Chapter 33. Care of the Surgical Patient
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. A nurse who is caring for patients on a surgical unit recognizes that the individual having corrective surgery
is the
1. 39-year-old scheduled for breast reduction.
2. 14-year-old scheduled for tumor debulking.
3. 4-month-old scheduled for cleft lip repair.
4. 55-year-old scheduled for an exploratory laparotomy.
2. Which of the following is most commonly taught to help prevent postsurgical respiratory complications?
1. Turning, coughing, and deep breathing
2. Splinting incisions
3. The use of postsurgical compression stockings
4. Measuring intake and output
3. A nurse who is caring for a male patient after a left-side total hip replacement recognizes that further
teaching is required when
1. The patient alternately flexes and extends the toes of both feet.
2. The patient circles both ankles clockwise and counterclockwise.
3. The patient bends the knees slightly and helps pull himself up in bed using the trapeze.
4. The patient turns on his right side and lifts the left leg with his toes pointed and then
returns the leg to the midline.
4. When determining the appropriate size of thigh-high antiembolism hose, a nurse would obtain which of the
following measurements?
1. Length from gluteal fold to the bottom of the heel
2. Length from midthigh to the tip of the toe
3. Circumference of the knee
4. Amount of edema noted in the ankles
5. A nurse is providing care for a patient who is wearing antiembolism hose following a colectomy. The
patient’s plan of care should include:
1. Turning the stockings off 4 hours each day.
2. Removing the stockings at bedtime and replacing them in the morning.
3. Rolling the stockings down 2 inches to create a band at the top.
4. Removing the stockings twice daily to wash and dry the legs.
6. The wife of a patient who recently returned from a radical neck dissection asks a nurse why her husband was
given scopolamine. The best response by the nurse is:
1. “It is important to dry secretions to reduce the bacteria in his saliva.”
2. “Swallowing is painful for him right now. Scopolamine helps keep him from drooling.”
3. “This medication will reduce the swelling in his lips and tongue by reducing the amount
of saliva that his body makes.”
4. “The scopolamine will help dry oral secretions to reduce his chances of aspirating saliva
into his lungs.”
7. A nurse is caring for a female patient who is scheduled for an abdominal hysterectomy. The nurse obtains
the patient’s signature on the consent form and then signs the form himself. The nurse’s signature indicates
that
1. The patient does not have any questions about the surgery.
, 2. The nurse verified that it was the patient who signed the form.
3. The patient understands the risks of the procedure.
4. The nurse has provided verbal and written information about the surgical procedure.
8. Which of the following members of the surgical team is responsible for monitoring a patient’s vital
signs during surgery?
1. The surgeon
2. The circulating nurse
3. The first surgical assistant
4. The anesthesiologist
9. A nursing instructor teaches a group of students the differences between conscious sedation and general
anesthesia. According to the instructor, which of the following is a primary benefit of conscious
sedation?
1. The patient will remember the procedure.
2. The patient will not require airway support.
3. It will block reflexes such as coughing and gagging.
4. It can be used for procedures that take long periods of time.
10. A nurse recognizes that which of the following patients may receive spinal anesthesia?
1. A 45-year-old scheduled for a pulmonary wedge resection
2. A 29-year-old scheduled for repair of a torn rotator cuff
3. A 48-year-old scheduled for a hemorrhoidectomy
4. A 66-year-old scheduled for a bone marrow biopsy
11. A nurse is caring for a patient who received spinal anesthesia. The patient reports having a bad headache later
that day. The nurse’s best response is:
1. “You may have an allergy to the anesthetic used. Have you ever had spinal
anesthesia before?”
2. “That sometimes happens due to loss of spinal fluid during anesthesia.”
3. “I will need to call the physician immediately.”
4. “Do you have a history of migraines?”
12. A nurse who is working in the post-anesthesia care unit (PACU) recognizes that a patient is most likely to
experience which of the following complications while in the unit?
1. Hypoventilation
2. Deep vein thrombosis
3. Atelectasis
4. Pneumonia
13. After assisting with the transfer of a patient from the post-anesthesia care unit into a bed on the unit, a nurse
should first
1. Review the physician’s orders.
2. Determine the type and amount of intravenous fluid hanging.
3. Perform a physical assessment.
4. Reassure the patient that he or she will receive excellent care on the unit.
14. A nurse is caring for a patient who returned from abdominal surgery 6 hours ago. The nurse notes that the
abdominal dressing is nearly saturated with serosanguineous drainage and that a small amount of drainage
