Deck 4: Nursing Care of Patients Having Surgery

Question 1

The nurse is planning care to support the cognitive-psychosocial status for an older patient having surgery. Which intervention would be appropriate for this patient?

A) Provide time for teaching and learning.
B) Set limits with the patient.
C) Tell the patient that his physician will make all care decisions.
D) Remind the patient that the call bell is for emergencies only.

Answer 1

Provide time for teaching and learning.

Question 2

An older patient is recovering from a surgical procedure. What should the nurse do to ensure the patient is comfortable?

A) Provide warm blankets.
B) Limit movement to once every eight hours.
C) Explain all activities using a loud voice.
D) Limit fluids.

Answer 2

Provide warm blankets.

Question 3

The nurse is caring for a patient recovering from surgery conducted in the previous 24 hours. What should the nurse do to assist this patient with pain control?

A) Administer prescribed analgesics around the clock.
B) Administer prescribed analgesics when the patient requests something for pain.
C) Assist the patient to a more comfortable position to reduce the amount of pain.
D) Offer the patient a back rub to reduce the amount of pain.

Answer 3

Administer prescribed analgesics around the clock.

Question 4

A patient diagnosed with emphysema is being prepared for surgery. What laboratory value should the nurse review to obtain information about the patient's respiratory status?

A) carbon dioxide
B) white blood cell count
C) serum creatinine
D) blood urea nitrogen

Question 5

The nurse in the same-day surgical care area is preparing a patient for surgery. What should the nurse do to ensure that this patient has a successful recovery from the surgery?

A) Provide teaching and additional resources to help the patient when at home.
B) Measure intake and output.
C) Assess vital signs.
D) Limit pain control measures since the patient will need to ambulate when leaving after the surgery.

Question 6

A patient received lorazepam (Ativan) as preoperative medication. What should the nurse assess when caring for this patient?

A) respiratory depression
B) nausea and vomiting
C) confusion
D) rash

Question 7

The nurse is preparing to discharge a patient after having outpatient surgery. Which criteria should the nurse use to determine whether the patient is eligible to be discharged?

A) stable vital signs
B) no nausea or dizziness
C) pain controlled
D) adequate urine output
E) patient's expressed readiness to go home

Question 8

After providing a patient with a preoperative sedative, the nurse notes that the surgical consent form has not been signed by the patient. What should the nurse do?

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.

Question 9

The nurse is providing care to a patient during the preoperative phase of surgery. Which of the following interventions would be appropriate for the nurse to provide during this time?

A) assisting with bathing
B) patient safety
C) assessing level of consciousness
D) monitoring intake and output

Question 10

A patient being prepared for surgery has been diagnosed with dehydration. Which laboratory values support the diagnosis for this patient?

A) hemoglobin and hematocrit
B) glucose
C) white blood cell count
D) platelet count

Question 11

A patient was instructed on exercises to perform as part of preoperative teaching. While recovering from surgery, the patient experiences a deep vein thrombosis (DVT). Which preoperative exercise should the nurse identify as not having been effective for this patient?

A) leg exercises
B) deep breathing and coughing
C) use of incentive spirometry
D) splinting when coughing

Question 12

When caring for an older patient having surgery, the nurse avoids shaving the patient. Which body system is the nurse supporting by using this intervention?

A) integumentary
B) sensory-perceptual
C) respiratory
D) cardiovascular

Question 13

A patient is scheduled for total hip replacement surgery. What medication should the nurse provide to the patient prior to the surgical procedure?

A) antibiotic
B) antacid
C) antiemetic
D) anticholinergic

Question 14

An older adult patient being prepared for surgery is scheduled for an electrocardiogram. What should the nurse explain to the patient regarding the purpose of this test?

A) It is routine for all patients having general anesthesia.
B) It is used to diagnose preexisting cardiac disease.
C) It is one way to validate laboratory values
D) It is a predictor of surgical procedure success.

Question 15

A patient tells the nurse that he must be having minor surgery since it will be done as an outpatient. How should the nurse respond to this patient?

A) "Every surgical procedure is serious, and I will make sure you have information to have 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 as an outpatient."

