NURSING 265 (SURGERY ) WEEK 9 QUESTIONS AND ANSWERS
ELABORATIONS!!
To ensure patient safety and reduce risks associated with surgical procedures, the
circulating nurse calls a surgical timeout prior to surgery. Which activities should
be included in the timeout?
Answers :-Verify patient identification.
-Complete a fire risk assessment.
-Verify surgical site and procedure
-Ensure that consent for the specific procedure was obtained.
A patient with diabetes is waiting in the preoperative holding area for a hernia
operation. The patient asks the nurse if the daily insulin dose should be taken.
Which response is the most appropriate?
Answers :"I will check with the surgeon and let you know."
If a diabetic patient on insulin is due for surgery, it is important to get clear
instructions from the surgeon regarding the insulin administration. The surgeon
may choose to avoid the dose or give an adjusted dose based on the blood sugar
levels. The nurse should not suggest taking a reduced dose, because it may cause a
fluctuation in blood sugar levels. The insulin should not be replaced with oral
drugs unless advised by the surgeon. The insulin dose may be skipped if the
surgeon advises that.
Two days after colectomy for an abdominal mass, the patient reports gas pains and
abdominal distension. The nurse plans care for the patient on the basis of the
knowledge that these symptoms occur as a result of which condition?
Answers :Slowed gastric emptying
Until peristalsis returns to normal after anesthesia, the patient may experience
slowed gastric motility, leading to gas pains and abdominal distension. Colectomy
,does not require a nasogastric tube; the bowel should not be inflamed following
surgery unless infection is present. Constipation may occur following surgery;
however, with bowel manipulation, slowed gastric emptying is the most common
reason for gas pains and abdominal distention because of gas.
The nurse is performing a preoperative assessment for a patient scheduled for
surgery. What does the nurse explain to the patient is the reason for obtaining
accurate documentation of the current medications being taken?
Answers :Some medications may interact with anesthetics, altering the potency
and effect of the drugs."
Drug interactions may occur between prescribed medications and anesthetic agents
used during surgery. For this reason, it is important to take a careful medication
history and check that they have been communicated to the anesthesia care
provider. Medications generally do not alter the patient's perceptions about surgery.
The anesthetics may interact with the other medications, but they are not likely to
alter renal and hepatic function. Routine medications are not always held during
surgery, and dosage and schedule adjustments are not always necessary. Routine
medications may or may not be prescribed for use the day of surgery.Test-Taking
Tip: Be aware that information from previously asked questions may help you
respond to other examination questions.
A patient is admitted to the postanesthesia care unit (PACU) with a blood pressure
of 100/60 mm Hg. Which action should the nurse take first?
Answers :Check the medical record for the patient's baseline blood pressure.
The first action of the nurse is to identify what the patient's normal blood pressure
is. Interventions are dependent on the baseline variation. Rousing the patient is an
intervention that can increase the blood pressure, but would be done after
determining the baseline blood pressure. Placing the patient in Trendelenburg is not
an appropriate action in this situation. Before notifying the anesthesiologist of the
blood pressure, the nurse needs to check the baseline blood pressure.Text
Reference - p. 355
, Five minutes after receiving a preoperative sedative medication by intravenous
(IV) injection, a patient asks to get up to go to the bathroom to urinate. What is the
most appropriate action for the nurse to take?
Answers :Offer the patient to use the urinal/bedpan after explaining the need to
maintain safety.
A patient is scheduled for a prostatectomy in one week. During the preoperative
meeting he reports that he takes a fish oil capsule daily. Which of the following is
the priority intervention?
Answers :Inform the health care provider because the procedure may need to be
rescheduled.
The anesthesia care provider is preparing to administer spinal anesthesia. When
assisting with the procedure, where does the nurse determine the anesthetic
injection will be administered?
Answers :Subarachnoid space
In spinal anesthesia, local anesthetic injection is given into the cerebrospinal fluid
in the subarachnoid space. It is mostly injected below the level of L2. As a result of
mixing the anesthetic with cerebrospinal fluid, autonomic, sensory, and motor
nerves are blocked. Spinal anesthesia is usually used for procedures on extremities,
lower gastrointestinal, prostate, and gynecologic surgeries. Local anesthetics are
not administered in the pleural space, subdural space, or subpleural space.
The nurse is preparing to prep the patient's skin for surgery. In which surgical area
will the patient's skin be prepped for surgery and what clothing will the person
doing the prepping be wearing?
