Deck 20: Nursing Management Preoperative Care

Question 1

The nurse is preparing a client the morning of surgery and the client refuses to remove a wedding ring, saying, "I have never taken it off since the day I was married." Which of the following actions should the nurse implement?

A)Have the client sign a release and leave the ring on.
B)Tape the wedding ring securely to the client's finger.
C)Tell the client that the hospital is not liable for loss of the ring.
D)Suggest that the client give the ring to a family member to keep.

Answer 1

Tape the wedding ring securely to the client's finger.

Question 2

The nurse is preparing a client for abdominal surgery who takes a diuretic and a ?-blocker pill to control blood pressure. Which of the following client information is most important for the nurse to communicate to the health care provider before surgery?

A)Pulse rate 59 beats/minute
B)Hematocrit 35%
C)Blood pressure 142/78 mm Hg
D)Serum potassium 3.3 mmol/L

Answer 2

Serum potassium 3.3 mmol/L

Question 3

The nurse is completing a preoperative assessment of a client scheduled for a colon resection and the client tells the nurse about using St. John's wort to prevent depression. Which of the following information should the nurse alert the staff in the postanaesthesia recovery area about?

A)Increased pain
B)Hypertensive episodes
C)Increased postanaesthesia waking time

Answer 3

Increased postanaesthesia waking time

Question 4

Which of the following topics is most important for the nurse to discuss preoperatively with a client who is scheduled for a colon resection?

A)Care for the surgical incision
B)Medications used during surgery
C)Deep-breathing and coughing techniques
D)Oral antibiotic therapy after discharge home

Question 5

The nurse is admitting a female client for an outpatient surgery procedure. Which of the following information is most important to report to the anaesthesiologist before surgery?

A)The client's lack of knowledge about postoperative pain control measures
B)The client's statement that her last menstrual period was 8 weeks previously
C)The client's history of a postoperative infection following a prior cholecystectomy
D)The client's concern that she will be unable to care for her children postoperatively

Question 6

According to the ASA Physical Status Classification System, which of the following assessments is consistent with a rating of ASA III?

A)Chronic asthma, controlled with an inhaler and corticosteroids
B)Poorly controlled asthma and is wheezing
C)Is in status asthmaticus and on a ventilator
D)Has no significant health problems

Question 7

The nurse is caring for a client with diabetes who is scheduled for a mastectomy at 1:00 PM today and it is now 8:30 AM. The client uses insulin to control blood glucose and has been NPO since midnight. Which of the following actions should the nurse take?

A)Withhold the usual scheduled insulin dose because the client is NPO.
B)Obtain a blood glucose measurement before any insulin administration.
C)Administer the usual insulin dose because stress will increase the blood glucose.
D)Administer a lower dose of insulin because there will be no oral intake before surgery.

Question 8

Ten minutes after the nurse administered the ordered preoperative opioid byintravenous (IV) injection, the client asks to get up to go to the bathroom to urinate. Which of the following actions is best for the nurse to implement?

A)Assist the client to the bathroom and ensure a call bell is within reach.
B)Offer a urinal or bedpan and position the client in bed to promote voiding.
C)Allow the client up to the bathroom because the onset of the medication takes more than 10 minutes.
D)Ask the client to wait because catheterization is performed at the beginning of the surgical procedure.

Question 9

The nurse is preparing a client for surgery. Which of the following information about medication use is most important for the nurse to communicate to the health care provider?

A)The client uses acetaminophen occasionally for aches and pains.
B)The client takes garlic capsules daily but did not take any on the surgical day.
C)The client has a history of cocaine use but quit using the drug over 10 years ago.
D)The client took a sedative medication the previous night to assist in falling asleep.

Question 10

Before the administration of preoperative medications, the nurse is preparing to witness the client signing the operative consent form when the client says, "I do not really understand what the doctor said." Which of the following actions is best for thenurseto take?

A)Provide an explanation of the planned surgical procedure.
B)Notify the surgeon that the informed-consent process is not complete.
C)Administer the prescribed preoperative antibiotics and withhold any ordered sedative medications.
D)Notify the operating room staff that the surgeon needs to give a more complete explanation of the procedure.

Question 11

Aclient who is scheduled for surgery in a week tells the nurse doing the preoperative assessment about an allergy to bananas, kiwifruit, and latex products. Which of the following actions is most important for the nurse to take?

A)Notify the dietitian about the food allergies.
B)Alert the surgery centre about the latex allergy.
C)Reassure the client that all allergies are noted on the medical record.
D)Ask whether the client uses antihistamines to reduce allergic reactions.

