NUR1460 – Class Assignment Questions Module 5 PERIOPERATIVE (already solved) summer 2021 / NUR1460C – Class Assignment Questions Module 5 PERIOPERATIVE (already solved) summer 2021

NUR1460 – Class Assignment Questions Module 5 PERIOPERATIVE Select the best answer for the question. Highlight the correct answer in yellow. 1. Colostomy surgery is categorized as what type of surgery? a. Cosmetic b. Curative c. Diagnostic d. Palliative 2. The nurse is providing preoperative care for a client who will have an arthroscopy of the left knee. As part of the Joint Commission National Patient Safety Goals (NPSG), what will the nurse be required to do? a. Ensure that the correct procedure is noted in the client’s history. b. Remind the surgeon that the client will have a left knee arthroscopy. c. Verify with the client that a left knee arthroscopy will be performed. d. Mark the left knee site with the client awake and the surgeon present. 3. As the nurse obtains informed consent, the client asks, “Now what exactly are they going to do to me?” What is the nurse’s response? a. Contact the anesthesiologist. b. Contact the surgeon. c. Explain the procedure. d. Have the client sign the form. 4. The nurse is educating a client who is about to undergo cardiac surgery with general anesthesia. Which statement by the client indicates the need for further instruction? a. “I will wake up with a tube in my throat.” b. “I will have a bandage on my chest.” c. “My family will not be able to see me right away.” d. “Pain medication will take away my pain.” 5. A preoperative client smokes a pack of cigarettes a day. What is the nurse’s teaching priority for the best physical outcomes? a. Instruct the client to quit smoking. b. Teach about the dangers of tobacco. c. Teach the importance of incentive spirometry. d. Tell the client that smoking increases postoperative complications. 6. During a preoperative assessment, which statement by a client requires further investigation by the nurse to assess surgical risks? a. “I am taking vitamins.”b. “I drink a glass of wine a night.” c. “I had a heart attack 4 months ago.” d. “I quit smoking 10 years ago.” 7. Which electrolyte laboratory result does the nurse report immediately to the anesthesiologist? a. Creatinine, 1.9 mg/dL (168 mcmol/L) b. Fasting glucose, 80 mg/dL (4.4 mmol/L) c. Potassium, 3.9 mEq/L (3.9 mmol/L) d. Sodium, 140 mEq/L (140 mmol/L) 8. The nurse is instructing a client about the use of antiembolism stockings. Which statement by the client indicates the need for further teaching? a. “I will take off my stockings one to three times a day for 30 minutes.” b. “My stockings are too loose.” c. “It’s better if they are too tight rather than too loose.” d. “These stockings help promote blood flow.” 9. At 8:00 a.m., the registered nurse is admitting a client scheduled for sinus surgery to the outpatient surgery department. Which information given by the client is of most immediate concern to the nurse? a. An allergy to iodine and shellfish b. Being nauseated after a previous surgery c. Having a small glass of juice at 7:00 a.m. d. Expressing anxiety about the surgery 10.A diabetic client who is scheduled for vascular surgery is admitted on the day of surgery with several orders. Which order does the nurse accomplish first? a. Use electric clippers to cut hair at the surgical site. b. Start an infusion of lactated Ringer’s solution at 75 mL/hr. c. Administer one-half of the client’s usual lispro insulin dose. d. Draw blood for glucose, electrolyte, and complete blood count values. 11.A client is having an arthroscopy of the left knee and has just been moved to the surgical holding area. Which statement by the nurse properly identifies the client while the nurse checks the identification label? a. “Are you Mr. Smith?” b. “Good morning, Mr. Smith.” c. “What is your name, and when were you born?” d. “What surgery are you having today?” 12.As the unit nurse is about to give a preoperative medication to a client going into surgery, it is discovered that the surgical consent form is not signed. What does the nurse do after verifying the procedure with the client? a. Calls the surgeonb. Calls the anesthesiologist c. Gives the medication as ordered d. Asks the client to sign the consent form 13.If sterile gauze falls to the ground and hits the front of the surgeon’s gown on the way down, what does the nurse do to ensure proper infection control? a. Helps the surgeon change the gown b. Picks the gauze up with a pair of sterile gloves c. Picks the gauze up without touching the surgeon d. Sprays an antimicrobial on the surgeon’s gown 14.Which statement by a nursing student indicates a need for further teaching about operating room (OR) surgical attire? a. “I must cover my facial hair.” b. “I don’t need a sterile gown to be in the OR.” c. “If I go into the OR, I must wear a protective mask.” d. “My scrubs will be sterile.” 