Answers :Operating room, wearing surgical attire and masks
ELABORATIONS!!
To ensure patient safety and reduce risks associated with surgical procedures, the
circulating nurse calls a surgical timeout prior to surgery. Which activities should
be included in the timeout?
Answers :-Verify patient identification.
-Complete a fire risk assessment.
-Verify surgical site and procedure
-Ensure that consent for the specific procedure was obtained.
A patient with diabetes is waiting in the preoperative holding area for a hernia
operation. The patient asks the nurse if the daily insulin dose should be taken.
Which response is the most appropriate?
Answers :"I will check with the surgeon and let you know."
If a diabetic patient on insulin is due for surgery, it is important to get clear
instructions from the surgeon regarding the insulin administration. The surgeon
may choose to avoid the dose or give an adjusted dose based on the blood sugar
levels. The nurse should not suggest taking a reduced dose, because it may cause a
fluctuation in blood sugar levels. The insulin should not be replaced with oral
drugs unless advised by the surgeon. The insulin dose may be skipped if the
surgeon advises that.
Two days after colectomy for an abdominal mass, the patient reports gas pains and
abdominal distension. The nurse plans care for the patient on the basis of the
knowledge that these symptoms occur as a result of which condition?
Answers :Slowed gastric emptying
Until peristalsis returns to normal after anesthesia, the patient may experience
slowed gastric motility, leading to gas pains and abdominal distension. Colectomy
,does not require a nasogastric tube; the bowel should not be inflamed following
surgery unless infection is present. Constipation may occur following surgery;
however, with bowel manipulation, slowed gastric emptying is the most common
reason for gas pains and abdominal distention because of gas.
The nurse is performing a preoperative assessment for a patient scheduled for
surgery. What does the nurse explain to the patient is the reason for obtaining
accurate documentation of the current medications being taken?
Answers :Some medications may interact with anesthetics, altering the potency
and effect of the drugs."
Drug interactions may occur between prescribed medications and anesthetic agents
used during surgery. For this reason, it is important to take a careful medication
history and check that they have been communicated to the anesthesia care
provider. Medications generally do not alter the patient's perceptions about surgery.
The anesthetics may interact with the other medications, but they are not likely to
alter renal and hepatic function. Routine medications are not always held during
surgery, and dosage and schedule adjustments are not always necessary. Routine
medications may or may not be prescribed for use the day of surgery.Test-Taking
Tip: Be aware that information from previously asked questions may help you
respond to other examination questions.
A patient is admitted to the postanesthesia care unit (PACU) with a blood pressure
of 100/60 mm Hg. Which action should the nurse take first?
Answers :Check the medical record for the patient's baseline blood pressure.
The first action of the nurse is to identify what the patient's normal blood pressure
is. Interventions are dependent on the baseline variation. Rousing the patient is an
intervention that can increase the blood pressure, but would be done after
determining the baseline blood pressure. Placing the patient in Trendelenburg is not
an appropriate action in this situation. Before notifying the anesthesiologist of the
blood pressure, the nurse needs to check the baseline blood pressure.Text
Reference - p. 355
, Five minutes after receiving a preoperative sedative medication by intravenous
(IV) injection, a patient asks to get up to go to the bathroom to urinate. What is the
most appropriate action for the nurse to take?
Answers :Offer the patient to use the urinal/bedpan after explaining the need to
maintain safety.
A patient is scheduled for a prostatectomy in one week. During the preoperative
meeting he reports that he takes a fish oil capsule daily. Which of the following is
the priority intervention?
Answers :Inform the health care provider because the procedure may need to be
rescheduled.
The anesthesia care provider is preparing to administer spinal anesthesia. When
assisting with the procedure, where does the nurse determine the anesthetic
injection will be administered?
Answers :Subarachnoid space
In spinal anesthesia, local anesthetic injection is given into the cerebrospinal fluid
in the subarachnoid space. It is mostly injected below the level of L2. As a result of
mixing the anesthetic with cerebrospinal fluid, autonomic, sensory, and motor
nerves are blocked. Spinal anesthesia is usually used for procedures on extremities,
lower gastrointestinal, prostate, and gynecologic surgeries. Local anesthetics are
not administered in the pleural space, subdural space, or subpleural space.
The nurse is preparing to prep the patient's skin for surgery. In which surgical area
will the patient's skin be prepped for surgery and what clothing will the person
doing the prepping be wearing?
Answers :Operating room, wearing surgical attire and masks
