar.
B) Change the operative consent form to reflect what the patient says.
C) Inform the surgeon that the patient is not ready for surgery.
D) Notify the surgeon of the patient's statement before medication is given.

Question 9

The nurse instructs the patient about postoperative coughing and deep-breathing exercises following abdominal surgery.Which technique should the nurse use to engage the patient in prevention of pneumonia and atelectasis?

A) Begin coughing and deep breathing when the patient is ready.
B) Take a deep breath, hold it for 10 seconds, and exhale slowly.
C) Support the incision when doing these exercises.
D) Begin coughing and deep breathing when the patient is wide awake.

Question 10

The nurse prepares the patient for surgery to begin in 1 hour,but the pregnancy test included in the preoperative orders written yesterday is not in the medical record.Which action should the nurse implement first?

A) Call the laboratory to determine if they have the pregnancy test results.
B) Collaborate with the surgeon.
C) Draw a stat pregnancy test.
D) Ask the patient if she is pregnant.

Question 11

The nurse interviews a preoperative patient who evades all questions about medications taken at home.Which is the best response for the nurse to use to facilitate safe,effective nursing care?

A) "I feel that you're uneasy about discussing medications."
B) "Why don't you want to talk about your medications?"
C) "You're avoiding me; so you must have a big secret."
D) "Don't you think that it's important to discuss medications?"

Question 12

The nurse is explaining the purpose and procedure regarding informed consent to a nursing student.What information should be included in the explanation?

A) The nurse provides information about the risks and benefits of the procedure.
B) Informed consent only describes the details of the surgery itself.
C) The nurse verifies it is complete and consistent with patient's understanding.
D) The nurse obtains consent after administration of the preoperative medication.

Question 13

The patient's family has had many surgical experiences with complications.What information is most important for the nurse to use to understand the patient's stress in the perioperative period?

A) Ask the patient if medications will calm him or her before surgery.
B) Identify specific concerns regarding the surgical experience.
C) Explain to the patient that stress is easily identified and managed.
D) Tell the patient that stress is unrelated to environmental factors.

Question 14

The nurse is caring for a patient who had an ovarian cyst removed under general anesthesia 12 hours ago.Which is the most important goal for this patient?

A) The patient will cough and deep breathe every hour for 48 hours.
B) The patient will have bowel sounds within 24 hours after surgery.
C) The patient will exercise the feet and ankles 3 times this shift.
D) The patient will ambulate tonight and 3 times tomorrow.

Question 15

A nurse admits a patient,who works in dental office,to ambulatory surgery.The patient's history includes multiple surgeries over the last 10 years.In addition,when the patient wears antiembolism stockings,a rash develops.Which action should the nurse take initially?

A) Use powdered gloves to provide care to this patient.
B) Remove latex products from the patient's room.
C) Inform the surgeon about the patient's hypersensitivity to latex.
D) Gather additional information about potential allergies.

Question 16

The nurse determines that the patient is at risk for atelectasis caused by pain from back surgery 3 hours ago.Which is the best goal for the nurse to help the patient achieve?

A) The patient's lungs will be clear when auscultated every 2 hours.
B) The nurse will manage the patient's pain with oral morphine.
C) Cool the patient's elevated temperature with a cooling mat.
D) Maintain adequate cardiac output with a positive fluid balance.

Question 17

The nurse assesses a patient before hip surgery.Which piece of information is most critical for the nurse to report to the surgeon before surgery?

A) The patient is complaining of a pounding headache.
B) There is a bruise on the patient's left anterior chest.
C) The patient uses continuous positive airway pressure (CPAP) at home.
D) The blood pressure is 20 mm Hg higher than baseline.

Question 18

The nurse provides instructions about postoperative exercises to the patient who is scheduled for a laparotomy.What does the nurse include in patient teaching?

A) Flex and extend the knees several times every few hours.
B) Cough and deep breathe at least once every day.
C) Repeat range-of-motion exercises twice.
D) Reposition in bed every 4 hours.

Question 19

The nurse assesses a patient before surgery.Which piece of patient information is most likely to require follow-up nursing interventions?

