What components are required for a patient to give consent to a procedure? (Select all that apply)
A. The patient understands the procedure.
B. The benefits are explained by the surgeon.
C. The surgeon coerces the patient to give consent. D. The risks are not disclosed to the patient.
E. Alternative treatment options are disclosed. - Answers A,B,E
Rationale: The surgeon must provide benefits, risks, and alternative treatment options for the
procedure/surgery before the nurse obtains consent. Coercion cannot occur for the patient must
voluntarily give consent. Patient comprehension is a requirement for consent.
A preoperative patient expresses anxiety about upcoming surgery. Which response by the
nurse is most likely to stimulate further discussion?
A. "I will be happy to explain the entire surgical procedure with you."
B. "Everyone is nervous before surgery."
C. "Can you share with me what you've been told about surgery?"
D. "Let me tell you about postoperative care and the amount of pain you can anticipate." - Answers C
Rationale: Open-ended questions help to stimulate further discussion. Reasons for anxiety can be
multiple, such as unpleasant interactions with health care providers, uncontrolled pain, anesthesia
reactions, and other post-operative complications. Plan of care can be individualized once the nurse
understands the patient's source of anxiety.
Which task would be most appropriate for the nurse to delegate to the unlicensed personnel?
A. Complete the preoperative checklist.
B. Assess the patient's preoperative vital signs.
C. Teach the patient about coughing and deep breathing.
D. Assist the patient to remove clothing and jewelry. - Answers D
The nurse provided preoperative teaching for a patient. The patient has a history of arthritis
and takes aspirin daily. The nurse determines that the patient needs additional teaching if the
patient makes which statement?
A. "Aspirin can cause abnormal blood clotting."
B. "Aspirin can cause bleeding after surgery."
C. "I need to continue to take aspirin until my surgery day."
D. "I need to check with my doctor about when to stop taking aspirin prior to surgery." - Answers C
Rationale: Aspirin is an antiplatelet, which is abnormal blood clotting and can cause bleeding after
surgery. The patient's physician will determine when to stop aspirin and ideally aspirin would be
stopped 10 days prior to surgery. Continuing aspirin to the surgery date puts the patient at risk for
bleeding during surgery, thus determining that the patient would need further education.
The nurse must obtain surgical consent forms for the scheduled surgery. Which patient(s) would not
be able to consent legally to surgery? (Select all that apply).
A. 65-year-old who cannot read nor write.
B. 80-year-old who is not oriented to place or situation.
C. 30-year-old who does not understand English.
D. 98-year-old who understands the procedure.
E. 6-year-old who has a fractured ankle. - Answers B, E
Rationale: The patient that cannot read nor write can still provide consent. The consent form
can be red to the patient and the surgeon would make sure all surgical questions are answered.
Patients who are not alert and oriented cannot provide consent, so the medical power of attorney or
next of kin would provide consent for the procedure. The patient who does not understand English
needs a certified interpreter to provide surgical consent. Patients must understand the procedure
before giving consent. Patients under the age of 18 cannot provide consent, therefore the legal
guardian or parent would give consent.
What components are required for a patient to give consent to a procedure? (Select all that apply)
A. The patient understands the procedure.
B. The benefits are explained by the surgeon.
C. The surgeon coerces the patient to give consent.
D. The risks are not disclosed to the patient.
,E. Alternative treatment options are disclosed. - Answers A. The patient needs to comprehend what
will occur with the procedure.
B. Benefits and risks need to be disclosed. The surgeon is responsible for this.
E. In addition to risks and benefits, alternative treatment options need to be disclosed to the patient.
Failure to provide all treatment options is unethical and deemed to be coercion.
What preoperative diagnostic and laboratory tests would be appropriate for a patient with heart
failure? SATA
A. Echocardiogram
B. Electrocardiogram (ECG)
C. B-type natriuretic peptide (BNP)
D. Renal Ultrasound
E. Chest Xray - Answers a. Patients who have heart issues need a further cardiac workup which
includes an echocardiogram. This provides us with useful information such as the patient's ejection
fraction, which is useful for heart failure patients.
b. Patients who have heart issues need a further cardiac workup which includes an electrocardiogram.
This provides information concerning heart rate and rhythm.
c. BNP correlates with left-ventricular pressures, thus a good indicator for heart failure. The higher the
BNP level, the increase in heart failure severity.
e. Chest x-ray would provide information such as pulmonary edema, which can be a result of heart
failure.