is leaking from the lower edge of the dressing. The nurse’s best action is to
1. Reinforce the dressing with additional gauze pads.
2. Remove the surgical dressing to assess the site directly.
3. Replace the surgical dressing with fresh dressings.
4. Reinforce the tape edges of the dressing.
, 15. A nurse is providing care to a 32-year-old who returned from a thyroidectomy 6 hours ago. The nurse notes
that the patient’s temperature is 99.5°F and that the patient has been taking sips of clear liquids, reports
mild nausea, and is using patient-controlled anesthesia to manage pain, which is 3/10. The nurse should
1. Order a low-salt diet.
2. Document the findings.
3. Contact the physician.
4. Assess the back of the patient’s throat.
16. A nurse is caring for a 28-year-old man who returned from the repair of a broken jaw 3 hours earlier. The
patient reports an urge to urinate and tried to use the urinal in the bed without success. The best action by
the nurse is to
1. Call to obtain an order to catheterize the patient.
2. Perform a digital rectal examination.
3. Assist the patient in standing and using the urinal.
4. Use the bladder scanner to determine the degree of distention.
17. A nurse who is providing care for a patient with a large abdominal wound removes the dressing and notes that
the wound has dehisced. The nurse should
1. Cover the wound with a large sterile dressing.
2. Pour sterile saline into the wound bed.
3. Notify the supervisor.
4. Ask the patient, “Did you feel anything pop open?”
18. A nurse is providing care for a patient with a nasogastric (NG) tube in place 10 hours after removal of a
portion of the stomach. The patient’s plan of care would include
1. Providing mouth care every 4 hours.
2. Keeping NG to continuous high suction.
3. Draping NG tubing over the patient’s shoulder.
4. Providing tube feeding every 3 hours.
19. Before placing antiembolism stockings on a patient for the first time, a nurse should
1. Obtain baseline vital signs.
2. Have the patient lie supine for 15 minutes.
3. Ask the patient to sit at the side of the bed.
4. Instruct the patient to apply lotion to his or her legs.
20. A nurse would expect an International Normalized Ratio (INR) to be ordered for which of the following
patients?
1. A 32-year-old with a history of asthma
2. A 29-year-old who takes digoxin (Lanoxin), a cardiac drug
3. A 53-year-old with a history of cirrhosis of the liver
4. A 71-year-old with a history of benign prostatic hypertrophy (BPH)
21. Most facilities require that several basic tests be performed on all patients before surgery. A nurse identifies
that these tests include all of the following except
1. Electrocardiogram (EKG).
2. Complete blood cell count (CBC).
3. Blood urea nitrogen (BUN).
4. Urinalysis (UA).
22. During standard preoperative testing, a nurse notices that a patient’s urine has an elevated specific gravity.
This finding is an indication that this patient is at risk for
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. A nurse who is caring for patients on a surgical unit recognizes that the individual having corrective surgery
is the
1. 39-year-old scheduled for breast reduction.
2. 14-year-old scheduled for tumor debulking.
3. 4-month-old scheduled for cleft lip repair.
4. 55-year-old scheduled for an exploratory laparotomy.
2. Which of the following is most commonly taught to help prevent postsurgical respiratory complications?
1. Turning, coughing, and deep breathing
2. Splinting incisions
3. The use of postsurgical compression stockings
4. Measuring intake and output
3. A nurse who is caring for a male patient after a left-side total hip replacement recognizes that further
teaching is required when
1. The patient alternately flexes and extends the toes of both feet.
2. The patient circles both ankles clockwise and counterclockwise.
3. The patient bends the knees slightly and helps pull himself up in bed using the trapeze.
4. The patient turns on his right side and lifts the left leg with his toes pointed and then
returns the leg to the midline.
4. When determining the appropriate size of thigh-high antiembolism hose, a nurse would obtain which of the
following measurements?
1. Length from gluteal fold to the bottom of the heel
2. Length from midthigh to the tip of the toe
3. Circumference of the knee
4. Amount of edema noted in the ankles
5. A nurse is providing care for a patient who is wearing antiembolism hose following a colectomy. The
patient’s plan of care should include:
1. Turning the stockings off 4 hours each day.
2. Removing the stockings at bedtime and replacing them in the morning.
3. Rolling the stockings down 2 inches to create a band at the top.
4. Removing the stockings twice daily to wash and dry the legs.
6. The wife of a patient who recently returned from a radical neck dissection asks a nurse why her husband was
given scopolamine. The best response by the nurse is:
1. “It is important to dry secretions to reduce the bacteria in his saliva.”
2. “Swallowing is painful for him right now. Scopolamine helps keep him from drooling.”
3. “This medication will reduce the swelling in his lips and tongue by reducing the amount
of saliva that his body makes.”
4. “The scopolamine will help dry oral secretions to reduce his chances of aspirating saliva
into his lungs.”
7. A nurse is caring for a female patient who is scheduled for an abdominal hysterectomy. The nurse obtains
the patient’s signature on the consent form and then signs the form himself. The nurse’s signature indicates
that
1. The patient does not have any questions about the surgery.
, 2. The nurse verified that it was the patient who signed the form.
