Deck 36: Preoperativepostoperative Care

Question 1

The nurse is providing the patient with preoperative education.When the nurse informs the patient that she will not be able to wear makeup,the patient states,"But I never go anywhere without my makeup." What should be the nurse's response?

A) She will speak with the surgeon and see if he will make an exception
B) The patient may wear makeup if she insists
C) Makeup makes it difficult for the surgeon to assess the patient
D) Makeup impedes circulation

Answer 1

Makeup makes it difficult for the surgeon to assess the patient

Question 2

Which assessment indicates that a patient meets the criteria for ambulatory surgery discharge?

A) The patient is able to drive home alone
B) Some respiratory depression is evident
C) The oxygen saturation level is at 85%
D) No intravenous (IV) narcotics have been given in the last 30 minutes

Answer 2

No intravenous (IV) narcotics have been given in the last 30 minutes

Question 3

Which finding indicates that the nurse should inform the surgeon,and that the surgery may need to be postponed?

A) The patient has a history of smoking
B) The patient is experiencing calf pain, redness, and swelling
C) The patient has an increased hemoglobin level
D) The patient experienced an upper respiratory infection a month ago

Answer 3

The patient is experiencing calf pain, redness, and swelling

Question 4

The goal of prophylactic antibiotic therapy is to protect the patient from infection with as little risk as possible.To achieve this goal,when should antibiotics be administered?

A) 24 hours before surgery
B) For 2 weeks after surgery
C) For no longer than 24 hours after surgery
D) When signs of infection first appear

Question 5

It has been reported that _____% of routine surgical patients develop deep vein thrombosis (DVT).

A) 5 to 10
B) 15 to 40
C) 45 to 60
D) 75 to 80

Question 6

What should the nurse tell the patient when instructing him on the performance of controlled coughing?

A) Repeat the breathing exercises twice
B) Cough two to three times and inhale between coughs
C) Place a pillow over the incisional site for splinting
D) Use the chest and shoulder muscles while inhaling during diaphragmatic breathing

Question 7

The nurse is helping the patient prepare for surgery.The patient has removed her jewelry and glasses.What should the nurse do with these items?

A) Put these items in the patient's bedside stand
B) Inventory the items and give them to the family
C) Place the items in a plastic bag and send them to the OR with the patient
D) Keep these items with her until the patient returns

Question 8

The patient is in the hospital awaiting surgery.When asked to remove her jewelry,the patient asks why she needs to remove her navel ring.What explanation should the nurse provide?

A) The navel ring may impede assessment of the skin
B) The ring may decrease circulation
C) She may leave it in place if she chooses
D) The navel ring may cause injury

Question 9

It has been reported that approximately __% of all hospital deaths can be attributed to pulmonary embolus (PE).

A) 5
B) 10
C) 25
D) 50

Question 10

Which of the following statements is true?

A) Informed consent is required by law to protect the surgeon in case of adverse outcome
B) Only the patient can sign a surgical consent
C) The nurse's legal responsibility is to ensure that the patient understands the information presented
D) The surgeon should give the patient information about the surgery

Question 11

What may a patient be given orally during the usual preparation for general surgery?

A) Ice chips
B) Always NPO for 12 to 14 hours prior
C) Allowed to brush teeth and swallow water
D) Specifically ordered oral medications with small amounts of water

Question 12

What is the effect of the presence of hyperglycemia in the immediate postoperative period?

A) Increases the risk for infection in the diabetic patient only
B) Decreases the risk for surgical site infection
C) Increases the risk for infection in diabetic and nondiabetic patients
D) Has no effect on the body's ability to fight infection

Question 13

A nurse determines that a patient is prepared for surgery if that patient:

A) Ate a piece of toast an hour before surgery
B) Voided before receiving the preoperative medication
C) Was unable to demonstrate the postoperative exercises
D) Had pulse and blood pressure measurements that were slightly above the expected readings

Question 14

What should the nurse understand about securing the patient's informed consent before surgery?

A) Consent is required by law to protect the patient's rights
B) The nurse is responsible for providing information about the surgical procedure
C) The nurse must legally provide a signature as a witness indicates that the patient fully understands the procedure
D) Consent is obtained immediately before surgery and after the preoperative medication is given.

Question 15

The patient has been taught how to use diaphragmatic breathing.When the patient returns from surgery,however,he cannot be placed upright and must remain flat.Of what must the nurse be aware?

A) Diaphragmatic breathing cannot be done in this position
B) Alternative breathing exercises need to be found
C) Diaphragmatic breathing exercises still can be performed
D) Diaphragmatic breathing exercises may be postponed

Question 16

The patient is wearing a simple wedding band that he cannot remove.He is scheduled for colon surgery.What should the nurse do before surgery is performed?

A) Get the ring cutter from the emergency department and cut the ring off
B) Call the physician and cancel the surgery
C) Tape the wedding ring in place
D) Call the physician for an order for extra antibiotics

Question 17

How should the nurse proceed when teaching positive expiratory pressure therapy (PEP)and "huff" coughing?

