Deck 17: Preoperative Nursing

Question 1

The nurse takes an informed consent document to the patient's room in preparation for an emergency surgical procedure. The patient states, "Doc said he would tell me all about the surgery when he gets here. Do you know what they are going to do?" What is the nurse's best response?

A) "Let's wait on signing this until your physician has talked to you."
B) "Let me go get a medical surgical textbook so I can use the pictures to explain the procedure."
C) "I am not certain; let me call the nursing supervisor to explain it to you."
D) "Go ahead and sign this so we will have that part done when the physician gets here."

Answer 1

"Let's wait on signing this until your physician has talked to you."

Question 2

After administering a preoperative sedative, the nurse notes that the surgical consent form has not been signed by the patient. What is the nurse's priority intervention?

A) Contact the surgeon.
B) Ask the patient to sign the consent form.
C) Send the patient for surgery with an unsigned consent form.
D) Phone the operating room suite to notify the nurse that the patient has not signed the consent form.

Answer 2

Contact the surgeon.

Question 3

A chart review reveals that a patient being prepared for surgery has been diagnosed with dehydration. Which laboratory results would the nurse review to evaluate the effect of treatment of this condition?

A) Hemoglobin and hematocrit
B) Glucose
C) White blood cell count
D) Platelet count

Answer 3

Hemoglobin and hematocrit

Question 4

The nurse is preparing a preoperative plan of care for an older Hispanic patient who is scheduled for a hysterectomy. What does the nurse recognize as the priority initial intervention?

A) Teach the patient about turning, coughing, and deep breathing.
B) Discuss the patient's concerns about the surgery.
C) Explain that the patient's pain will be controlled during the postoperative time frame.
D) Determine if the patient understands English or if an interpreter is needed.

Question 5

Which information would the nurse manager tell a newly licensed nurse to collect as part of the preoperative assessment?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Patient history
B) Current health problem
C) Discharge plans
D) Current medications
E) Past surgical history

Question 6

A patient who is being admitted for surgery asks the nurse why information is being collected about the patient's use of herbal and natural supplements. Which statement is an appropriate nursing response?

A) "Herbal supplements may interact with medications given during or after surgery."
B) "We would like to continue these medications postoperatively."
C) "The physician is in charge of medications."
D) "There is no need to take these preparations."

Question 7

The patient who is preparing for surgery asks the nurse to keep his glasses in place until he is under anesthesia. Which statement by the nurse demonstrates accurate, therapeutic communication?

A) "I will contact the surgery department to discuss your requests."
B) "You cannot keep your glasses on."
C) "The policies in the surgery unit will not allow it."
D) "Certainly, you can keep them for that time."

Question 8

Prior to surgery, the nurse instructed the patient on exercises that should be done prior to and after surgery. The patient is currently recovering from surgery and is experiencing a deep vein thrombosis. Which preoperative exercise instruction was not adequate for this patient?

A) Leg exercises
B) Deep breathing and coughing
C) Use of incentive spirometry
D) Splinting when coughing

Question 9

A patient is receiving preoperative instructions from the nurse. The patient has chronic pain and has been taking aspirin on a routine basis. The nurse knows which potential postoperative complication could occur?

A) Blood clots
B) Pneumonia
C) Poor wound healing
D) Bleeding

Question 10

During preoperative assessment, the patient says, "My surgery must be minor because it's being done on an outpatient basis." How should the nurse respond?

A) "Every surgical procedure is serious, and I will make sure you have the information you need for a successful recovery."
B) "You are right."
C) "If it were more serious, you would be admitted to the hospital."
D) "Your insurance plan does not cover inpatient surgical procedures. That's why your surgery is being done on an outpatient basis."

Question 11

Place the steps of deep breathing in the order the nurse should teach the elderly preoperative patient.
Standard Text: Click and drag the options below to move them up or down.

A) Breathe out normally.
B) Breathe in deeply through your nose.
C) Hold your breath to a count of three.
D) Slowly exhale.
E) Take five to ten deep breaths every hour.

Question 12

Which patient information is essential for the nurse to provide the physician who is preparing to administer conscious sedation to a patient?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) The patient has a history of snoring.
B) The patient drank a cup of coffee 2 hours ago.
C) The patient wants to be asleep for the procedure.
D) The patient's father was hypertensive.
E) The patient has a history of gout.

Question 13

A 28-year-old female patient has the following preoperative assessment: type 1 diabetes; no other significant health or family history; no recent surgeries; no use of alcohol, tobacco products, or illegal drugs; medications include insulin and aspirin. The nurse can anticipate which tests to be performed preoperatively?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Urine pregnancy test
B) Serum glucose
C) Chest X-ray
D) ECG
E) Hemoglobin and hematocrit

Question 14

The nurse completes a preoperative assessment of a patient who uses a continuous positive airway pressure (CPAP) machine every night. What should be the nurse's next action?

