Question 1

A client voluntarily signed the operative consent form.What is the nurse's next action?

Accepted Answer

The nurse's signature as a witness indicates that the consent form was signed by the client voluntarily.None of the other steps are necessary.

Question 2

Which action is most appropriate during a preoperative chart review?

Accepted Answer

During the preoperative chart review,the nurse should make sure that the consent form is signed,dated,and witnessed.The nurse does not have to call the surgeon for food allergies,nor should the marks be washed off the surgical site.The client should be taught about the procedure before the preoperative chart review.

Question 3

The nurse is caring for an older adult client with a history of chronic lung disease who will be undergoing surgery the following day.When postoperative care is planned,which potential problem is the highest priority for this client?

Accepted Answer

Breathing problems take priority over the other problems listed.This would be compounded in a client with any chronic lung disorder.

Question 4

Twenty minutes after a client has received a preoperative injection of atropine and midazolam (Versed),the client tells the nurse that he must be allergic to the medication because his mouth is dry and his heart seems to be beating faster than normal.What is the nurse's priority action?

Accepted Answer

Although these are expected physiologic responses to the preoperative medication,whenever the client states that he or she can feel a change in normal cardiac function,he should be assessed.

Question 5

The nurse is caring for a client who will be undergoing emergency surgery as soon as possible.Which information is most important for the nurse to teach the client at this time?

Accepted Answer

With only a few minutes before surgery,the nurse should tell the client what to expect in the operating room and in the recovery room to minimize his or her anxiety.Although the other information is important,the nurse needs to start with what is vital for the client to know right now.

Question 6

When the nurse brings a client's preoperative medications,the client responds,"I don't need that.I had a good night's sleep last night." What is the nurse's best response?

Accepted Answer

Preoperative medications can include sedatives but are often given to prevent laryngospasm and to help reduce pharyngeal and gastric secretions.The client must be fully aware of the rationale for all medications and the risks of not taking them.

Question 7

A client is brought to the hospital unconscious and needs emergency surgery.The client's only family member cannot come to the hospital before the surgery.Which is the best option for obtaining informed consent for the client's emergent surgery?

Accepted Answer

In the event that a family member cannot come to the hospital before the surgery needs to begin,verbal consent should be obtained over the phone with two witnesses.

Question 8

A client receiving preoperative medication tells the nurse that she took all the following vitamins and herbs last night before going to bed.Which one does the nurse report to the surgical team as a priority?

Accepted Answer

Garlic interferes with coagulation,increasing the client's risk for bleeding during and after the surgical procedure.This would be a critical piece of information for the surgical team to know.

Question 9

The nurse reviews a client's laboratory results before surgery and notes a fasting blood glucose of 120 mg/dL,a prothrombin time (PT)of 25 seconds,and potassium (K⁺)of 3.8 mEq/L.Which action by the nurse is best?

Accepted Answer

The prothrombin time is elevated,which could lead to bleeding during or after surgery.The surgeon and the anesthesiologist should be notified of this laboratory test result right away,and additional coagulation studies will be needed.The potassium is within normal limits.The blood glucose level is elevated but not critically so.The surgeon should be notified of all laboratory work,and the client may need an IV solution without glucose.The results should be recorded,but the surgery will likely be cancelled owing to the coagulation problem,which is the priority concern with this client.

Question 10

A client undergoing preoperative assessment informs the nurse that he takes medication for high blood pressure and for asthma.What is the nurse's best action?

Accepted Answer

Medications for cardiac and respiratory problems usually are given with sips of water before surgery.However,the nurse should notify the surgeon and the anesthesiologist before giving the client any advice.While some medications can be given with a sip of water,other medications must be held for a specified time before surgery.Documentation should occur,but only after the nurse has consulted with the physician and anesthesiologist and has spoken to the client.

Question 11

During the preoperative assessment,the client tells the nurse that he smokes three packs of cigarettes daily.Which action by the nurse is best?

Accepted Answer

Smoking increases the client's risk for atelectasis and hypoxia.The nurse should assess the client for signs of respiratory disease.The physician will need to know this information but will not necessarily cancel the operation.Baseline laboratory studies need to be ordered by the physician.There is no indication for giving a nebulizer to this client.

Question 12

The nurse is performing preoperative teaching with an older adult client who will be having colon resection surgery the following day.The surgeon has ordered bowel preparation the night before.Which action is a priority?

