Chapter 19: Postoperative Nursing Management
Hinkle: Brunner & Suddarth's Textbook of Medical-Surgical
Nursing, 13th Edition
MULTIPLE CHOICE
1. The recovery room nurse is admitting a patient from the OR following the
patient's successful splenectomy. What is the first assessment that the
nurse should perform on this newly admitted patient?
A) Heart rate and rhythm
B) Skin integrity
C) Core body temperature
D) Airway patency
ANS: D
The primary objective in the immediate postoperative period is to maintain
ventilation and, thus, prevent hypoxemia and hypercapnia. Both can occur if
the airway is obstructed and ventilation is reduced. This assessment is followed
by cardiovascular status and the condition of the surgical site. The core
temperature would be assessed after the airway, cardiovascular status, and
wound (skin integrity).
2. An adult patient is in the recovery room following a nephrectomy performed for
the treatment of renal cell carcinoma. The patient's vital signs and level of
consciousness stabilized, but the patient then complains of severe nausea and
begins to retch. What should the nurse do next?
A) Administer a dose of IV analgesic.
B) Apply a cool cloth to the patient's forehead.
C) Offer the patient a small amount of ice chips.
D) Turn the patient completely to one side.
ANS: D
Turning the patient completely to one side allows collected fluid to escape from
, the side of the mouth if the patient vomits. After turning the patient to the side,
the nurse can offer a cool cloth to the patient's forehead. Ice chips can increase
feelings of nausea. An analgesic is not administered for nausea and vomiting.
3. The perioperative nurse is preparing to discharge a female patient home from
day surgery performed under general anesthetic. What instruction should the
nurse give the patient prior to the patient leaving the hospital?
A) The patient should not drive herself home.
B) The patient should take an OTC sleeping pill for 2 nights.
C) The patient should attempt to eat a large meal at home to aid wound healing.
D) The patient should remain in bed for the first 48 hours postoperative.
ANS: A
Although recovery time varies, depending on the type and extent of surgery and
the patient's overall condition, instructions usually advise limited activity for 24
to 48 hours. Complete bedrest is contraindicated in most cases, however. During
this time, the patient should not drive a vehicle and should eat only as tolerated.
The nurse does not normally make OTC recommendations for hypnotics.
4. The nurse is caring for a 78-year-old man who has had an outpatient
cholecystectomy. The nurse is getting him up for his first walk postoperatively.
To decrease the potential for orthostatic hypotension and consequent falls, what
should the nurse have the patient do?
A) Sit in a chair for 10 minutes prior to ambulating.
B) Drink plenty of fluids to increase circulating blood volume.
C) Stand upright for 2 to 3 minutes prior to ambulating.
D) Perform range-of-motion exercises for each joint.
ANS: C
Older adults are at an increased risk for orthostatic hypotension secondary to
age- related changes in vascular tone. The patient should sit up and then stand
for 2 to 3 minutes before ambulating to alleviate orthostatic hypotension. The
nurse should assess the patient's ability to mobilize safely, but full assessment of
, range of motion in all joints is not normally necessary. Sitting in a chair and
increasing fluid intake are insufficient to prevent orthostatic hypotension and
consequent falls.
5. The perioperative nurse is providing care for a patient who is recovering on
the postsurgical unit following a transurethral prostate resection (TUPR). The
patient is reluctant to ambulate, citing the need to recover in bed. For what
complication is the patient most at risk?
A) Atelectasis
B) Anemia
C) Dehydration
D) Peripheral edema
ANS: A
Atelectasis occurs when the postoperative patient fails to move, cough, and
breathe deeply. With good nursing care, this is an avoidable complication, but
reduced mobility greatly increases the risk. Anemia occurs rarely and usually in
situations where the patient loses a significant amount of blood or continues
bleeding postoperatively. Fluid shifts postoperatively may result in dehydration
and peripheral edema, but the patient is most at risk for atelectasis.
6. The nurse is caring for a patient on the medical-surgical unit postoperative day
5. During each patient assessment, the nurse evaluates the patient for infection.
Which of the following would be most indicative of infection?
