Chapter 09 Ignatavicius: Medical-Surgical Nursing, 10th Edition
1. A preoperative nurse is assessing a client prior to surgery. Which informa-
tion would be most important for the nurse to relay to the surgical team?:
Use of multiple herbs and supplements
2. A nurse works on the postoperative floor and has four clients who are
being discharged tomorrow. Which one has the greatest need for the nurse
to consult other members of the health care team for postdischarge care?:
Older adult who lives alone at home despite some memory loss.
3. A clinic nurse is teaching a client prior to surgery. The client does not
seem to comprehend the teaching, forgets a lot of what is said, and asks the
same questions again and again. What action by the nurse is best?: Assess
the client for anxiety.
4. A preoperative nurse is reviewing morning laboratory values on four
clients waiting for surgery. Which result warrants immediate communication
with the surgical team?: Potassium: 2.9 mEq/L (2.9 mmol/L)
5. An inpatient nurse brings an informed consent form to a client for an
oper- ation scheduled for tomorrow. The client asks about possible
complications from the operation. What response by the nurse is best?: Do
not have the client sign the consent and call the primary health care
provider.
6. A client has a great deal of pain when coughing and deep breathing after
abdominal surgery despite having pain medication. What action by the
nurse is best?: Demonstrate how to splint the incision.
7. A nurse is giving a client instructions for showering the night before
surgery. What instruction is most appropriate?: "Use the prescribed
solution and wash the area where you will have surgery very
1/4
, Chapter 09 Ignatavicius: Medical-Surgical Nursing, 10th Edition
thoroughly."
8. A postoperative client has an abdominal drain. What assessment by the
nurse indicates that goals for the priority client problems related to the
drain are being met?: There is no redness, warmth, or drainage at the
insertion site.
9. The perioperative nurse manager and the postoperative unit manager are
concerned about the increasing number of surgical infections in their
hospital. What action by the managers is best?: Audit charts to see if the
Surgical Care Improvement Project (SCIP) outcomes were met.
10.A nurse assesses a client in the preoperative holding area and finds
brittle nails and hair, dry skin turgor, and muscle wasting. What action by the
nurse is best?: Consult the primary health care provider about a dietitian
referral.
11.A client has arrived in the inpatient postoperative unit. What action by
the inpatient nurse takes priority?: Participating in hand-off report
12.The postanesthesia care unit (PACU) charge nurse notes vital signs on
four postoperative clients. Which client would the nurse assess first?: Client
with a respiratory rate of 6 breaths/min
13.A client had a surgical procedure with spinal anesthesia. The client's
blood pressure was 122/78 mm Hg 30 minutes ago and is now 138/60 and
the client reports nausea. What action by the nurse is best?: Notify the
primary health care provider.
14.A postoperative client vomited. After cleaning and comforting the
client, which action by the nurse is most important?: Auscultate lung
sounds.
2/4
1. A preoperative nurse is assessing a client prior to surgery. Which informa-
tion would be most important for the nurse to relay to the surgical team?:
Use of multiple herbs and supplements
2. A nurse works on the postoperative floor and has four clients who are
being discharged tomorrow. Which one has the greatest need for the nurse
to consult other members of the health care team for postdischarge care?:
Older adult who lives alone at home despite some memory loss.
3. A clinic nurse is teaching a client prior to surgery. The client does not
seem to comprehend the teaching, forgets a lot of what is said, and asks the
same questions again and again. What action by the nurse is best?: Assess
the client for anxiety.
4. A preoperative nurse is reviewing morning laboratory values on four
clients waiting for surgery. Which result warrants immediate communication
with the surgical team?: Potassium: 2.9 mEq/L (2.9 mmol/L)
5. An inpatient nurse brings an informed consent form to a client for an
oper- ation scheduled for tomorrow. The client asks about possible
complications from the operation. What response by the nurse is best?: Do
not have the client sign the consent and call the primary health care
provider.
6. A client has a great deal of pain when coughing and deep breathing after
abdominal surgery despite having pain medication. What action by the
nurse is best?: Demonstrate how to splint the incision.
7. A nurse is giving a client instructions for showering the night before
surgery. What instruction is most appropriate?: "Use the prescribed
solution and wash the area where you will have surgery very
1/4
, Chapter 09 Ignatavicius: Medical-Surgical Nursing, 10th Edition
thoroughly."
8. A postoperative client has an abdominal drain. What assessment by the
nurse indicates that goals for the priority client problems related to the
drain are being met?: There is no redness, warmth, or drainage at the
insertion site.
9. The perioperative nurse manager and the postoperative unit manager are
concerned about the increasing number of surgical infections in their
hospital. What action by the managers is best?: Audit charts to see if the
Surgical Care Improvement Project (SCIP) outcomes were met.
10.A nurse assesses a client in the preoperative holding area and finds
brittle nails and hair, dry skin turgor, and muscle wasting. What action by the
nurse is best?: Consult the primary health care provider about a dietitian
referral.
11.A client has arrived in the inpatient postoperative unit. What action by
the inpatient nurse takes priority?: Participating in hand-off report
12.The postanesthesia care unit (PACU) charge nurse notes vital signs on
four postoperative clients. Which client would the nurse assess first?: Client
with a respiratory rate of 6 breaths/min
13.A client had a surgical procedure with spinal anesthesia. The client's
blood pressure was 122/78 mm Hg 30 minutes ago and is now 138/60 and
the client reports nausea. What action by the nurse is best?: Notify the
primary health care provider.
14.A postoperative client vomited. After cleaning and comforting the
client, which action by the nurse is most important?: Auscultate lung
sounds.
2/4
