Preoperative Care: Medsurg Chapter 18 N141
Exam With Complete Solutions
1. The nurse is providing preoperative teaching to the following patients. To
which patient should the nurse plan to teach coughing and deep breathing
exercises?
A. A 20-year-old man who is scheduled for a tonsillectomy
B. A 40-year-old woman who is scheduled for an open cholecystectomy
C. A 30-year-old woman who is scheduled for a transsphenoidal
hypophysectomy
D. A 50-year-old man who is scheduled for an evacuation of a subdural
hematoma - ANSWER B. A 40-year-old woman who is scheduled for an open
cholecystectomy
Rationale-
Patients with abdominal surgeries should be taught how to cough and deep
breathe to prevent pulmonary complications such as atelectasis and
pneumonia.
-Coughing and deep breathing is contraindicated in cranial surgeries
(e.g., subdural hematoma evacuation or transsphenoidal hypophysectomy) and
tonsillectomies.
2. A 58-year-old man with a recent diagnosis of prostate cancer is scheduled for
a radical prostatectomy. Before signing the consent, the patient tells the nurse,
"I am not sure if this surgery is safe." Which response by the nurse is the most
appropriate?
A. "Tell me what you know about your surgery and the risks involved."
B. "Any surgery has risks, but we will be here to take good care of you."
C. "You seem anxious. Once you sign the consent, I can give you a sedative."
D. "You do not need to be concerned. Your surgeon has not had any complaints -
ANSWER A. "Tell me what you know about your surgery and the risks involved."
Rationale
, The health care provider performing the surgery is responsible for obtaining the
patient's consent.
- The nurse may witness the patient's signature on the consent form.
- As a patient advocate, the nurse should verify that the patient understands the
surgery and the risks involved
-. If the nurse determines that the patient is unclear about operative plans, the
nurse should contact the health care provider about the patient's need for more
information.
-The other options provide false reassurance or do not respond to the patient's
concern.
3. The nurse is assigned to provide preoperative teaching to a 54-year-old man
who is scheduled for coronary artery bypass surgery. The patient speaks only
Spanish but the nurse only speaks English. What is the best method for the
nurse to teach the patient how to use an incentive spirometer?
A. Give the patient a pamphlet written in Spanish with directions on the use of
the incentive spirometer.
B. Ask another Spanish-speaking patient in the preoperative area to translate as
the nurse describes the procedure.
C. Have the hospital translator available while the nurse demonstrates the
procedure and the patient returns the demonstration.
D. Notify the postoperative unit to have a Spanish-speaking nurse provide
education on the incentive spirometer after surgery. - ANSWER C. Have the
hospital translator available while the nurse demonstrates the procedure and
the patient returns the demonstration.
Rationale
If the patient does not speak English, it is essential that the services of a
competent translator be obtained.
-Hospitals are required to provide translators for common languages other than
English.
-Demonstration and return demonstration is the most effective teaching method
for use of equipment such as the incentive spirometer and should be done in the
preoperative period if possible.
4. Lorazepam (Ativan) 1 mg IV is ordered for a 45-year-old male patient before a
scheduled surgery.
Which of the following is the most appropriate action for the nurse to take before
the administration of this medication?
Exam With Complete Solutions
1. The nurse is providing preoperative teaching to the following patients. To
which patient should the nurse plan to teach coughing and deep breathing
exercises?
A. A 20-year-old man who is scheduled for a tonsillectomy
B. A 40-year-old woman who is scheduled for an open cholecystectomy
C. A 30-year-old woman who is scheduled for a transsphenoidal
hypophysectomy
D. A 50-year-old man who is scheduled for an evacuation of a subdural
hematoma - ANSWER B. A 40-year-old woman who is scheduled for an open
cholecystectomy
Rationale-
Patients with abdominal surgeries should be taught how to cough and deep
breathe to prevent pulmonary complications such as atelectasis and
pneumonia.
-Coughing and deep breathing is contraindicated in cranial surgeries
(e.g., subdural hematoma evacuation or transsphenoidal hypophysectomy) and
tonsillectomies.
2. A 58-year-old man with a recent diagnosis of prostate cancer is scheduled for
a radical prostatectomy. Before signing the consent, the patient tells the nurse,
"I am not sure if this surgery is safe." Which response by the nurse is the most
appropriate?
A. "Tell me what you know about your surgery and the risks involved."
B. "Any surgery has risks, but we will be here to take good care of you."
C. "You seem anxious. Once you sign the consent, I can give you a sedative."
D. "You do not need to be concerned. Your surgeon has not had any complaints -
ANSWER A. "Tell me what you know about your surgery and the risks involved."
Rationale
, The health care provider performing the surgery is responsible for obtaining the
patient's consent.
- The nurse may witness the patient's signature on the consent form.
- As a patient advocate, the nurse should verify that the patient understands the
surgery and the risks involved
-. If the nurse determines that the patient is unclear about operative plans, the
nurse should contact the health care provider about the patient's need for more
information.
-The other options provide false reassurance or do not respond to the patient's
concern.
3. The nurse is assigned to provide preoperative teaching to a 54-year-old man
who is scheduled for coronary artery bypass surgery. The patient speaks only
Spanish but the nurse only speaks English. What is the best method for the
nurse to teach the patient how to use an incentive spirometer?
A. Give the patient a pamphlet written in Spanish with directions on the use of
the incentive spirometer.
B. Ask another Spanish-speaking patient in the preoperative area to translate as
the nurse describes the procedure.
C. Have the hospital translator available while the nurse demonstrates the
procedure and the patient returns the demonstration.
D. Notify the postoperative unit to have a Spanish-speaking nurse provide
education on the incentive spirometer after surgery. - ANSWER C. Have the
hospital translator available while the nurse demonstrates the procedure and
the patient returns the demonstration.
Rationale
If the patient does not speak English, it is essential that the services of a
competent translator be obtained.
-Hospitals are required to provide translators for common languages other than
English.
-Demonstration and return demonstration is the most effective teaching method
for use of equipment such as the incentive spirometer and should be done in the
preoperative period if possible.
4. Lorazepam (Ativan) 1 mg IV is ordered for a 45-year-old male patient before a
scheduled surgery.
Which of the following is the most appropriate action for the nurse to take before
the administration of this medication?
