MED SURG PERIOPERATIVE CARE UPDATED 2025
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. - ANSWER D - Mark the left
knee site with the client awake and the surgeon present.
The nurse will be required to mark the left knee site with the client awake and the surgeon present. The
Joint Commission NSPG requires that the surgical site be marked by an independent licensed
professional and should, when possible, involve the client. The surgeon is accountable and should be
present.The EMR should identify the correct procedure, but is not a specific JCAHO requirement. The
nurse will verify the procedure with the client when possible, but this is not a requirement.
Communication with the surgeon is ideal, but is not specifically required.
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." - ANSWER D - "Pain medication will take away my pain."
,The client's statement that, "Pain medication will take away my pain," indicates the need for further
instruction. Pain medication will reduce pain, but will not take it away completely.The client statement
about waking up with a tube in the throat is accurate, because the client will be intubated. Following
heart surgery, a dressing is placed on the chest. The client will not be able to see family immediately
because he or she will go to recovery first.
Which task would be best for the charge nurse to assign to the LPN/LVN working in the surgery
admitting area?
A - Provide preoperative teaching to a client who needs insertion of a tunneled central venous catheter.
B - Insert a retention catheter in a client who requires a flap graft of a sacral pressure ulcer.
C - Obtain the medical history from a client who is scheduled for a total hip replacement.
D - Assess the client who is being admitted for an elective laparoscopic cholecystectomy. - ANSWER B -
Insert a retention catheter in a client who requires a flap graft of a sacral pressure ulcer.
Insertion of a catheter is the best task within the scope of skills approved for the LPN/LVN.Preoperative
teaching and physical assessment of a preoperative client are under the scope of the RN. History
information would be completed by the RN on the unit.
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 - ANSWER C - Having a small glass of juice at 7:00 a.m.
, Clients need to be NPO for a sufficient length of time before surgery to prevent aspiration of fluid into
the lungs. Intake of food or fluids may delay the start time of the surgery, so the nurse must notify the
surgeon and anesthesiologist for possible rescheduling.The nurse would confirm that all allergies are
charted, and that the client has the correct allergy band identification. Many clients experience nausea
after surgery; the nurse would document this in the client's information as well. The nurse would talk
with the client and explore the anxiety; this is a normal feeling before surgery.
The nurse completes the preoperative checklist on a client scheduled for general surgery. Which factor
contributes the greatest risk for the planned procedure?
A - Age 59 years
B - General anesthesia complications experienced by the client's brother
C - Diet-controlled diabetes mellitus
D - Ten pounds (4.5 kg) over the client's ideal body weight - ANSWER C - Diet-controlled diabetes
mellitus
The client's greatest risk factor is diabetes mellitus. Diabetes contributes an increased risk for surgery or
postsurgical complications.Older adults are at greater risk for surgical procedures, but this client is not
classified as an older adult. Family medical history and problems with anesthetics may indicate possible
reactions to anesthesia, but this is not the best answer. Obesity increases the risk for poor wound
healing, but being 10 pounds (4.5 kg) overweight does not categorize this client as obese.
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."
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. - ANSWER D - Mark the left
knee site with the client awake and the surgeon present.
The nurse will be required to mark the left knee site with the client awake and the surgeon present. The
Joint Commission NSPG requires that the surgical site be marked by an independent licensed
professional and should, when possible, involve the client. The surgeon is accountable and should be
present.The EMR should identify the correct procedure, but is not a specific JCAHO requirement. The
nurse will verify the procedure with the client when possible, but this is not a requirement.
Communication with the surgeon is ideal, but is not specifically required.
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." - ANSWER D - "Pain medication will take away my pain."
,The client's statement that, "Pain medication will take away my pain," indicates the need for further
instruction. Pain medication will reduce pain, but will not take it away completely.The client statement
about waking up with a tube in the throat is accurate, because the client will be intubated. Following
heart surgery, a dressing is placed on the chest. The client will not be able to see family immediately
because he or she will go to recovery first.
Which task would be best for the charge nurse to assign to the LPN/LVN working in the surgery
admitting area?
A - Provide preoperative teaching to a client who needs insertion of a tunneled central venous catheter.
B - Insert a retention catheter in a client who requires a flap graft of a sacral pressure ulcer.
C - Obtain the medical history from a client who is scheduled for a total hip replacement.
D - Assess the client who is being admitted for an elective laparoscopic cholecystectomy. - ANSWER B -
Insert a retention catheter in a client who requires a flap graft of a sacral pressure ulcer.
Insertion of a catheter is the best task within the scope of skills approved for the LPN/LVN.Preoperative
teaching and physical assessment of a preoperative client are under the scope of the RN. History
information would be completed by the RN on the unit.
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 - ANSWER C - Having a small glass of juice at 7:00 a.m.
, Clients need to be NPO for a sufficient length of time before surgery to prevent aspiration of fluid into
the lungs. Intake of food or fluids may delay the start time of the surgery, so the nurse must notify the
surgeon and anesthesiologist for possible rescheduling.The nurse would confirm that all allergies are
charted, and that the client has the correct allergy band identification. Many clients experience nausea
after surgery; the nurse would document this in the client's information as well. The nurse would talk
with the client and explore the anxiety; this is a normal feeling before surgery.
The nurse completes the preoperative checklist on a client scheduled for general surgery. Which factor
contributes the greatest risk for the planned procedure?
A - Age 59 years
B - General anesthesia complications experienced by the client's brother
C - Diet-controlled diabetes mellitus
D - Ten pounds (4.5 kg) over the client's ideal body weight - ANSWER C - Diet-controlled diabetes
mellitus
The client's greatest risk factor is diabetes mellitus. Diabetes contributes an increased risk for surgery or
postsurgical complications.Older adults are at greater risk for surgical procedures, but this client is not
classified as an older adult. Family medical history and problems with anesthetics may indicate possible
reactions to anesthesia, but this is not the best answer. Obesity increases the risk for poor wound
healing, but being 10 pounds (4.5 kg) overweight does not categorize this client as obese.
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."
