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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. - ---
CORRECT ANSWER-->A
The patients 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 patients 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 patients insurance does not cover outpatient surgery.
,d. The patient has not had surgery using general anesthesia
before. - ---CORRECT ANSWER-->A
After outpatient surgery, the patient should not drive home
and will need assistance with transportation and home care.
The patients experience with surgery is assessed, but it does
not have as much application to the patients physiologic safety.
The patients insurance coverage is important to establish, but
this is not usually the nurses role or a priority in nursing care.
Having clear liquids a few hours before surgery does not usually
increase risk for aspiration.
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 patients lack of knowledge about postoperative pain
control measures
b. The patients statement that her last menstrual period was 8
weeks previously
c. The patients history of a postoperative infection following a
prior cholecystectomy
d. The patients concern that she will be unable to care for her
children postoperatively - ---CORRECT ANSWER-->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.
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. - ---CORRECT ANSWER-->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.
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
b. Cognitive-perceptual
c. Sexuality-reproductive
d. Coping-stress tolerance - ---CORRECT ANSWER-->A
The value-belief pattern includes information about conflicts
between a patients values and proposed medical care. In the
cognitive-perceptual pattern, the nurse will ask questions about
pain and sensory intactness. The sexuality-reproductive pattern
includes data about the impact of the surgery on the patients
sexuality. The coping-stress tolerance pattern assessment will
elicit information about how the patient feels about the
surgery.
A patient undergoing an emergency appendectomy has been
using St. Johns wort to prevent depression. Which complication
would the nurse expect in the post-anesthesia care unit?
a. Increased pain
b. Hypertensive episodes
c. Longer time to recover from anesthesia
d. Increased risk for postoperative bleeding - ---CORRECT
ANSWER-->C
St. Johns wort may prolong the effects of anesthetic agents and
increase the time to waken completely after surgery. It is not
associated with increased bleeding risk, hypertension, or
increased pain