15.A preoperative client wears a hearing aid and is extremely hard of hearing without it. What does the nurse do to help reduce this client’s anxiety? a. Actively listen to this client’s concerns. b. Allow the client to wear the hearing aid to surgery. c. Ask if the client may wear the hearing aid until anesthesia is given. d. Explain that it is hospital policy to remove a hearing aid before surgery. 16.A surgical client has signed do-not-resuscitate (DNR) orders before going to the operating room (OR). A complication requiring resuscitation occurs during surgery. What is the nurse’s proper action? a. Call the legal department. b. Call the client’s primary health care provider. c. Honor the DNR order. d. Resuscitate per OR procedure. 17.A client who is preparing to undergo a vaginal hysterectomy is concerned about being exposed. How does the nurse ensure that this client’s privacy will be maintained? a. Remind the client that she will be asleep. b. Ensure that drapes will minimize perianal exposure. c. Explain postoperative expectations. d. Restrict the number of technicians in the procedure. 18.Which intervention does the nurse implement for an older adult client to minimize skin breakdown related to surgical positioning? a. Apply elastic stockings to lower extremities. b. Monitor for excessive blood loss. c. Pad bony prominences.d. Secure joints on a board in anatomic positions. 19.A client has undergone an 8-hour surgical procedure under general anesthesia. In assessing the client for complications related to positioning, the nurse is most concerned with which finding? a. Decreased sensation in the lower extremities b. Diminished peripheral pulses in the lower extremities c. Pale, cool extremities d. Reddened areas over bony prominences 20.The nurse anesthetist notices that a surgical client has an unexpected rise in the end-tidal carbon dioxide level, with a decrease in oxygen saturation and sinus tachycardia. What is the nurse anesthetist’s initial action? a. Administer cardiopulmonary resuscitation. b. Continue as normal. c. Immediately stop all inhalation anesthetic agents and succinylcholine. d. Inform the surgeon. 21.The nurse is performing a dressing change on a client who underwent abdominal surgery 6 days prior. The nurse notes a moderate amount of serosanguineous drainage on the old dressing. What will the nurse do? a. Apply extra gauze to the new dressing. b. Contact the surgeon to discuss the need for antibiotics. c. Notify the surgeon about possible wound dehiscence. d. Perform the dressing change according to unit protocol. 22.Which client is at greatest risk for slow wound healing? a. A 12-year-old healthy girl b. A 47-year-old obese man with diabetes c. A 48-year-old woman who smokes d. A 98-year-old healthy man 23.The nurse reviews a routine discharge teaching plan concerning postoperative care with a client. Which statement by the client indicates that teaching about wound care was effective? a. “I may need to restrict my activities for several months.” b. “I should remove the dressing if the wound is draining.” c. “Some bleeding from the incision is normal for several weeks.” d. “The wound will completely heal in about 2 months.” 24.Which assessment finding in a postoperative client after general anesthesia requires immediate intervention? a. Heart rate of 58 beats/min b. Pale, cool extremities c. Respiratory rate of 6 breaths/min d. Suppressed gag reflex25.In conducting a postoperative assessment of a client, what is important for the nurse to examine first? a. Breathing pattern b. Level of consciousness c. Oxygen saturation d. Surgical site 26.How does the nurse position a client with postoperative nausea and vomiting? a. Flat in bed, with the head in alignment with the body b. Prone, with the head of the bed flat c. Side-lying, with the head in a neutral position d. Supine in bed, with the neck flexed 27.The nurse assesses a client’s wound 24 hours postoperatively. Which finding causes the nurse the greatest concern and should be reported to the surgeon? a. Crusting along the incision line b. Redness and swelling around the incision c. Sanguineous drainage at the suture site d. Serosanguineous drainage on the dressing 28.Which action does the nurse implement for a client with wound evisceration? a. Apply direct pressure to the wound. b. Cover the wound with a sterile, warm, moist dressing. c. Irrigate the wound with warm, sterile saline. d. Replace tissue protruding into the opening. 29.After gastric surgery, a client arrives in the post-anesthesia care unit. Which nursing action is most appropriate for the RN to delegate to an experienced nursing assistant? a. Monitor respiratory rate and airway patency. b. Irrigate the nasogastric tube with saline. c. Position the client on the left side. d. Assess the client’s pain level. 