Question 16

A patient scheduled for outpatient surgery asks the nurse why he will not be admitted to the hospital for the surgery. What should the nurse explain as an advantage of having outpatient surgery?

A) reduced risk of healthcare-associated infections
B) ability to use home care for postoperative care in the home
C) reduced use of postoperative medications
D) inadequate staffing on the surgical care areas

Question 17

The nurse is assessing a patient who has returned to the care area after surgery. What should the nurse do to ensure the patient receives appropriate care?

A) Check the physician's orders to see if preoperative orders have been reordered.
B) Schedule the patient for vital signs assessments every four hours.
C) Orient the patient to person, place, and time.
D) Assess the patient's mental status.

Question 18

An older patient, being prepared for surgery, has a low glomerular filtration rate. Which aspect of the patient's care should the nurse realize this finding will impact?

A) medication dosages
B) postoperative activity level
C) intraoperative bleeding
D) oxygenation status

Question 19

An older patient, recovering from surgery, is prescribed a soft diet. The nurse realizes that this diet supports which age-related change?

A) decline in gastric motility
B) reduced intestinal absorption
C) lactose intolerance
D) gall bladder insufficiency

Question 20

A patient with a history of sleep apnea is experiencing difficulty maintaining an airway during conscious sedation. What should the nurse do to assist this patient?

A) Prepare to administer a reversal agent.
B) Begin artificial ventilations.
C) Measure oxygen saturation.
D) Apply prescribed oxygen via face mask.

Question 21

The nurse takes the form identified below to a 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."

Question 22

An older patient is being prepared for orthopedic surgery. For what potential risk should the nurse plan care?

A) decreased tolerance of general anesthesia
B) prolonged effects of anesthesia because of herbal supplements
C) wound dehiscence
D) decreased cognitive acuity

Question 23

A patient is signing a surgical consent. Afterwards, the nurse also signs the form. What is the meaning of the nurse's signature?

A) It means the patient was alert and aware of what was being signed.
B) It means the patient understood the procedure as described by the nurse.
C) It means the surgeon was too busy to wait for the patient to sign the form.
D) It means there is a likelihood of a successful outcome.

Question 24

The patient is scheduled for a perineal surgery. Place an "X" on the position in which the nurse would place this patient for surgery.

Question 25

A patient is being transferred from the operating room to the recovery room. In which phase of the surgical process will the nurse in the recovery room provide care?

A) postoperative
B) preoperative
C) intraoperative
D) restorative

Question 26

A patient who is recovering from abdominal surgery has a Penrose drain. What should the nurse include in the care of this patient?

A) Make sure there is a safety pin on the end of the drain.
B) Empty the drain every 30 minutes.
C) Clean the wound with normal saline every two hours.
D) Remove the drain four hours postoperatively.

Question 27

A patient recovering from surgery reports a pain level of 6 on a 0-10 pain scale but refuses additional pain medication since he does not want to "become addicted." The nurse's response should focus on which concept?

A) Physical dependence on pain medication is uncommon during the short-term postoperative use.
B) This patient already might have an addiction problem.
C) This patient might benefit from a placebo dose.
D) The physician should be notified to discuss pain management.

Question 28

The nurse is assisting a postoperative patient in using an incentive spirometer. Which postoperative complications is this nurse attempting to avoid?

A) atelectasis
B) deep vein thrombosis
C) hemorrhage
D) pulmonary embolism

Question 29

An older patient is receiving an NSAID for postoperative pain. What should the nurse assess in this patient?

A) urine output
B) blood pressure
C) respiratory rate
D) heart rate

Question 30

The patient who is preparing for surgery asks the nurse to keep his glasses and hearing aid in place until he is under anesthesia. Which nursing response demonstrates accurate therapeutic communication?

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

Question 31

An older postoperative patient is given an antiemetic for nausea. Which manifestation indicates to the nurse that this patient is experiencing a possible reaction to the medication?

A) involuntary muscle movements
B) confusion
C) dry mouth
D) breakthrough vomiting

Question 32

After complaining of discomfort from a surgical procedure, the patient voices fear of addiction with taking analgesics as prescribed. What information should be provided to the patient regarding these concerns?