Question 12

On the day of surgery, the nurse is admitting a client with a history of cigarette smoking. Which of the following actions is most important at this time?

A)Auscultate for adventitious breath sounds.
B)Ask whether the client has smoked recently.
C)Remind the client about harmful effects of smoking.
D)Calculate the cigarette smoking history in pack-years.

Question 13

The nurse is preparing to administer atropine to a client before surgery. Which of the following symptoms should the nurse teach the client to expect?

A)Dizziness
B)Weakness
C)Dry mouth
D)Forgetfulness

Question 14

The nurse is providing preoperative teaching to an older-adult client who has poor hearing and vision. The partner answers most questions directed to the client. Which of the following actions should the nurse take when implementing client teaching?

A)Use printed materials for instruction so that the client will have more time to review the material.
B)Direct the teaching toward the partner as the client's support person and caregiver.
C)Provide additional time for the client to understand preoperative instructions and carry out procedures.
D)Ask the partner to wait in the hall in order to focus preoperative teaching with the client.

Question 15

Aclient is seen at the health care provider's office several weeks before hip surgery for preoperative assessment. The client reports use of Echinacea, ginseng, glucosamine, and chondroitin. Which of the following actions should the nurse take?

A)Ascertain that there will be no interactions with anaesthetic agents.
B)Discuss the supplement use with the client's health care provider.
C)Teach the client that these products may be continued preoperatively.
D)Advise the client to stop the use of all herbs and supplements at this time.

Question 16

The nurse is obtaining the health history for a client who is scheduled for outpatient knee surgery. Which of the following statements by the client is most important for the nurse to report to the health care provider?

A)"I had a heart valve replacement last year."
B)"I had bacterial pneumonia 6 months ago."
C)"I have knee pain whenever I walk or jog."
D)"I have a strong family history of breast cancer."

Question 17

The clinic nurse is reviewing the complete blood cell count (CBC) results for a client who is scheduled for surgery in a few days. The results are white blood cell count (WBC)
10)2*10^9/L; hemoglobin 150 g/L; hematocrit 45%; platelets 150*10^9/L. Which of the
Following actions should the nurse take?

A)Send the CBC results to the surgery facility.
B)Call the surgeon and anaesthesiologist immediately.
C)Ask the client about any symptoms of a recent infection.
D)Discuss the possibility of blood transfusion with the client.

Question 18

The nurse is interviewing a client who is to have outpatient surgery using a general anaesthetic. Which of the following information is most important to communicate to the surgeon and anaesthesiologist before surgery?

A)The client drinks three or four cups of coffee every morning before going to work.
B)The client takes a baby Aspirin daily but stopped taking aspirin 2 weeks ago.
C)The client drank 120 mL of apple juice 3 hours before coming to the hospital.
D)The client's father died after receiving general anaesthesia for abdominal surgery.

Question 19

Aclient arrives at the ambulatory surgery centre for a scheduled outpatient surgery. Which of the following information is of most concern to the nurse?

A)The client has not had outpatient surgery before.
B)The client is planning to drive home after surgery.
C)The client's insurance does not cover the scheduled procedure.
D)The client had a glass of water a few hours before arriving.

Question 20

The nurse is conducting a preoperative interview with a client who is scheduled for an elective hysterectomy and the client tells the nurse, "I am afraid that I will die in surgery like my mother did!" Which of the following responses by the nurse is most appropriate?

A)"Tell me more about what happened to your mother."
B)"You will receive medications to reduce your anxiety."
C)"You should talk to the doctor again about the surgery."
D)"Surgical techniques have improved a lot in recent years."

Question 21

The nurse is providing preoperative teaching to a client who is scheduled for surgery in 3 days. Which of the following information should the nurse include when addressing preoperative sensory information? (Select all that apply.)

A)Warming blankets are available as the operating room is often cold.
B)Lighting in the operating room is low that may cause the client to have blurred vision.
C)The operating room bed is narrow and a safety strap is used to secure the client to the bed.
D)Not to be alarmed by the quiet environment as there is no conversation in the operating room.
E)Machines may be making "ticking and pinging noises" that can be heard.

Question 22

The nurse is analyzing a client's preoperative blood studies. Which of the following blood studies should the nurse review to assess for anemia and infection in a client with no known health problems? (Select all that apply.)

A)Red blood cell count
B)White blood cell count
C)Serum potassium
D)Hematocrit
E)Prothrombin (INR) time