Deck 33: Care of the Surgical Patient

Question 1

After sending a client to have a bowel resection, a nurse prepares the room for the client's return.Which of the following preparations should be included?

A)Placing the bed in the lowest position
B)Placing a lift sheet on the bed
C)Placing tables at the bedside
D)Putting the bed in high Fowler position

Answer 1

Placing a lift sheet on the bed

Question 2

A nurse is providing preoperative teaching to the client.During this teaching the nurse notes that the client should be sure to cough, breathe deeply, and turn from side to side every few hours.The nurse provides this teaching to help prevent which of the following? Select all that apply.

A)Hypoventilation
B)Deep vein thrombosis
C)Atelectasis
D)Pneumonia
E)Postoperative pain

Answer 2

Hypoventilation
Atelectasis
Pneumonia

Question 3

A nurse recognizes that which of the following clients may receive spinal anesthesia?

A)A 45-year-old scheduled for a pulmonary wedge resection
B)A 29-year-old scheduled for repair of a torn rotator cuff
C)A 48-year-old scheduled for a hemorrhoidectomy
D)A 66-year-old scheduled for a bone marrow biopsy

Answer 3

A 48-year-old scheduled for a hemorrhoidectomy

Question 4

Which member of the surgical team is the primary client advocate responsible for ensuring that everything done in the operating room is in the best interest of the client?

A)The surgeon
B)The circulating nurse
C)The first surgical assistant
D)The anesthesiologist

Question 5

A nurse is providing preoperative care to a client with a history of congenital heart disease.Which preoperative medication does the nurse expect will be administered prophylactically?

A)Anticholinergics
B)Antiemetics
C)Anticoagulants
D)Antibiotics

Question 6

A nurse is caring for a female client who is scheduled for an abdominal hysterectomy.The nurse obtains the client's signature on the consent form and then signs the form himself.What does the nurse's signature indicate?

A)The client does not have any questions about the surgery.
B)The nurse has verified that it was the client who signed the form.
C)The client understands the risks of the procedure.
D)The nurse has provided verbal and written information about the surgical procedure.

Question 7

The nurse is preparing a client for a routine colonoscopy.The client asks if the procedure will be painful.Which response by the nurse is accurate?

A)You will be under general anesthesia, so you won't feel a thing.
B)It will be painless because we'll block sensory perception to a very small area of tissue.
C)The health-care provider will inject a local anesthetic numbing agent, so it won't hurt.
D)You will have conscious sedation during the procedure, so it will be like you're sleeping.

Question 8

Which are the nurse's immediate priorities when a client enters the postanesthesia care unit (PACU)? Select all that apply.

A)Apply a pulse oximeter.
B)Apply an electrocardiogram (EKG)monitor.
C)Apply a blood pressure monitor.
D)Observe client outputs.
E)Observe client respiration rate.

Question 9

A nurse is caring for a 30-year-old man who returned from the repair of a broken jaw 3 hours earlier.The client reports an urge to urinate and tried to use the urinal in the bed without success.The nurse assesses the client and notes the bladder is distended.Which actions should nurse to take? Select all that apply.

A)Call to obtain an order to catheterize the client.
B)Help the client stand to urinate.
C)Run water to encourage voiding.
D)Help the client to the bathroom.
E)Notify the surgeon immediately.

Question 10

Which of the following clients would likely receive preoperative anticholinergics? Select all that apply.

A)A 4-year-old client having tubes placed in his or her ears
B)A 30-year-old client who has type I diabetes
C)A 60-year-old client with Parkinson's disease
D)A 70-year-old client who previously had a stroke
E)A 6-year-old client having his or her tonsils removed

Question 11

Who is responsible for completing the preoperative checklist? Select all that apply.

A)Nursing unit nurse
B)Registered nurse first assistant
C)Circulating nurse
D)Anesthesia provider
E)Scrub nurse

Question 12

Which of the following procedures involves removal of something? Select all that apply.

A)Tonsillectomy
B)Craniotomy
C)Hysterectomy
D)Tracheotomy
E)Colostomy

Question 13

Which of the following would be classified as elective surgeries? Select all that apply.

