CHAPTER 18 NURSING MANAGEMENT PREOPERATIVE
CARE
1. 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.”
2. 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.
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?
b. The patient’s statement that her last menstrual period was 8 weeks previously
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?
b. Alert the surgery center about a possible latex allergy.
5. A patient who is scheduled for a therapeutic abortion tells the nurse, “having an abortion is not right.” Which
functional health pattern should the nurse further assess?
A
. Value-belief
6. A patient undergoing an emergency appendectomy has been using st. John’s wort to prevent depression. Which
complication would the nurse expect in the postanesthesia care unit?
C
. Longer time to recover from anesthesia
7. The surgical unit nurse has just received a patient with a history of smoking from the postanesthesia care unit.
Which action is most important at this time?
,11.
A
. Auscultate for adventitious breath sounds.
8. The nurse obtains a health history from a patient who is scheduled for elective hip surgery in 1 week. The patient
reports use of garlic and ginkgo biloba. Which action by the nurse is most appropriate?
D. Discuss the herb and supplement use with the patient’s health care provider.
9. The nurse is preparing to witness the patient signing the operative consent form when the patient says, “i do not
really understand what the doctor said.” Which action is best for the nurse to take?
b. Notify the surgeon that the informed consent process is not complete.
10. Which topic is most important for the nurse to discuss preoperatively with a patient who is scheduled for
abdominal surgery for an open cholecystectomy?
C
. Deep breathing and coughing techniques
Five minutes after receiving the ordered preoperative midazolam (versed) by iv injection, the patient asks to get up to
go to the bathroom to urinate. Which action by the nurse is most appropriate?
b. Offer a urinal or bedpan and position the patient in bed to promote voiding.
12. The nurse plans to provide preoperative teaching to an alert older man who has hearing and vision deficits. His wife
usually answers most questions that are directed to the patient. Which action should the nurse take when doing the
teaching?
C
. Provide additional time for the patient to understand preoperative instructions and carry out procedures.
13. A patient who has diabetes and uses insulin to control blood glucose has been npo since midnight before having a
knee replacement surgery. Which action should the nurse take?
B. Obtain a blood glucose measurement before any insulin administration.
,14. The outpatient surgery nurse reviews the complete blood cell (cbc) count results for a patient who is scheduled for
surgery in a few days. The results are white blood cell (wbc) count 10.2 ´ 103/µl; hemoglobin 15 g/dl; hematocrit
45%; platelets 150 ´ 103 /µl. Which action should the nurse take?
d. Send the patient to the holding area when the operating room calls.
15. as the nurse prepares a patient the morning of surgery, the patient refuses to remove a wedding ring, saying, “i have
never taken it off since the day i was married.” Which response by the nurse is best?
d. Suggest that the patient give the ring to a family member to keep.
16. a patient has received atropine before surgery and complains of dry mouth. Which action by the nurse is best?
d. Tell the patient dry mouth is an expected side effect.
17. which statement by a patient scheduled for surgery is most important to report to the health care provider?
A
. “i had a heart valve replacement last year.”
18. The nurse interviews a patient scheduled to undergo general anesthesia for a hernia repair. Which information is
mostimportant to communicate to the surgeon and anesthesiologist before surgery?
d. The patient’s father died after receiving general anesthesia for abdominal surgery.
19. Which information in the preoperative patient’s medication history is most important to communicate to the health
care provider?
B. The patient takes garlic capsules daily but did not take any on the surgical day.
20. A patient who takes a diuretic and a b-blocker to control blood pressure is scheduled for breast reconstruction
surgery.
Which patient information is most important to communicate to the health care provider before surgery?
d. Serum potassium 3.2 meq/l
1. When caring for a preoperative patient on the day of surgery, which actions included in the plan of care can the
nurse delegate to unlicensed assistive personnel (uap)? (select all that apply.) C. Obtain and document baseline viral
signs
d. Remove nail polish and apply pulse oximeter
e. Transport the patient by stretcher to the operating room
, 13.
Chapter 19: nursing management: intraoperative care
1. The nurse educator facilitates student clinical experiences in the surgical suite. Which action, if performed by a
student, would require the nurse educator to intervene?
C
. The student wears surgical scrubs in the semirestricted area.
2. Which statement, if made by a new circulating nurse, is appropriate?
A
. “i will assist in preparing the operating room for the patient.”
3. which action best describes the role of the certified registered nurse anesthetist (crna) on the surgical care team?
b. Releases or discharges patients from the postanesthesia care area.
4. Which action best describes how the scrub nurse maintains aseptic technique during surgery?
D. Changes gloves after touching the upper arm of the surgeon’s gown
5. which action most effectively demonstrates that a new staff member understands the role of scrub nurse? C
. Keeps both hands above the operating table level
6. Which data identified during the perioperative assessment alert the nurse that special protection techniques should
be implemented during surgery?
b. History of spinal and hip arthritis
7. a patient scheduled to undergo total knee replacement surgery under general anesthesia asks the nurse, “will the
doctor put me to sleep with a mask over my face?” Which response by the nurse is most appropriate?
A
. “a drug may be given to you through your iv line first. I will check with the anesthesia care provider.”
8. A patient received inhalation anesthesia during surgery. Postoperatively the nurse should monitor the patient for
which complication?
D. Laryngospasm
9. which action should the perioperative nurse take to best protect the patient from burn injury during surgery?