A) Presence of an indwelling urinary catheter
B) Rectal temperature of 99.5 F (37.5C)
C) Red, warm, tender incision
D) White blood cell (WBC) count of 8,000/mL
ANS: C
Redness, warmth, and tenderness in the incision area should lead the nurse to
suspect a postoperative infection. The presence of any invasive device
Hinkle: Brunner & Suddarth's Textbook of Medical-Surgical
Nursing, 13th Edition
MULTIPLE CHOICE
1. The recovery room nurse is admitting a patient from the OR following the
patient's successful splenectomy. What is the first assessment that the
nurse should perform on this newly admitted patient?
A) Heart rate and rhythm
B) Skin integrity
C) Core body temperature
D) Airway patency
ANS: D
The primary objective in the immediate postoperative period is to maintain
ventilation and, thus, prevent hypoxemia and hypercapnia. Both can occur if
the airway is obstructed and ventilation is reduced. This assessment is followed
by cardiovascular status and the condition of the surgical site. The core
temperature would be assessed after the airway, cardiovascular status, and
wound (skin integrity).
2. An adult patient is in the recovery room following a nephrectomy performed for
the treatment of renal cell carcinoma. The patient's vital signs and level of
consciousness stabilized, but the patient then complains of severe nausea and
begins to retch. What should the nurse do next?
A) Administer a dose of IV analgesic.
B) Apply a cool cloth to the patient's forehead.
C) Offer the patient a small amount of ice chips.
D) Turn the patient completely to one side.
ANS: D
Turning the patient completely to one side allows collected fluid to escape from
, the side of the mouth if the patient vomits. After turning the patient to the side,
the nurse can offer a cool cloth to the patient's forehead. Ice chips can increase
feelings of nausea. An analgesic is not administered for nausea and vomiting.
3. The perioperative nurse is preparing to discharge a female patient home from
day surgery performed under general anesthetic. What instruction should the
nurse give the patient prior to the patient leaving the hospital?
A) The patient should not drive herself home.
B) The patient should take an OTC sleeping pill for 2 nights.
C) The patient should attempt to eat a large meal at home to aid wound healing.
D) The patient should remain in bed for the first 48 hours postoperative.
ANS: A
Although recovery time varies, depending on the type and extent of surgery and
the patient's overall condition, instructions usually advise limited activity for 24
to 48 hours. Complete bedrest is contraindicated in most cases, however. During
this time, the patient should not drive a vehicle and should eat only as tolerated.
The nurse does not normally make OTC recommendations for hypnotics.
4. The nurse is caring for a 78-year-old man who has had an outpatient
cholecystectomy. The nurse is getting him up for his first walk postoperatively.
To decrease the potential for orthostatic hypotension and consequent falls, what
should the nurse have the patient do?
A) Sit in a chair for 10 minutes prior to ambulating.
B) Drink plenty of fluids to increase circulating blood volume.
C) Stand upright for 2 to 3 minutes prior to ambulating.
D) Perform range-of-motion exercises for each joint.
ANS: C
Older adults are at an increased risk for orthostatic hypotension secondary to
age- related changes in vascular tone. The patient should sit up and then stand
for 2 to 3 minutes before ambulating to alleviate orthostatic hypotension. The
nurse should assess the patient's ability to mobilize safely, but full assessment of
, range of motion in all joints is not normally necessary. Sitting in a chair and
increasing fluid intake are insufficient to prevent orthostatic hypotension and
consequent falls.
5. The perioperative nurse is providing care for a patient who is recovering on
the postsurgical unit following a transurethral prostate resection (TUPR). The
patient is reluctant to ambulate, citing the need to recover in bed. For what
complication is the patient most at risk?
A) Atelectasis
B) Anemia
C) Dehydration
D) Peripheral edema
ANS: A
Atelectasis occurs when the postoperative patient fails to move, cough, and
breathe deeply. With good nursing care, this is an avoidable complication, but
reduced mobility greatly increases the risk. Anemia occurs rarely and usually in
situations where the patient loses a significant amount of blood or continues
bleeding postoperatively. Fluid shifts postoperatively may result in dehydration
and peripheral edema, but the patient is most at risk for atelectasis.
6. The nurse is caring for a patient on the medical-surgical unit postoperative day
5. During each patient assessment, the nurse evaluates the patient for infection.
Which of the following would be most indicative of infection?
A) Presence of an indwelling urinary catheter
B) Rectal temperature of 99.5 F (37.5C)
C) Red, warm, tender incision
D) White blood cell (WBC) count of 8,000/mL
ANS: C
Redness, warmth, and tenderness in the incision area should lead the nurse to
suspect a postoperative infection. The presence of any invasive device