A)A tonsillectomy for a 10-year-old with a history of frequent pharyngitis
B)An appendectomy for a 12-year-old with acute appendicitis
C)A colectomy with colostomy for an 18-year-old with Crohn disease
D)A mastectomy for a 56-year-old with recently diagnosed breast cancer
E)A total hip replacement for an 87-year-old with a fractured femur

Question 14

A nurse is providing care to a 32-year-old who returned from a thyroidectomy 6 hours ago.The nurse notes that the client's temperature is 99.5°F and that the client has been taking sips of clear liquids.The client reports mild nausea and is using client-controlled anesthesia to manage pain, which the client rates as a 3 out of 10.Which action should the nurse take?

A)Order a low-salt diet.
B)Document the findings.
C)Contact the physician.
D)Assess the back of the client's throat.

Question 15

During standard preoperative testing, a nurse notices that a client's urine has an elevated specific gravity.This finding is an indication that this client is at risk for which of the following?

A)Dehydration
B)Anemia
C)Ischemia
D)Impaired renal function

Question 16

A nurse is caring for a client who received spinal anesthesia.The client reports having a bad headache later that day.Which is the best response from the nurse?

A)You may have an allergy to the anesthetic used.
B)You might have lost some spinal fluid during anesthesia.
C)I am going to contact the health-care provider immediately.
D)This sounds like a migraine.I'm going to request some pain reliever for you.

Question 17

The nurse is providing postoperative care to a client with a large wound.The nurse removes the dressing and notes that the wound has dehisced.Which actions should the nurse take? Select all that apply.

A)Cover the wound with a large sterile dressing.
B)Pour sterile saline into the wound bed.
C)Notify the surgeon immediately.
D)Ask the client, "Did you feel anything pop open?"
E)Reassess the wound in 1 hour.

Question 18

Before placing antiembolism stockings on a client for the first time, a nurse should do which of the following?

A)Obtain baseline vital signs.
B)Have the client lie supine for 15 minutes.
C)Ask the client to sit at the side of the bed.
D)Instruct the client to apply lotion to his or her legs.

Question 19

The nurse is providing preoperative teaching to a client and the client's family.Which statements made by the nurse are accurate regarding preoperative teaching? Select all that apply.

A)If you all know what to expect, you'll all be able to support optimal healing.
B)Having a thorough understanding of the procedure is conducive to the shortest recovery period.
C)This will help eliminate postoperative complications.
D)My goal is to help you feel more comfortable and calm any anxiety you might have.
E)I'll go over just a few details, since you probably already know the basics of this procedure.

Question 20

A nurse is caring for a client who returned from abdominal surgery 6 hours ago.The nurse notes that the abdominal dressing is nearly saturated with serosanguineous drainage and that a small amount of drainage is leaking from the lower edge of the dressing.Which action should the nurse take first?

A)Reinforce the dressing with additional gauze pads.
B)Remove the surgical dressing to assess the site directly.
C)Replace the surgical dressing with fresh dressings.
D)Reinforce the tape edges of the dressing.

Question 21

Which of the following statements is made by the nurse in preoperative teaching to help prevent postsurgical blood clot formation?

A)You should turn, cough, and breathe deeply.
B)It's important to move your ankles in circles with toes extended.
C)You will wear postsurgical compression stockings.
D)I will measure your input and output carefully.
E)You should alternate ankle flexion and extension for a total of 10 times each.

Question 22

A nurse would include which of the following questions in a presurgical assessment? Select all that apply.

A)"What did you eat today?"
B)"Is there a possibility you may be pregnant?"
C)"Are you taking any medications at this time?"
D)"Do you smoke or use tobacco in any form?"
E)"What surgery is planned? Why are you having surgery?"

Question 23

The plan of care for a client at risk for cardiac complications during the immediate postoperative period would include which of the following? Select all that apply.

A)Monitoring the client's heart rate continuously
B)Administering intravenous fluids as ordered
C)Assessing the client's skin color and capillary refill frequently
D)Assessing the client's peripheral pulses bilaterally
E)Evaluating for bowel sounds hourly

Question 24

While caring for a client in the surgical center, which of the following preoperative laboratory values would a nurse expect to be included in the orders? Select all that apply.

A)White blood cell (WBC)count
B)Hemoglobin (Hgb)
C)Alkaline phosphatase (Alk Phos)
D)Platelet count (PLT)
E)Urinalysis (UA)