A) The patient's father died after surgery last year.
B) The patient was exposed to chickenpox 8 weeks ago.
C) The serum hemoglobin level is 13.5 g/dL.
D) The patient's weight is 136 pounds; height is 5 feet 6 inches.

Question 20

The nurse instructs the patient about scheduled surgery involving general anesthesia and about postoperative care.Which should the nurse include in patient teaching?

A) Determine patient preference about pain medication.
B) Avoid eating or drinking anything 2 hours before surgery.
C) Ask for antianxiety medication in the operating room.
D) Follow the rules for beginning to exercise after the incision has healed.

Question 21

After instructing the patient in using the incentive spirometer (IS),the nurse instructs nursing assistive personnel (NAP)to encourage the patient to use it.What does the nurse provide to the NAP as a rationale for using the IS after surgery?

A) It helps to maintains venous return.
B) It helps to reexpand the lungs.
C) It prevents any type of respiratory infection.
D) It decreases the blood pressure.

Question 22

The nurse wants to detect a paralytic ileus promptly in a patient after a total abdominal hysterectomy.Which method is best for the nurse to use to assess for this postoperative complication?

A) Auscultate the bowel sounds every few hours.
B) Palpate the suprapubic region for distention.
C) Evaluate the patient's postoperative appetite.
D) Administer stool softeners for prophylaxis.

Question 23

The patient had shoulder surgery 2 hours ago,and the Hemovac drain is filling at a continuous rate.Which should the nurse do first?

A) Notify the surgeon.
B) Monitor the Hemovac drainage.
C) Irrigate the Hemovac with sterile saline.
D) Attach a larger Hemovac drain.

Question 24

1. Postoperative pain tends to be undertreated in _______ ___________.

Question 25

4. The __________ phase in the care of postoperative patients extends from the time the patient leaves the operating room (OR)to the time of transfer to the nursing unit.

Question 26

The nurse is caring for the patient after general anesthesia.How often does the nurse perform routine patient assessment and documentation in the postanesthesia care unit (PACU)?

A) Every 5 minutes
B) Every 5 to 15 minutes
C) Every 15 to 30 minutes
D) Every 30 minutes to 1 hour

Question 27

The nurse is caring for a shivering 66-year-old patient immediately after back surgery under general anesthesia.Which nursing intervention is most suitable for this patient?

A) Apply warm blankets to stop the shivering.
B) Administer medication to relax the muscles.
C) Use a cooling mat to lower the body temperature.
D) Tell the patient that shivering is to be expected after surgery.

Question 28

At what point in the surgical recovery process does the nurse need to ambulate the hospitalized patient for the first time?

A) At discharge from the postanesthesia care unit (PACU)
B) After discharge to home and before complete recovery
C) Between induction for surgery and arrival in the PACU
D) After discharge from the PACU and before discharge to home

Question 29

The nurse is caring for the patient who has stridor 30 minutes after a thyroidectomy.Which action should the nurse implement?

A) Reposition the patient's head to open the airway.
B) Apply a pressure dressing with gauze.
C) Turn the patient to the recovery position.
D) Apply oxygen at 10 L/min by face mask.

Question 30

3. Maintenance of body temperature in infants and children after surgery is a priority because of their ____________ temperature-control mechanisms.

Question 31

2. Effective methods for helping children share their feelings about surgery are _____ and __________.

Question 32

The patient is coughing up white mucus after having been intubated for surgery.What action would be most appropriate for the nurse to maintain a patent airway?

A) Administer supplemental oxygen.
B) Place the patient in a supine position.
C) Perform oropharyngeal suctioning.
D) Prepare for endotracheal intubation.

Question 33

The nurse assesses the patient on the first postoperative day after major abdominal surgery.Which is the most important patient outcome that requires follow-up interventions by the nurse?

A) The pain level is 2 on a scale of 0 to 10 after an analgesic.
B) The patient is voiding an average of 45 mL/hr.
C) Bowel sounds are inaudible in all quadrants.
D) The patient performs breathing exercises every 6 to 8 hours.