A) "Addiction to opioid analgesics is rare when used for short-term postoperative pain management."
B) "Psychological tolerance is not commonly experienced by patients who take narcotic analgesics during the postoperative experience."
C) "Pain tolerance and the need for opioid analgesics are individualized."
D) "Patients should be screened for addiction potential prior to being given narcotics."
E) "I'll turn the TV on to help distract you from your pain."

Question 33

A patient's postoperative wound has sanguineous drainage with a thick, reddish appearance. The nurse realizes this patient's wound is in which phase of healing?

A) Inflammatory
B) Proliferative
C) Stationary
D) Remodeling

Question 34

A patient says that his condition must be getting worse since he was receiving 10 mg morphine sulfate through the IV for pain but now is prescribed Demerol 50 mg by mouth at home. How should the nurse respond to this patient?

A) "Oral doses need to be higher than those given through an IV. It does not mean your condition is worse."
B) "The doctor is making sure that you do not have any pain once you go home."
C) "I will get the doctor so he can explain what is going on with your condition."
D) "All patients have more pain when they go home so the doctor is making sure you have enough medication."

Question 35

A patient is scheduled for extraction of a cataract. How should the nurse classify this patient's surgical procedure?

A) minor elective
B) minor diagnostic
C) major constructive
D) major elective

Question 36

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. How should the nurse respond to this patient?

A) "Herbal supplements may interact with anesthetic agents."
B) "Herbal remedies may cause pain relievers to be ineffective."
C) "The physician is in charge of medications."
D) "There is no need to take these preparations."

Question 37

During the assessment of a postoperative patient's bowel sounds, the nurse auscultates absent sounds over all four abdominal quadrants. The nurse realizes this finding could indicate what health problem?

A) paralytic ileus
B) normal bowel function
C) the onset of flatus
D) the onset of stool

Question 38

An older patient is completing preoperative diagnostic testing. The nurse notes that the patient's carbon dioxide level is elevated. What should the nurse be monitoring for this patient?

A) Respiratory status and arterial blood gases
B) Serum potassium level
C) Serum sodium level
D) Intake and output

Question 39

The nurse is assigned as the surgical scrub nurse for outpatient cases. Place an "X" on the picture that depicts how the nurse will dress for these cases.

Question 40

An older surgical patient is having an epidural catheter inserted for pain control. What does the nurse realize is an advantage of using this method of pain medication for this patient?

A) improved bowel activity
B) faster wound healing
C) earlier ambulation
D) improved appetite

Question 41

A patient being prepared for surgery has a history of chronic obstructive pulmonary disease. Which diagnostic test should the nurse expect to be completed prior to this patient's surgical procedure?

A) Pulmonary function tests
B) CT scan of the brain
C) Lumbar puncture
D) Abdominal MRI

Question 42

The nurse suspects that a patient recovering from surgery in the postanesthesia recovery unit (PACU) is developing malignant hyperthermia. Place these interventions in the order in which they should be performed.

A) Administer oxygen with a nonrebreather mask.
B) Check IV access.
C) Notify the anesthesia provider.
D) Administer Dantrolene.
E) non of the above.

Question 43

A patient who has reacted poorly to general anesthesia in the past is scheduled for surgery to repair a rotator cuff tear. For which types of anesthesia should the nurse prepare educational materials for this patient?

A) Spinal
B) Topical
C) Epidural
D) Nerve block
E) Local nerve infiltration

Question 44

While completing item number 4 in the preoperative preparation section of the form provided below, the nurse notes that the patient depends on a hearing aid. What action should the nurse take?

A) Leave the device in the patient's ear and notify the OR nurse of its presence.
B) Remove the device and place it in a denture cup in the patient's room.
C) Remove the device and give it to the patient's family member.
D) Place a piece of tape across the patient's ear and the device.

Question 45

While the nurse is assisting a patient recovering from epidural anesthesia to ambulate, the patient becomes dizzy and has a blood pressure of 78/48 mmHg. What actions should the nurse take?

A) Notify the anesthesiologist.
B) Notify the pharmacy to obtain atropine.
C) Continuously monitor blood pressure.
D) Prepare to administer intravenous fluids.
E) Prepare to administer vasoactive medications.