CARE
1. 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.”
2. 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.
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?
b. The patient’s statement that her last menstrual period was 8 weeks previously
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?
b. Alert the surgery center about a possible latex allergy.
5. A patient who is scheduled for a therapeutic abortion tells the nurse, “having an abortion is not right.” Which
functional health pattern should the nurse further assess?
A
. Value-belief
6. A patient undergoing an emergency appendectomy has been using st. John’s wort to prevent depression. Which
complication would the nurse expect in the postanesthesia care unit?
C
. Longer time to recover from anesthesia
7. The surgical unit nurse has just received a patient with a history of smoking from the postanesthesia care unit.
Which action is most important at this time?
,11.
A
. Auscultate for adventitious breath sounds.
8. The nurse obtains a health history from a patient who is scheduled for elective hip surgery in 1 week. The patient
reports use of garlic and ginkgo biloba. Which action by the nurse is most appropriate?
D. Discuss the herb and supplement use with the patient’s health care provider.
9. The nurse is preparing to witness the patient signing the operative consent form when the patient says, “i do not
really understand what the doctor said.” Which action is best for the nurse to take?
b. Notify the surgeon that the informed consent process is not complete.
10. Which topic is most important for the nurse to discuss preoperatively with a patient who is scheduled for
abdominal surgery for an open cholecystectomy?
C
. Deep breathing and coughing techniques
Five minutes after receiving the ordered preoperative midazolam (versed) by iv injection, the patient asks to get up to
go to the bathroom to urinate. Which action by the nurse is most appropriate?
b. Offer a urinal or bedpan and position the patient in bed to promote voiding.
12. The nurse plans to provide preoperative teaching to an alert older man who has hearing and vision deficits. His wife
usually answers most questions that are directed to the patient. Which action should the nurse take when doing the
teaching?
C
. Provide additional time for the patient to understand preoperative instructions and carry out procedures.
13. A patient who has diabetes and uses insulin to control blood glucose has been npo since midnight before having a
knee replacement surgery. Which action should the nurse take?
B. Obtain a blood glucose measurement before any insulin administration.
,14. The outpatient surgery nurse reviews the complete blood cell (cbc) count results for a patient who is scheduled for
surgery in a few days. The results are white blood cell (wbc) count 10.2 ´ 103/µl; hemoglobin 15 g/dl; hematocrit
45%; platelets 150 ´ 103 /µl. Which action should the nurse take?
d. Send the patient to the holding area when the operating room calls.
15. as the nurse prepares a patient the morning of surgery, the patient refuses to remove a wedding ring, saying, “i have
never taken it off since the day i was married.” Which response by the nurse is best?
d. Suggest that the patient give the ring to a family member to keep.
16. a patient has received atropine before surgery and complains of dry mouth. Which action by the nurse is best?
d. Tell the patient dry mouth is an expected side effect.
17. which statement by a patient scheduled for surgery is most important to report to the health care provider?
A
. “i had a heart valve replacement last year.”
18. The nurse interviews a patient scheduled to undergo general anesthesia for a hernia repair. Which information is
mostimportant to communicate to the surgeon and anesthesiologist before surgery?
d. The patient’s father died after receiving general anesthesia for abdominal surgery.
19. Which information in the preoperative patient’s medication history is most important to communicate to the health
care provider?
B. The patient takes garlic capsules daily but did not take any on the surgical day.
20. A patient who takes a diuretic and a b-blocker to control blood pressure is scheduled for breast reconstruction
surgery.
Which patient information is most important to communicate to the health care provider before surgery?
d. Serum potassium 3.2 meq/l
1. When caring for a preoperative patient on the day of surgery, which actions included in the plan of care can the
nurse delegate to unlicensed assistive personnel (uap)? (select all that apply.) C. Obtain and document baseline viral
signs
d. Remove nail polish and apply pulse oximeter
e. Transport the patient by stretcher to the operating room
, 13.
Chapter 19: nursing management: intraoperative care
1. The nurse educator facilitates student clinical experiences in the surgical suite. Which action, if performed by a
student, would require the nurse educator to intervene?
C
. The student wears surgical scrubs in the semirestricted area.
2. Which statement, if made by a new circulating nurse, is appropriate?
A
. “i will assist in preparing the operating room for the patient.”
3. which action best describes the role of the certified registered nurse anesthetist (crna) on the surgical care team?
b. Releases or discharges patients from the postanesthesia care area.
4. Which action best describes how the scrub nurse maintains aseptic technique during surgery?
D. Changes gloves after touching the upper arm of the surgeon’s gown
5. which action most effectively demonstrates that a new staff member understands the role of scrub nurse? C
. Keeps both hands above the operating table level
6. Which data identified during the perioperative assessment alert the nurse that special protection techniques should
be implemented during surgery?
b. History of spinal and hip arthritis
7. a patient scheduled to undergo total knee replacement surgery under general anesthesia asks the nurse, “will the
doctor put me to sleep with a mask over my face?” Which response by the nurse is most appropriate?
A
. “a drug may be given to you through your iv line first. I will check with the anesthesia care provider.”
8. A patient received inhalation anesthesia during surgery. Postoperatively the nurse should monitor the patient for
which complication?
D. Laryngospasm
9. which action should the perioperative nurse take to best protect the patient from burn injury during surgery?
