Deck 29: Pre-Operative and Post-Operative Care

Question 1

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.

Answer 1

The patient will ambulate tonight and 3 times tomorrow.

Question 2

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.

Answer 2

Administer a preoperative enema to the patient.

Question 3

A patient will be on bed rest for several days after extensive surgery.Which activity does the nurse teach the patient to prevent complications from decreased perfusion?

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.

Answer 3

Flex and rotate the ankles several times every hour while awake.

Question 4

While being prepared for surgery, the patient tells the nurse about forgetting to take the ordered antibiotics in preparation for the surgery.What action by the nurse is most appropriate?

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

Question 5

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) The patient will perform coughing and deep breathing as directed.
D) The patient will ambulate 4 hours after surgery.

Question 6

The nurse admits a patient for ambulatory surgery.The patient tells the nurse that he or she 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 7

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 8

The nurse admits the patient to the postanesthesia care unit (PACU) after minor hand surgery with minimal 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.

Question 9

The nurse assesses a patient before surgery.Which piece of patient information requires follow-up nursing interventions?

A) The patient's father died during 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 10

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 11

The patient's family has had many experiences with surgical 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 complications rarely occur with surgical procedures today.

Question 12

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

Question 13

A nurse admits a patient to ambulatory surgery.The patient's history includes multiple surgeries over the last 10 years.In addition, when the patient wears antiembolism stockings or has tape on the skin, a rash develops.Which action does the nurse take initially?

A) Use sterile 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 14

The nurse instructs the patient about postoperative coughing and deep-breathing exercises following abdominal surgery.Which technique does the nurse teach the patient to facilitate cooperation?

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) Perform coughing and deep breathing every four hours.

Question 15

The nurse is explaining the purpose and procedure regarding informed consent to a nursing student.What information is 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 any preoperative medication.

Question 16

The nurse instructs the patient about scheduled surgery involving general anesthesia and about postoperative care.Which does the nurse include during this time?

A) Determine patient cultural and religious preferences.
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 17

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

A) "They prevent any chance of blood clots after surgery."
B) "They are required since you will be on bed rest."
C) "They are connected to a pump and improve circulation."
D) "They help improve circulation and reduce the risk of blood clots in your legs."

Question 18

The patient is prepared for shoulder surgery and tells the preoperative nurse that the scar will be invisible after the surgery.Which action does 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 19

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 does the nurse implement first?

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

Question 20

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) Tighten the thighs pushing the knee into the bed 5 times every 1-2 hours.
B) Cough and deep breathe every time you change position.
C) Use your hands to splint your incision because they are cleaner than the pillow is.
D) Reposition in bed every 4 hours.

Question 21

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 0-10 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 6-8 hours.

Question 22

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 23

The patient had shoulder surgery 2 hours ago, and the Hemovac drain is filling at a continuous rate, requiring the nurse to empty it frequently.Which does the nurse do first?

A) Notify the surgeon.
B) Continue to document the output.
C) Irrigate the Hemovac with sterile saline.
D) Attach a larger Hemovac drain.

Question 24

The nurse is caring for a shivering 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) Give the patient antipyretics to reduce the fever.
D) Tell the patient that shivering is to be expected after surgery.

Question 25

The nurse has assessed the Aldrete score on four patients in PACU.Which patient is the most appropriate to transfer to the post-surgical nursing unit?

A) Score 0
B) Score 4
C) Score 8
D) Score 10

Question 26

A patient on the post-surgical nursing unit has rhinorrhea, muscle aching, and profuse sweating.What action by the nurse is most appropriate?

A) Notify the surgeon of the findings.
B) Assess the patient for drug abuse.
C) Administer pain medication.
D) Assess the patient's cardiac history.

Question 27

What does the student nurse learn about age-related differences in surgical patients? (Select all that apply).

A) Perform assessments and procedures guided by a child's developmental level.
B) Dehydration is not as likely to occur in children due to lower fluid volume.
C) Temperature management is a priority in children due to immature thermoregulation
D) The older patient may need more time to learn information and practice skills.
E) The older adult's liver and kidney function does not influence drug action.

Question 28

The patient in the PACU 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 29

The student nurse has learned about complications from general anesthesia.Which of the following are included? (Select all that apply.)

A) Hypotension
B) Dysrhythmias
C) Hallucinations
D) Increased intraocular pressure
E) Edema of the face and throat

Question 30

The nurse is caring for the patient who is vomiting after arriving in the PACU.Which action does the nurse implement first?

A) Reposition the patient on the side.
B) Give the ordered antiemetic.
C) Prepare to insert a nasogastric (NG) tube.
D) Apply oxygen at 10 L/min by face mask.

Question 31

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 prevent atelectasis and pneumonia.
C) It prevents any type of respiratory infection.
D) It strengthens the lungs for recovery.

Question 32

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 5-15 minutes
C) Every 15-30 minutes
D) Every 30 minutes to 1 hour