Question 46

The nurse is changing the abdominal surgical dressing of an older patient who has developed pneumonia and a cough. Upon removing the dressing, the nurse notes the situation as pictured below. What should be the nurse's intervention?

A) Place saline moistened sterile dressing over the incision.
B) Notify the patient's surgeon of the occurrence.
C) Don sterile gloves and insert the loop of bowel back into the abdomen.
D) Document the presence of a dehiscence in the medical record.
E) Replace the dressing and ask the oncoming shift to advise the physician about the situation when rounds are made.

Question 47

A older patient recovering from total hip replacement surgery 8 hours ago has not been able to void spontaneously. Which actions should the nurse take to assist this patient?

A) Increase fluids.
B) Turn onto the left side.
C) Palpate the bladder for distention.
D) Insert an indwelling urinary catheter.
E) Complete a bladder scan at the bedside.

Question 48

The patient who had an emergency abdominal surgery looks at his incision on the first postoperative day and says, "I sure hope this doesn't leave much of a scar. Is there some type of medicine or ointment I can put on it?" What should the nurse consider prior to responding to that comment?

A) This incision will heal by primary intention and will probably leave only a hairline scar.
B) This incision will fill in with granulation tissue and leave a moderately big scar despite any medication applied.
C) This incision was done in an emergent fashion but continuous application of steroid creams will prevent scarring.
D) This incision will have to be reclosed later and will leave a large scar unless a topical antibiotic is used continuously.

Question 49

The nurse is changing the surgical dressing on an older patient's abdomen and sees the item pictured in the diagram below. How should the nurse care for this device?

A) Plan to replace the precut gauze as part of the dressing change.
B) Cleanse around the tube with the cleanser ordered or according to protocol.
C) Use the safety pin to secure the outermost bandage to the dressing.
D) Remove the tube, culture the wound, and cleanse it with saline gauze
E) Remove the safety pin

Question 50

The nurse is reviewing the patient's current medications as a part of preparation for an elective surgery. What information should the nurse reinforce with the patient?

A) "Continue to take your regular prescribed dose of warfarin (Coumadin)."
B) "You may take your regular herbal supplements up until the day before surgery."
C) "Discontinue your antihypertensive medications two days prior to surgery."
D) "Stop taking your daily aspirin at least three days prior to surgery."

Question 51

The nurse is preparing to teach an older patient scheduled for surgery on performing diaphragmatic breathing. Place the steps of this breathing technique in the order in which the nurse should teach the patient.

A) Sit up straight in bed.
B) Place your hands lightly on your abdomen.
C) Breathe in deeply through your nose.
D) Hold your breath for five seconds.
E) Completely exhale through pursed lips.
F) non of the above.

Question 52

The nurse determines that a patient recovering from spinal anesthesia is experiencing complications from the anesthesia. Which actions should the nurse expect to be provided to this patient?

A) Caffeine
B) Analgesics
C) Intravenous fluids
D) Epidural blood patch
E) Vasoactive medication

Question 53

The intraoperative nurse is caring for a patient in the maintenance phase of anesthesia. Which actions should the nurse prepare to provide to the patient at this time?

A) Prepare the skin.
B) Assess oxygen saturation level.
C) Participate in the surgical procedure.
D) Position the patient for the surgical procedure.
E) Measure blood pressure and heart rate.

Question 54

A patient is scheduled to have a hernia repair done today on an outpatient basis. The patient's sibling angrily says, "When I had this done 20 years ago, they kept me in the hospital nearly a week. Why can't my brother stay here where someone can take care of him?" What are appropriate responses by the nurse?

A) "He will be at less risk of getting an infection at home."
B) "He will probably be more comfortable in his own bed at home."
C) "It is cheaper for the insurance company if he goes home today."
D) "The government won't let him stay."
E) "If you ask the physician, the hospital will probably let him stay."

Question 55

Which patient information is essential for the nurse to provide the physician who is preparing to administer conscious sedation to a patient?

A) The patient has a history of snoring.
B) The patient drank a cup of coffee two 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.