A common reason that a nurse may need extra time when preparing older adults for surgery is their:
A. ineffective coping
B. limited adaptation to stress
C. diminished vision and hearing
D. Need to include caregivers in activities - Answers C. As patients get older, several types of vision
changes can occur, such as age-related macular degeneration, cataracts, glaucoma, etc. Hearing also
changes with age. Age-related hearing loss is called presbycusis.
The nurse is monitoring a patient who is receiving epidural anesthesia. What epidural complication
causes hypotension and bradycardia?
a. Blockade of motor nerve fibers
b. Blockade of sensory nerve fibers
c. Blockade of sympathetic nerve fibers
d. Blockade of parasympathetic nerve fibers - Answers C. The sympathetic nervous system is the
"flight or fight" response, which causes tachycardia and hypertension. Blockade of this response
would cause a parasympathetic response, resulting in bradycardia and hypotension.
The patient provides document specifying his wishes if is he is unable to do so. What is this document
called?
A. Informed Consent
B. Insurance Card
C. Patient's Bill of Rights
D. Advanced Directive - Answers D. Advanced Directive
Which patient is at greatest risk for surgery?
A. 18 year old boy taking lorazepam
B. 58 year old man taking atenolol
C. 73 year old woman taking an analgesic
D. 35 year old woman taking warfarin - Answers D. 35 year old woman taking warfarin
The nurse reports which of the following laboratory findings to the surgeon?
A. Potassium 3.4 mEq/L
B. Creatinine 1.9 mg/dL
C. Sodium 140 mEq/L
D. Fasting glucose 80 mg/dL - Answers B. Creatinine 1.9 mg/dL (range for creatinine is 0.5-1.3 mg/dL)
The patient is signing a consent. What is required for informed consent? (select all that apply)
A. Alternative treatment options discussed with the patient
B. Patient requires family member to translate consent form
C. Patient voluntarily signs the consent form
D. Questions answered after the patient signs the consent form - Answers A, C
What complications are associated with the administration of total parenteral nutrition (TPN)?
, A.Diarrhea
B.Malabsorption
C. Hyperglycemia
D. Vomiting - Answers C. Hyperglycemia
What is the primary purpose of maintaining NPO before surgery?
A. To prevent malnutrition
B. To prevent electrolyte imbalance
C. To prevent aspiration pneumonia
D. To prevent intestinal obstruction - Answers C. To prevent aspiration pneumonia
A pt on tube feeding and has a residual of 300 mL with nausea and vomiting. What would the nurse
do first?
A. Stop the tube feeding
B. Place the patient in a supine position
C. Notify the physician
D. Nothing - Answers A. Stop the tube feeding
An obese patient is admitted for abdominal surgery. This patient is more prone to which post-op
complication?
A. Anemia
B. Protein loss
C. Dehiscence
D. Seizures - Answers C. Dehiscence
The patient reports several allergies. What should the nurse do next?
A. Note the information in the chart
B. Ask patient to describe severity of allergies
C. Place an allergy alert wristband on the patient
D. Notify anesthesia for possible risk for anesthetic allergies - Answers B. Ask patient to describe
severity of allergies
The patient is receiving epidural analgesia. What complications can occur? (select all that apply)
A. Hypotension
B. Tachycardia
C. Hypertension
D. Bradycardia - Answers A. Hypotension and D. Bradycardia
Which of the following pre-op assessment findings indicates a need to contact the surgeon?
A. Temp 100.7 degrees Fahrenheit
B. Pulse 90 beats per minute
C. Respiratory rate 20 breaths per minute
D. Blood pressure 140/74 - Answers A. Temp 100.7 degrees Fahrenheit
You observe the patient pacing and asking questions repeatedly. The likely cause of the behavior is
A. Anxiety about the surgical procedure
B. Separation anxiety from family members
C. Undiagnosed urinary tract infection
D. Underlying emotional problem - Answers A. Anxiety about the surgical procedure
The RN determines the patient is unable to describe procedure. The nurse should:
A. Obtain consent because this is expected with pre-op anxiety
B. Teach the patient about the procedure
C. Ask the unit manager to assist with teaching plan
D. Inform the surgeon so more information can be provided - Answers D. Inform the surgeon so more
information can be provided
What is the rationale for palliative surgery?
A. Resolve health problem by repairing cause
B. Always improve functional ability
C. Enhance personal appearance
D. Relieve or reduce symptoms - Answers D. Relieve or reduce symptoms
Which patient most likely requires special pre-operative assessment?
A. Woman taking daily anticoagulants to treat afib
B. Man taking daily thyroid supplement to treat hypothyroidism
C. Man taking acetaminophen once a week