Question 1

The perioperative nurse realizes that the most effective means of evaluating the client's understanding of previous teaching is to:

Accepted Answer

In the immediate preoperative period,assess the client's understanding of previous teaching.The other options are not truly evaluations of the client's knowledge.

Question 2

Which of the following client evaluations is most reflective of compliance for a preoperative client with a nursing diagnosis of deficient knowledge regarding preoperative requirements related to lack of exposure to information?

Accepted Answer

The answer shows proof of the client's compliance,whereas the remaining options are either goals or outcomes.

Question 3

Which of the following client outcomes is most therapeutic for a preoperative client with a nursing diagnosis of deficient knowledge regarding preoperative requirements related to lack of exposure to information?

Accepted Answer

The answer provides for behavior that is measurable and pertinent to the preoperative goals.Sharing the information and calling for the appointment are appropriate outcomes,but they are not the most therapeutic because they not related to actual compliance with the preoperative routine.The remaining option is a client goal.

Question 4

A client scheduled for an ambulatory surgery procedure requiring anesthetics arrives with a low-grade fever and a productive sough.The postponement of the procedure is most likely a result of the:

Accepted Answer

Cough and low-grade fever increases the risk for respiratory complications during anesthesia (e.g. ,pneumonia and spasm of laryngeal muscles).Although the other options are not incorrect,they do not represent the most likely risk factor that would result in the cancellation of the procedure.

Question 5

The client had surgery in the morning that involved the right femoral artery.To assess the client's circulation status to the right leg,the nurse will make sure to check the pulse at the:

Accepted Answer

The nurse should assess peripheral pulses and capillary refill distal to the site of surgery.After surgery to the femoral artery,the nurse assesses posterior tibial and dorsalis pedis pulses.The nurse also compares pulses in the affected extremity with those in the nonaffected extremity.

Question 6

The initial client education-related nursing action by the preadmission nurse is to:

Accepted Answer

Preadmission nurses call clients up to 1 week before surgery to clarify questions and reinforce explanations.The remaining options are directed toward either facilitating compliance with preoperative requirements or addressing the needs of the client's family.

Question 7

Which of the following statements made by a nurse reflects the greatest insight into the responsibility an ambulatory care nurse has to the client's family?

Accepted Answer

Family members attempt to provide support through their presence but face many of the same stressors as the client.You need to effectively communicate with the client and family;they are clients as well.

Question 8

Which of the following goals is most appropriate for a preoperative client with a nursing diagnosis of deficient knowledge regarding preoperative requirements related to lack of exposure to information?

Accepted Answer

Understanding the need for the surgery is not as directly related to preoperative requirements as is the understanding of preoperative routines.The remaining options are client outcomes.

Question 9

Upon admission to the postanesthesia care unit (PACU),the client who has no orthopedic or neurological restrictions is positioned with the:

Accepted Answer

To promote a patent airway,the head of the bed may be slightly elevated and the client's neck slightly extended,with the client's head turned to the side.The client's head should not be flexed as this may occlude the airway.The client's arms should never be positioned over or across the chest,because this reduces maximal chest expansion.

Question 10

Which of the following preoperative assessment findings would most likely delay a planned procedure requiring general anesthetic?

Accepted Answer

Preoperative assessment occasionally reveals an abnormality that delays or cancels surgery.A client who presents with a cough and low-grade fever on admission would require the nurse to notify the surgeon immediately.The other options do not necessarily warrant delay or cancellation of a procedure.

Question 11

A client who has type 2 diabetes is scheduled for the removal of a skin lesion on his right shoulder at an ambulatory surgery unit.The nursing diagnosis the client is at greatest risk for postoperatively is:

Accepted Answer

Diabetes increases susceptibility to infection and impairs wound healing from altered glucose metabolism and associated circulatory impairment.The stress of surgery often causes increases in blood glucose levels.Although all the options present with possible nursing diagnoses,the remaining options are not of primary concern because steps can be taken (e.g. ,antibiotic,intravenous fluids)to minimize the risk.Impaired wound healing is not as easily managed.

Question 12

Which of the following best describes the primary nursing role regarding a client's consent to surgery immediately before surgery?

Accepted Answer

It is the surgeon's responsibility to explain the procedure and obtain the informed consent.After the client completes the consent form,place it in the medical record.The record goes to the operating room with the client after the nurse confirms all required information has been included.

Question 13

A 74-year-old is accompanied by his daughter to the ambulatory surgery department for the surgical removal of a suspicious skin lesion.The client has experienced dysphasia since a cerebral vascular accident 3 years ago.The most effective way for the nurse to secure the necessary preoperative interview information is to:

Accepted Answer

If a client is unable to relate all of the necessary information,rely on family members as resources.The remaining options are not reliable,effective methods of securing information regarding this client.

Question 14

Which of the following statements made by the nurse shows the most informed understanding of the role of family in the client's postoperative recovery?

Accepted Answer

Often a family member is the caregiver when the client recovers from surgery.Perioperative preparation of family members before surgery helps to maximize effective caregiving while minimizing anxiety and misunderstanding.

Question 15

The nurse recognizes which of the following as the greatest barrier to meeting a preoperative client's nursing diagnosis of deficient knowledge regarding surgical procedure?

Accepted Answer

Anxiety and fear are barriers to learning,and both emotions heighten as surgery approaches.Education should be provided before any preoperative sedation is administered;the information should be introduced in terms that the client can understand.The presence of denial is an assumption that is not necessarily correct.

Question 16

The nurse knows that the client is most likely going to arrive for the surgical procedure having adhered to the required bowel preparation if:

Accepted Answer

Given a rationale for preoperative and postoperative procedures,the client is better prepared to participate in care.The remaining options may have an effect on compliance but not to the degree that understanding the need and purpose of the bowel preparation.

Question 17

A client with a history of sleep apnea has had a same-day surgery procedure that will require the administration of morphine postoperatively to manage pain.This client will be assessed most appropriately by the perioperative nurse for the risk for respiratory complications by frequently:

Accepted Answer

Administration of opioids increases risk for airway obstruction postoperatively.Clients will desaturate as revealed by a drop in oxygen saturation by pulse oximetry.The remaining options are not as specific for this particular client's risk.

Question 18

Which of the following statements made by a nurse reflects the greatest insight into the planning needs of a same-day surgical experience?

Accepted Answer

Ambulatory and same-day surgical programs offer challenges in gathering a complete assessment in a limited time.Clients are admitted only hours before the surgical event,so it is important for you to organize and verify data obtained preoperatively and implement a perioperative plan of care.Although the remaining options are not incorrect,they do not stress the importance of effective organization of the client's plan of care.

Question 19

A prostate biopsy is an acceptable procedure to be performed as an ambulatory surgery on an otherwise healthy adult male because the American Society of Anesthesiologists (ASA)considers that a:

Accepted Answer

ASA physical status classes 1 and 2 and also stable class 3 are now acceptable for ambulatory surgery.Classes 4 and 5 require inpatient surgery.

Question 20

A client who is scheduled for surgery is found to have thrombocytopenia.A specific postoperative concern for the nurse for this client is:

Accepted Answer

A client with thrombocytopenia is at risk for hemorrhaging during and after surgery.Clients with immunological disorders or diabetes mellitus have an increased risk for wound infection after surgery.A client who has a fever is at risk for fluid imbalance.A client who has chronic respiratory disease may be at increased risk for respiratory depression,not the client with thrombocytopenia.

Quiz 50: Care of Surgical Clients