A) Instruct the patient to remain flat in bed
B) Place a nose clip on the patient's nose
C) Instruct the patient to breathe through his nose
D) Instruct the patient to exhale with long slow breaths

Question 18

A patient asks a nurse what may be "left on" during the surgery.The nurse tells the patient that an item that may remain in place is:

A) A hearing aid
B) An artificial limb
C) A pair of eyeglasses
D) A pair of contact lenses

Question 19

Which change in an older adult patient places that individual at greater risk for surgery?

A) Increased tactile sense
B) Decreased glomerular filtration rate
C) Increased number of red blood cells
D) Decreased rigidity of arterial walls

Question 20

Currently,it is estimated that surgical site infections account for what percentage of hospital-acquired infections?

A) 22 to 40
B) 10 to 20
C) 45 to 70
D) 75 to 100

Question 21

How often is assessment of a patient in the PACU or recovery room documented?

A) Every 5 minutes
B) Every 15 minutes
C) Every 30 minutes
D) Hourly

Question 22

A patient is being transferred to a room from the PACU.What should the nurse do upon transfer?

A) Remove the indwelling urinary catheter
B) Turn off the nasogastric tube suction
C) Use a black pen to note the drainage on the dressing
D) Change the dressing immediately when the patient reaches the room

Question 23

What should the nurse tell the patient when instructing her about postoperative exercises?

A) Turn every 4 hours
B) Complete leg exercises once daily
C) Repeat individual leg exercises 20 times
D) Perform exercises with the unaffected extremities

Question 24

How should a patient who has received spinal anesthesia be positioned?

A) Prone
B) Lying on the side
C) Supine, with the head flat
D) In Trendelenburg's position

Question 25

Being overweight or obese increases the risk for many diseases and health conditions,including which of the following? (Select all that apply.)

A) Hypertension
B) Coronary heart disease
C) Sleep apnea
D) Respiratory problems
E) None of above

Question 26

The first phase of postoperative care takes place during the ____________period.

Question 27

Preoperative medications are ordered to do which of the following? (Select all that apply.)

A) Reduce pain
B) Reduce anxiety
C) Increase respiratory secretions
D) Decrease level of relaxation

Question 28

Which of the following have been identified as evidence-based guidelines to reduce surgical site infections (SSIs)? (Select all that apply.)

A) Prepping the surgical site with a razor followed by an antiseptic scrub
B) Giving antibiotics immediately after the procedure
C) Maintaining blood glucose levels
D) Maintaining normal body temperatures

Question 29

When assessing a postoperative patient,a nurse notes tenderness,redness,and swelling in the left calf.What should the nurse do next?

A) Massage the lower leg
B) Prepare for heparin therapy
C) Keep the leg in a dependent position
D) Have the patient exercise that extremity

Question 30

Paralytic ileus is a possible postoperative complication.How does the nurse assess for this?

A) Auscultates for bowel sounds every 4 hours
B) Checks blood pressure while sitting and standing
C) Observes the patient's performance of leg exercises
D) Palpates the suprapubic region for distention

Question 31

Preoperative antibiotics may be ordered prophylactically but are given within ______________ minutes of incision.

Question 32

The postanesthesia care unit (PACU)nurse has received a patient from the operating room.Upon assessment,the nurse notes drainage seeping through the dressing.What should she do? (Select all that apply.)

A) Call the operating for surgical backup
B) Mark the dressing using a black pen
C) Check the dressing every shift
D) Check the dressing every 10 to 15 minutes

Question 33

Upon entering a patient's room,the nurse finds that the abdominal surgical wound has eviscerated.What should the nurse do?

A) Cover the site with dry sterile dressings
B) Report the incident to the oncoming shift
C) Attempt to replace the organs
D) Cover the site with saline-soaked sterile gauze

Question 34

How should the nurse position the patient recovering in the postanesthesia care unit (PACU)when he is restricted to the supine position?

A) Keep the bed flat during recovery
B) Position the patient's hands over his chest
C) Flex the neck and turn the head to the side
D) Extend the neck and turn the head to the side

Question 35

How should the nurse position the postsurgical patient who has not received spinal anesthesia to maintain a patent airway in the recovery phase?

A) On his side with head facing down and neck slightly extended
B) On his side with head facing down and neck slightly flexed
C) On his back with hands over his chest
D) On his side with head facing up and neck slightly extended

Question 36

The nurse is assisting the patient with diaphragmatic breathing exercises.Which of the following is part of the proper technique? (Select all that apply.)

A) Have patient inhale slowly
B) Have patient inhale through his mouth
C) Have patient inhale through his nose
D) Have patient use chest and shoulder muscles

Question 37

Therapies and regimens designed to prevent venous thromboembolism (VTE)include which of the following? (Select all that apply.)

A) Pneumatic compression stockings
B) Venous foot pump
C) Low-molecular-weight heparin
D) Fondaparinux
E) None of above

Question 38

The nurse explains to the patient that the incentive spirometer is used to prevent:

A) Lung collapse
B) Blood clotting
C) Stomach and intestinal problems
D) Hemorrhage

Question 39

The second phase of recovery for inpatients is the period of time that extends from the time the patient is discharged from the recovery room or postanesthesia care unit (PACU)to the time the patient is discharged from the hospital; this is known as the__________________ period.

Question 40

The term _____________ is now used because it incorporates both DVT and PE.