3. The patient understands the risks of the procedure.
4. The nurse has provided verbal and written information about the surgical procedure.
8. Which of the following members of the surgical team is responsible for monitoring a patient’s vital
signs during surgery?
1. The surgeon
2. The circulating nurse
3. The first surgical assistant
4. The anesthesiologist
9. A nursing instructor teaches a group of students the differences between conscious sedation and general
anesthesia. According to the instructor, which of the following is a primary benefit of conscious
sedation?
1. The patient will remember the procedure.
2. The patient will not require airway support.
3. It will block reflexes such as coughing and gagging.
4. It can be used for procedures that take long periods of time.
10. A nurse recognizes that which of the following patients may receive spinal anesthesia?
1. A 45-year-old scheduled for a pulmonary wedge resection
2. A 29-year-old scheduled for repair of a torn rotator cuff
3. A 48-year-old scheduled for a hemorrhoidectomy
4. A 66-year-old scheduled for a bone marrow biopsy
11. A nurse is caring for a patient who received spinal anesthesia. The patient reports having a bad headache later
that day. The nurse’s best response is:
1. “You may have an allergy to the anesthetic used. Have you ever had spinal
anesthesia before?”
2. “That sometimes happens due to loss of spinal fluid during anesthesia.”
3. “I will need to call the physician immediately.”
4. “Do you have a history of migraines?”
12. A nurse who is working in the post-anesthesia care unit (PACU) recognizes that a patient is most likely to
experience which of the following complications while in the unit?
1. Hypoventilation
2. Deep vein thrombosis
3. Atelectasis
4. Pneumonia
13. After assisting with the transfer of a patient from the post-anesthesia care unit into a bed on the unit, a nurse
should first
1. Review the physician’s orders.
2. Determine the type and amount of intravenous fluid hanging.
3. Perform a physical assessment.
4. Reassure the patient that he or she will receive excellent care on the unit.
14. A nurse is caring for a patient who returned from abdominal surgery 6 hours ago. The nurse notes that the
abdominal dressing is nearly saturated with serosanguineous drainage and that a small amount of drainage
is leaking from the lower edge of the dressing. The nurse’s best action is to
1. Reinforce the dressing with additional gauze pads.
2. Remove the surgical dressing to assess the site directly.
3. Replace the surgical dressing with fresh dressings.
4. Reinforce the tape edges of the dressing.
, 15. A nurse is providing care to a 32-year-old who returned from a thyroidectomy 6 hours ago. The nurse notes
that the patient’s temperature is 99.5°F and that the patient has been taking sips of clear liquids, reports
mild nausea, and is using patient-controlled anesthesia to manage pain, which is 3/10. The nurse should
1. Order a low-salt diet.
2. Document the findings.
3. Contact the physician.
4. Assess the back of the patient’s throat.
16. A nurse is caring for a 28-year-old man who returned from the repair of a broken jaw 3 hours earlier. The
patient reports an urge to urinate and tried to use the urinal in the bed without success. The best action by
the nurse is to
1. Call to obtain an order to catheterize the patient.
2. Perform a digital rectal examination.
3. Assist the patient in standing and using the urinal.
4. Use the bladder scanner to determine the degree of distention.
17. A nurse who is providing care for a patient with a large abdominal wound removes the dressing and notes that
the wound has dehisced. The nurse should
1. Cover the wound with a large sterile dressing.
2. Pour sterile saline into the wound bed.
3. Notify the supervisor.
4. Ask the patient, “Did you feel anything pop open?”
18. A nurse is providing care for a patient with a nasogastric (NG) tube in place 10 hours after removal of a
portion of the stomach. The patient’s plan of care would include
1. Providing mouth care every 4 hours.
2. Keeping NG to continuous high suction.
3. Draping NG tubing over the patient’s shoulder.
4. Providing tube feeding every 3 hours.
19. Before placing antiembolism stockings on a patient for the first time, a nurse should
1. Obtain baseline vital signs.
2. Have the patient lie supine for 15 minutes.
3. Ask the patient to sit at the side of the bed.
4. Instruct the patient to apply lotion to his or her legs.
20. A nurse would expect an International Normalized Ratio (INR) to be ordered for which of the following
patients?
1. A 32-year-old with a history of asthma
2. A 29-year-old who takes digoxin (Lanoxin), a cardiac drug
3. A 53-year-old with a history of cirrhosis of the liver
4. A 71-year-old with a history of benign prostatic hypertrophy (BPH)
21. Most facilities require that several basic tests be performed on all patients before surgery. A nurse identifies
that these tests include all of the following except
1. Electrocardiogram (EKG).
2. Complete blood cell count (CBC).
3. Blood urea nitrogen (BUN).
4. Urinalysis (UA).
22. During standard preoperative testing, a nurse notices that a patient’s urine has an elevated specific gravity.
This finding is an indication that this patient is at risk for