30.The RN has just received reports about all of these clients on the inpatient surgical unit. Which client does the nurse care for first? a. A 43-year-old who had a bowel resection 7 days ago and has new serosanguineous drainage on the dressing b. A 46-year-old who had a thoracotomy 5 days ago and needs discharge teaching before going home c. A 48-year-old who had bladder surgery earlier in the day and is reporting pain when coughingd. A 49-year-old who underwent repair of a dislocated shoulder this morning and has a temperature of 100.4°F (38°C) 31.A client who is exposed to invading organisms recovers rapidly after the invasion without damage to healthy body cells. How has the immune response protected the client? a. Intact skin and mucous membranes b. Self-tolerance c. Inflammatory response against invading foreign proteins d. Antibody–antigen interaction 32.Which statement accurately explains otitis media? a. The inflammatory response is triggered by the invasion of foreign proteins. b. Phagocytosis by macrophages and neutrophils destroys and eliminates foreign invaders. c. It is caused by a left shift or increase in immature neutrophils. d. Many immune system cells released into the blood have specific effects. 33.A complete blood count with differential is performed on a client with chronic sinusitis. Which finding does the nurse expect? a. Segmented neutrophils, 62% b. Lymphocytes, 28% c. Bands, 5% d. Basophils, 4% 34.The nurse is preparing a client for discharge on postoperative day 1 after a modified radical mastectomy. Which instruction is most important for the nurse to include in this client’s discharge plan? a. “Please report any increased redness, swelling, warmth, or pain to your health care provider.” b. “Do not allow anyone to take your blood pressure or draw blood on the side where you had your breast removed.” c. “A referral has been made to the American Cancer Society’s Reach to Recovery program, and a volunteer will call you next week.” d. “Avoid the prone and hunchback positions, and ask your health care provider for any other needed activity restrictions.” 35.Because of a flu epidemic, the respiratory floor of a hospital does not have any open beds. Which client does the nurse determine is ready for discharge at the request of the discharge planner? a. Older adult client with a history of congestive heart failure, oxygen saturation of 91%, and on O2 at 2 L, with white blood cell count (WBC) 150,000 mm3 (15.5 × 109/L), segmented neutrophils (segs) (8.0 × 109/L), bands 5% (0.5 × 109/L), lungs with slight crackles in bases, able to assist with activities of daily living, and afebrileb. Middle-aged client with history of multiple sclerosis, decreased ability to ambulate since hospitalization, lungs clear, WBC count 9,500 mm3 (9.5 × 109/L), segs (6.0 × 109/L), bands 1.0% (0.1 × 109/L), oxygen saturation of 93% on room air, and afebrile c. Young adult client with crackles in all lung lobes, with productive cough of copious amounts of thick yellow sputum, WBC count 20,000 mm3 (20.0 × 109/L), segs (7.0 × 109/L), bands 10.0% (1.1 × 109/L), oxygen saturation of 95% on O2 at 2 L, and temperature of 100.4°F (38°C) d. Older adult client with recent history of right hip replacement, with productive cough, WBC count 3,400 mm3 (3.4 × 109/L), segs (6.2 × 109/L), bands 5% (0.5 × 109/L), lungs with crackles right mid-lobe posterior chest wall, oxygen saturation of 89% with O2 at 2 L, and afebrile 36.Which statement best exemplifies a client’s protection from cancer provided by cell-mediated immunity (CMI) after exposure to asbestos? a. Cytotoxic and cytolytic T cells destroy cells that contain the major histocompatibility complex of a processed antigen. b. Helper and inducer T cells recognize self-cells versus non-self-cells and secrete lymphokines that can enhance the activity of white blood cells. c. Suppressor T cells prevent hypersensitivity when a client is exposed to non-self-cells or to proteins. d. Balance elicits protection when helper or inducer T cells outnumber suppressor T cells by a ratio of 2:1. 37.Which postoperative kidney transplantation client does the nurse assess first for signs and symptoms of hyperacute rejection? a. Older adult with Parkinson disease receiving a donation from an identical twin b. Grand multipara female with a history of subsequent blood transfusions c. Middle-aged man with a 20-pack-year history d. Young adult with type 1 diabetes 38.The nurse is teaching a client about cyclosporine (Sandimmune) therapy after liver transplantation. Which client statement indicates the need for further teaching? a. “I will be on this medicine for the rest of my life.” b. “I must undergo regular kidney function tests.” c. “I must regularly monitor my blood sugar.” d. “My gums may become swollen because of this drug.” 39.Which home health nurse should the nurse manager assign to care for an 18-year-old client with a kidney