Accepted Answer

Safety is the priority,and the older adult client can become exhausted and may fall.Antibiotics,if ordered,would be administered with a sip of water,but this is not the priority.The client would not be encouraged to drink juice,because this is not a clear liquid.

Question 13

The nurse is completing preoperative teaching for a client,and it becomes apparent that the client does not understand the surgery that will be performed.What is the priority action for the nurse?

Accepted Answer

The surgeon should be notified right away so that the client can be instructed about the surgery to be performed.The client cannot give informed consent unless he or she understands the procedure.

Question 14

When examining an adult client's preoperative laboratory results,the nurse notes that the potassium level is 2.9 mEq/mL.What is the nurse's priority action?

Accepted Answer

The normal range for serum potassium is 3.5 to 5.0 mEq/L or mmol/L.A value of 2.9 represents hypokalemia,which must be corrected before surgery.The surgeon should be notified of this finding.The finding should be documented; however,notifying the surgeon is the priority.

Question 15

A client is brought to the emergency department (ED)after a motorcycle accident.The client has suffered a ruptured spleen.What is the immediate priority?

Accepted Answer

Emergent surgery is indicated when the client may die without immediate intervention.Other interventions are appropriate but do not have the priority because controlling hemorrhage via surgery is the priority.

Question 16

The nurse has just completed preoperative teaching with a client who will be having surgery the following day.Which statement by the client indicates that additional teaching is needed?

Accepted Answer

The client should void before receiving any preoperative medication.The medication could make the client sleepy and at risk for falling.The other statements are correct.

Question 17

Four clients are scheduled for surgery.Which client does the nurse determine is at highest risk for postsurgical complications?

Accepted Answer

The older client is at highest risk for postoperative complications.Older adults often have multiple medical conditions,take several medications,are slightly dehydrated,and may have cognitive or physical impairments that potentially could hinder their recovery from an operation.

Question 18

A client tells the nurse that he has an advance directive with durable power of attorney for health care.The client asks how the advance directive will affect the surgery.What is the nurse's best response?

Accepted Answer

The advance directive with durable power of attorney indicates whom the client wishes to designate for medical decisions if he is unable to make decisions for himself.An advance directive with power of attorney does not eliminate the need for intubation during surgery.Although the document does not affect the procedure,simply acknowledging that fact does not help the client understand.If the client's heart stops during the operation and the client has not made his or her wishes known about that situation,the power of attorney would be consulted.

Question 19

A client will be undergoing palliative surgery.The client's daughter asks what this means.What is the nurse's best response?

Accepted Answer

The purpose of palliative surgery is to improve the client's quality of life by reducing or eliminating distressing symptoms.It does not cure a health problem and often does not prolong life.

Question 20

What recently learned information about a client who is scheduled to have surgery within the next 2 hours is the nurse certain to communicate to the surgical team?

Accepted Answer

The team will need to communicate with the client in the surgical holding area,in the operating room,and in the postanesthesia recovery unit.Any problem with communication,such as a hearing impairment,should be stressed,so that team members can use alternative means to ensure accurate communication with the client.

Quiz 16: Care of Preoperative Patients

A client voluntarily signed the operative consent form.What is the nurse's next action?

Which action is most appropriate during a preoperative chart review?

The nurse is caring for an older adult client with a history of chronic lung disease who will be undergoing surgery the following day.When postoperative care is planned,which potential problem is the highest priority for this client?

Twenty minutes after a client has received a preoperative injection of atropine and midazolam (Versed) ,the client tells the nurse that he must be allergic to the medication because his mouth is dry and his heart seems to be beating faster than normal.What is the nurse's priority action?

The nurse is caring for a client who will be undergoing emergency surgery as soon as possible.Which information is most important for the nurse to teach the client at this time?

When the nurse brings a client's preoperative medications,the client responds,"I don't need that.I had a good night's sleep last night." What is the nurse's best response?

A client is brought to the hospital unconscious and needs emergency surgery.The client's only family member cannot come to the hospital before the surgery.Which is the best option for obtaining informed consent for the client's emergent surgery?

A client receiving preoperative medication tells the nurse that she took all the following vitamins and herbs last night before going to bed.Which one does the nurse report to the surgical team as a priority?

The nurse reviews a client's laboratory results before surgery and notes a fasting blood glucose of 120 mg/dL,a prothrombin time (PT) of 25 seconds,and potassium (K⁺) of 3.8 mEq/L.Which action by the nurse is best?

