Med Surg 1 Lewis Ch. 18, 19, And 20 Periop, Pre-op,
Post-op Exam With Complete Solutions
A patient scheduled for an elective hysterectomy tells the nurse, "I am
afraid that I will die in surgery like my mother did!" Which response by the
nurse is most appropriate?
a. "Tell me more about what happened to your mother."
b. "You will receive medications to reduce your anxiety."
c. "You should talk to the doctor again about the surgery."
d. "Surgical techniques have improved a lot in recent years." - ANSWER
ANS: A
The patient's statement may indicate an unusually high anxiety level or a
family history of problems such as malignant hyperthermia, which will
require precautions during surgery. The other statements may also address
the patient's concerns, but further assessment is needed first.
A patient arrives at the ambulatory surgery center for a scheduled
laparoscopy procedure in outpatient surgery. Which information is of most
concern to the nurse?
a. The patient is planning to drive home after surgery.
b. The patient had a sip of water 4 hours before arriving.
c. The patient's insurance does not cover outpatient surgery.
d. The patient has not had surgery using general anesthesia before. -
ANSWER ANS: A
After outpatient surgery, the patient should not drive home and will need
assistance with transportation and home care. The patient's experience
with surgery is assessed, but it does not have as much application to the
patient's physiologic safety. The patient's insurance coverage is important
, to establish, but this is not usually the nurse's role or a priority in nursing
care. Having clear liquids a few hours before surgery does not usually
increase risk for aspiration.
3. A 38-year-old female is admitted for an elective surgical procedure.
Which information obtained by the nurse during the preoperative
assessment is most important to report to the anesthesiologist before
surgery?
a. The patient's lack of knowledge about postoperative pain control
measures
b. The patient's statement that her last menstrual period was 8 weeks
previously
c. The patient's history of a postoperative infection following a prior
cholecystectomy
d. The patient's concern that she will be unable to care for her children
postoperatively - ANSWER ANS: B
This statement suggests that the patient may be pregnant, and pregnancy
testing is needed before administration of anesthetic agents. Although the
other data may also be communicated with the surgeon and
anesthesiologist, they will affect postoperative care and do not indicate a
need for further assessment before surgery.
4. A patient who has never had any prior surgeries tells the nurse doing the
preoperative assessment about an allergy to bananas and avocados.
Which action is most important for the nurse to take?
a. Notify the dietitian about the food allergies.
b. Alert the surgery center about a possible latex allergy.
c. Reassure the patient that all allergies are noted on the medical record.
d. Ask whether the patient uses antihistamines to reduce allergic reactions.
- ANSWER ANS: B
Certain food allergies (e.g., eggs, avocados, bananas, chestnuts, potatoes,
peaches) are related to latex allergies. When a patient is allergic to latex,
special nonlatex materials are used during surgical procedures, and the
staff will need to know about the allergy in advance to obtain appropriate
nonlatex materials and have them available during surgery. The other
actions also may be appropriate, but prevention of allergic reaction during
surgery is the most important action.
Post-op Exam With Complete Solutions
A patient scheduled for an elective hysterectomy tells the nurse, "I am
afraid that I will die in surgery like my mother did!" Which response by the
nurse is most appropriate?
a. "Tell me more about what happened to your mother."
b. "You will receive medications to reduce your anxiety."
c. "You should talk to the doctor again about the surgery."
d. "Surgical techniques have improved a lot in recent years." - ANSWER
ANS: A
The patient's statement may indicate an unusually high anxiety level or a
family history of problems such as malignant hyperthermia, which will
require precautions during surgery. The other statements may also address
the patient's concerns, but further assessment is needed first.
A patient arrives at the ambulatory surgery center for a scheduled
laparoscopy procedure in outpatient surgery. Which information is of most
concern to the nurse?
a. The patient is planning to drive home after surgery.
b. The patient had a sip of water 4 hours before arriving.
c. The patient's insurance does not cover outpatient surgery.
d. The patient has not had surgery using general anesthesia before. -
ANSWER ANS: A
After outpatient surgery, the patient should not drive home and will need
assistance with transportation and home care. The patient's experience
with surgery is assessed, but it does not have as much application to the
patient's physiologic safety. The patient's insurance coverage is important
, to establish, but this is not usually the nurse's role or a priority in nursing
care. Having clear liquids a few hours before surgery does not usually
increase risk for aspiration.
3. A 38-year-old female is admitted for an elective surgical procedure.
Which information obtained by the nurse during the preoperative
assessment is most important to report to the anesthesiologist before
surgery?
a. The patient's lack of knowledge about postoperative pain control
measures
b. The patient's statement that her last menstrual period was 8 weeks
previously
c. The patient's history of a postoperative infection following a prior
cholecystectomy
d. The patient's concern that she will be unable to care for her children
postoperatively - ANSWER ANS: B
This statement suggests that the patient may be pregnant, and pregnancy
testing is needed before administration of anesthetic agents. Although the
other data may also be communicated with the surgeon and
anesthesiologist, they will affect postoperative care and do not indicate a
need for further assessment before surgery.
4. A patient who has never had any prior surgeries tells the nurse doing the
preoperative assessment about an allergy to bananas and avocados.
Which action is most important for the nurse to take?
a. Notify the dietitian about the food allergies.
b. Alert the surgery center about a possible latex allergy.
c. Reassure the patient that all allergies are noted on the medical record.
d. Ask whether the patient uses antihistamines to reduce allergic reactions.
- ANSWER ANS: B
Certain food allergies (e.g., eggs, avocados, bananas, chestnuts, potatoes,
peaches) are related to latex allergies. When a patient is allergic to latex,
special nonlatex materials are used during surgical procedures, and the
staff will need to know about the allergy in advance to obtain appropriate
nonlatex materials and have them available during surgery. The other
actions also may be appropriate, but prevention of allergic reaction during
surgery is the most important action.