transplant who has many questions about the prescribed cyclosporine (Sandimmune)?a. RN who has worked for the home health agency for 5 years in maternalchild health b. RN who has extensive critical care nursing experience and has worked in home health for a year c. RN who transferred to the home health agency after working for 10 years in an outpatient dialysis unit d. RN who worked for 5 years in an organ transplant unit and has recently been hired by the home health agency 40.Which nursing activity can the nurse delegate to a home health aide? a. Changing the dressing for a client with a low absolute neutrophil count b. Assisting with bathing for a client with chronic rejection of a liver transplant c. Teaching a client with bacterial pneumonia how to take the prescribed antibiotic d. Assessing incisional tenderness for a client who had a recent kidney transplant e. A client had a routine sigmoidoscopy with a tissue biopsy. What post procedure complication would the nurse report to the health care provider? 41.Which substance, produced in the stomach, facilitates the absorption of vitamin B12? a. Intrinsic factor b. Pepsinogen c. Glucagon d. Hydrochloric acid 42. What is a common gastrointestinal problem that older adults experience more frequently as they age? a. Decreased hydrochloric acid levels b. Excess lipase production c. Increased liver size d. Increased peristalsis 43.A client is admitted to the hospital with severe right upper quadrant (RUQ) abdominal pain. Which assessment technique does the nurse use for this client? a. Assesses the abdomen in the following sequence: inspection, palpation, percussion, auscultation b. Examines the RUQ of the abdomen last following all other assessment techniques. c. Have the client lie in a supine position with legs straight and arms at the sidesd. Gently palpates any bulging mass and documents findings. 44.The nurse is assessing an alert client who had abdominal surgery yesterday. What method provides the most accurate data about resumption of peristalsis in the client? a. Asking the client whether he or she has passed flatus (gas) within the previous 12 to 24 hours. b. Auscultating bowel sounds in all abdominal quadrant c. Counting the number of bowels sounds in each abdominal quadrant over one minute. d. observing the abdomen for symmetry and distention 45.The nurse is educating a group of older adults about screening for colorectal cancer. Which statement by a group member indicates the need for further clarification about these guidelines? a. “A barium enema every 5 years is a screening option.” b. “I will need to have a routine colonoscopy every 5 years.” c. “My routine flexible sigmoidoscopy every 5 years is OK.” d. “The ‘virtual’ colonoscopy every 5 years is acceptable.” 46.The outpatient clinic nurse is caring for a recovering client who had a colonoscopy. The client asks for a drink. How does the nurse respond to this request? a. “After I hear bowel sounds, you can have a drink.” b. “Twenty minutes after the procedure was completed, you may have some liquids.” c. “When you are able to pass flatus (gas), you can have a drink.” d. “You can have fluids when you get home and are settled.” 47.The nurse is assessing a client who has come to the emergency department with acute abdominal pain. The client is very thin and the nurse observes visible peristaltic movements when inspecting the abdomen. What does the nurse suspect? a. Acute diarrhea b. Aortic aneurysm c. Intestinal obstruction d. Pancreatitis 48.After a colonoscopy, a client reports severe abdominal pain. The nurse obtains these data: temperature 100.2°F (37.9°C), pulse 122 beats/min, blood pressure 100/45 mm Hg, respirations 44 breaths/min, and O2 saturation 89%. Which request from the health care provider does the nurse implement first? a. Give cefazolin (Ancef) 500 mg IV. b. Infuse normal saline at 200 mL/hr. c. Give morphine sulfate 2 mg IV.d. Provide oxygen at 6 L/min per nasal cannula. 49.A client arrives at the emergency department with acute abdominal pain in the left lower quadrant. In which order does the nurse examine and assess the client’s abdomen? (left lower quadrant (LLQ), left upper quadrant (LUQ), right lower quadrant (RLQ), and right upper quadrant (RUQ))? a. LLQ, RLQ, LUQ, RUQ b. LUQ, LLQ, RUQ, RLQ c. RLQ, LLQ, RUQ, LUQ d. RUQ, LUQ, RLQ, LLQ 50.The nurse practitioner is performing an abdominal assessment on a newly admitted client. In which order should the nurse proceed with assessment technique? a. Auscultation, percussion, palpation, inspection b. Inspection, auscultation, percussion, palpation c. Palpation, percussion, inspection, auscultation d. Percussion, auscultation, palpation, inspection 51.Which factors place a client at risk for gastrointestinal (GI) problems? (Select all that apply.) a. Eating a high-fiber diet b. Smoking a half-pack of cigarettes per day c. Socioeconomic