A client undergoing preoperative assessment informs the nurse that he takes medication for high blood pressure and for asthma.What is the nurse's best action?

During the preoperative assessment,the client tells the nurse that he smokes three packs of cigarettes daily.Which action by the nurse is best?

The nurse is performing preoperative teaching with an older adult client who will be having colon resection surgery the following day.The surgeon has ordered bowel preparation the night before.Which action is a priority?

The nurse is completing preoperative teaching for a client,and it becomes apparent that the client does not understand the surgery that will be performed.What is the priority action for the nurse?

When examining an adult client's preoperative laboratory results,the nurse notes that the potassium level is 2.9 mEq/mL.What is the nurse's priority action?

A client is brought to the emergency department (ED) after a motorcycle accident.The client has suffered a ruptured spleen.What is the immediate priority?

The nurse has just completed preoperative teaching with a client who will be having surgery the following day.Which statement by the client indicates that additional teaching is needed?

Four clients are scheduled for surgery.Which client does the nurse determine is at highest risk for postsurgical complications?

A client tells the nurse that he has an advance directive with durable power of attorney for health care.The client asks how the advance directive will affect the surgery.What is the nurse's best response?

A client will be undergoing palliative surgery.The client's daughter asks what this means.What is the nurse's best response?

What recently learned information about a client who is scheduled to have surgery within the next 2 hours is the nurse certain to communicate to the surgical team?

Quiz 16: Care of Preoperative Patients

A client voluntarily signed the operative consent form.What is the nurse's next action?

Which action is most appropriate during a preoperative chart review?

The nurse is caring for an older adult client with a history of chronic lung disease who will be undergoing surgery the following day.When postoperative care is planned,which potential problem is the highest priority for this client?

Twenty minutes after a client has received a preoperative injection of atropine and midazolam (Versed) ,the client tells the nurse that he must be allergic to the medication because his mouth is dry and his heart seems to be beating faster than normal.What is the nurse's priority action?

The nurse is caring for a client who will be undergoing emergency surgery as soon as possible.Which information is most important for the nurse to teach the client at this time?

When the nurse brings a client's preoperative medications,the client responds,"I don't need that.I had a good night's sleep last night." What is the nurse's best response?

A client is brought to the hospital unconscious and needs emergency surgery.The client's only family member cannot come to the hospital before the surgery.Which is the best option for obtaining informed consent for the client's emergent surgery?

A client receiving preoperative medication tells the nurse that she took all the following vitamins and herbs last night before going to bed.Which one does the nurse report to the surgical team as a priority?

The nurse reviews a client's laboratory results before surgery and notes a fasting blood glucose of 120 mg/dL,a prothrombin time (PT) of 25 seconds,and potassium (K+) of 3.8 mEq/L.Which action by the nurse is best?

A client undergoing preoperative assessment informs the nurse that he takes medication for high blood pressure and for asthma.What is the nurse's best action?

During the preoperative assessment,the client tells the nurse that he smokes three packs of cigarettes daily.Which action by the nurse is best?

The nurse is performing preoperative teaching with an older adult client who will be having colon resection surgery the following day.The surgeon has ordered bowel preparation the night before.Which action is a priority?

The nurse is completing preoperative teaching for a client,and it becomes apparent that the client does not understand the surgery that will be performed.What is the priority action for the nurse?

When examining an adult client's preoperative laboratory results,the nurse notes that the potassium level is 2.9 mEq/mL.What is the nurse's priority action?

A client is brought to the emergency department (ED) after a motorcycle accident.The client has suffered a ruptured spleen.What is the immediate priority?

The nurse has just completed preoperative teaching with a client who will be having surgery the following day.Which statement by the client indicates that additional teaching is needed?

Four clients are scheduled for surgery.Which client does the nurse determine is at highest risk for postsurgical complications?

A client tells the nurse that he has an advance directive with durable power of attorney for health care.The client asks how the advance directive will affect the surgery.What is the nurse's best response?

A client will be undergoing palliative surgery.The client's daughter asks what this means.What is the nurse's best response?

What recently learned information about a client who is scheduled to have surgery within the next 2 hours is the nurse certain to communicate to the surgical team?

The nurse reviews a client's laboratory results before surgery and notes a fasting blood glucose of 120 mg/dL,a prothrombin time (PT) of 25 seconds,and potassium (K⁺) of 3.8 mEq/L.Which action by the nurse is best?