A) Contact the primary care health care provider to verify the patient's use of CPAP.
B) Explain to the patient that CPAPs are not allowed in the hospital setting.
C) Discuss the patient's surgery with the family.
D) Contact anesthesia to notify of the CPAP usage.

Question 15

The nurse is providing preoperative teaching for a patient who will be having a coronary artery bypass graft (CABG). What is a priority nursing intervention for this patient?

A) Ensure the patient and family understand the various tubes that the patient will have in place.
B) Teach the patient about an incentive spirometer.
C) Discuss the location of the bed controls in the intensive care unit.
D) Teach the patient to request pain medication when the pain is unbearable.

Question 16

For which patient is the nurse most likely to request an order for a preoperative chest X-ray?

A) A 22-year-old with Down syndrome
B) A 50-year-old with a history of gallbladder disease
C) A 16-year-old with a history of abdominal pain
D) A 55-year-old current smoker with a recent productive cough

Question 17

The nurse is completing a preoperative assessment on a patient. Which reason would the nurse prioritize as the most important for this assessment?

A) The data provide information and guidance for preoperative and postoperative instruction.
B) The assessment data can be used to help plan for a future residential care institution.
C) The data provide information for the health care provider's history and physical.
D) The potential risks are identified for the family to comfort them in case there is a bad outcome from surgery.

Question 18

An elderly patient is being prepared for orthopedic surgery. The nurse realizes this patient is at risk for which complication?

A) Decreased tolerance of general anesthesia
B) Prolonged effects of anesthesia because of herbal supplements
C) Wound dehiscence
D) Increased hypotensive effects of anesthesia

Question 19

Which preoperative finding should the nurse report immediately to the rest of the health care team?

A) No prior patient history or family history of malignant hyperthermia
B) Patient's age greater than 70
C) Heart rate of 88 beats per minute
D) Latex allergy

Question 20

A patient is receiving preoperative teaching. Which information should the nurse provide?

A) Teaching regarding the call lights and bed controls for the medical-surgical unit
B) Teaching regarding pain control in the postanesthesia recovery room (PACU)
C) Teaching regarding patient medications upon discharge
D) Teaching regarding the type of IV pump the patient will have after discharge to home health

Question 21

A patient has postponed an elective surgical procedure. The nurse would advise the patient that a new preoperative health assessment will be necessary if the original assessment document is over _____ days old.

Question 22

According to the medical record a patient is classified as an ASA I. The nurse assessing this patient would plan care for which situation?

A) A patient with severe chronic illness
B) A normally healthy patient
C) A patient with a mild underlying illness
D) A patient whose organs are being harvested for transplant

Question 23

A patient asks the nurse about the possibility of donating blood for his upcoming surgery. Which information should the nurse provide?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "You must have approval from your surgeon."
B) "You must have a hemoglobin level of at least 14 g/dL to donate blood to yourself."
C) "As long as you are still in good health, this plan can be considered."
D) "Because you have an intermittent fever, this donation is not possible."
E) "This is a type of directed donation that is not recommended."

Question 24

A 45-year-old woman is scheduled for an abdominal hysterectomy. She is a nonsmoker and has been taking opioid medications for pain control. She has a history of asthma and hypertension and is 20 pounds overweight. Which assessment data would the nurse evaluate as indicating increased risk for postoperative nausea and vomiting?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) She is middle-aged.
B) The scheduled surgery is gynecologic.
C) The patient has been taking opioid medications.
D) The patient is overweight.
E) The patient is female.

Question 25

The nurse wonders if a patient's outcome would be better if the patient stopped smoking 3 weeks or 2 months before surgery. This is an example of which concept?

A) A question to ask the patient
B) The nurse's ability to think critically
C) A question to ask the health care provider
D) A potential nursing research question

Question 26

A patient who is having outpatient gallbladder surgery states he will have a ride to the hospital for the surgery, but not a ride home, and he does not have anyone to be with him at home. Which nursing response is most appropriate at this time?

A) "The health care provider will refuse to do the surgery on a patient who must go home alone."
B) "Would it be better to reschedule your surgery until a day when you have someone who can take you home?"
C) "I am sorry; you will not be able to have your surgery then."
D) "No problem, you can drive yourself home after the surgery."

Question 27

Research allows nurses to validate and enhance nursing care. Which research would be most relevant to promoting nursing care and outcomes for the preoperative patient?

A) How does the interaction of the patient with the health care provider impact the patient's long-term recovery?
B) What is the optimal timing for preoperative teaching?
C) How much pain medicine does the patient prefer?
D) When should the patient be discharged?

Question 28

A patient who has a permanent pacemaker must have surgery to repair a bowel obstruction. Which information should the nurse provide this patient?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "Because the surgical area is in your abdomen, the fact that you have a pacemaker is not important."
B) "Some changes in medication given during the surgery will be necessary."
C) "Your surgeon will need information about the type of pacemaker."
D) "Your pacemaker will have to be turned off before surgery."
E) "Cardiac monitoring during surgery will be different because you have a pacemaker."