status d. Some herbal preparations e. Use of nonsteroidal anti-inflammatory drugs (NSAIDs) 52.A patient who had surgery for inflammatory bowel disease is being discharged. The case manager will arrange for home health care follow-up. The patient tells the nurse that family members will also be helping with care. What information is critically important for the nurse to provide to these collaborating members? a. A list of medical supply facilities where wound care supplies may be purchased b. Proper handwashing techniques to avoid cross-contamination of the patient’s wound c. The amount of pain medication that the patient is allowed to take in each dose d. Written and oral instructions regarding signs/symptoms to report to the primary health care provider 53.A patient is scheduled for discharge after surgery for inflammatory bowel disease. The patient’s spouse will be assisting home health services with the patient’s care. What is most important for the home health nurse to assess in the patient and the spouse with regard to the patient’s home care?a. Ability of the patient and spouse to perform incision care and dressing changes b. Effective coping mechanisms for the patient and spouse after the surgical experience c. Knowledge about the patient’s requested pain medications d. Understanding of the importance of keeping scheduled follow-up appointments 54.A patient with a history of osteoarthritis has a 10-inch (25.5 cm) incision following a colon resection. The incision has become infected, and the wound requires extensive irrigation and packing. What aspect of the patient’s care does the nurse make certain to discuss with the primary health care provider before the patient’s discharge? a. Having a home health consultation for wound care b. Requesting an antianxiety medication c. Requesting pain medication for the patient’s osteoarthritis d. Placing the patient in a skilled nursing facility for rehabilitation 55.A patient who developed viral gastroenteritis with vomiting and diarrhea is scheduled to be seen in the clinic the following day. What will the nurse teach the patient to do in the meantime? a. “Avoid all solid foods to allow complete bowel rest.” b. “Consume extra fluids to replace fluid losses.” c. “Take an over-the-counter antidiarrheal medication.” d. “Contact your primary health care provider for an antibiotic medication.” 56.A patient returns to the unit after having an exploratory abdominal laparotomy. How does the nurse position this patient after the patient is situated in bed? a. High Fowler’s b. Lateral Sims’ (side-lying) c. Semi-Fowler’s d. Supine 57.A home health patient has had severe diarrhea for the past 24 hours. Which nursing action does the RN delegate to the home health aide (unlicensed assistive personnel [UAP]) who assists the patient with self-care? a. Instructing the patient about the use of electrolyte-containing oral rehydration products b. Administering loperamide (Imodium) 4 mg from the patient’s medicine cabinet c. Checking and reporting the patient’s heart rate and blood pressure in lying, sitting, and standing positionsd. Teaching the patient how to clean the perineal area after each loose stool 58.The RN receives a change-of-shift report about four patients. Which patient does the nurse assess first? a. A 20-year-old with ulcerative colitis (UC) who had six liquid stools during the previous shift b. A 25-year-old who has just been admitted with possible appendicitis and has a temperature of 102°F (37.9°C) c. A 56-year-old who had a colon resection earlier in the day and whose colostomy bag does not have any stool in it d. A 60-year-old admitted with acute gastroenteritis who is reporting severe cramping and nausea 59.An 80-year-old patient with a 2-day history of myalgia, nausea, vomiting, and diarrhea is admitted to the medical–surgical unit with a diagnosis of gastroenteritis. Which primary health care provider request does the nurse implement first? a. Administer acetaminophen (Tylenol) 650 mg rectally. b. Draw blood for a complete blood count and serum electrolytes. c. Obtain a stool specimen for culture and sensitivity. d. Start an IV solution of 5% dextrose in 0.45 normal saline at 125 mL/hr. 60.An obese patient is discharged 10 days after being hospitalized for peritonitis, which resulted in an exploratory laparotomy. Which assessment finding by the patient’s home health nurse requires immediate action? a. Pain when coughing b. States, “I am too tired to walk very much” c. States, “I feel like the incision is splitting open” d. Temperature of 100.8°F (38.2°C). 61.A patient admitted with severe diarrhea is experiencing skin breakdown from frequent stools. What is an important comfort measure for this patient? a. Applying hydrocortisone cream b. Cleaning the area with soap and hot water c. Using sitz baths three times daily d. Wearing absorbent cotton underwear