Chapter 42 Care of the Surgical Patient
The patient is 38 years old and is in her second postoperative day after
placement of an intramedullary rod in her left femur. She is receiving
analgesia via a patient- controlled analgesia (PCA) device. The inappropriate
intervention related to caring for a patient with a PCA is:
a. Maintaining the system.
b. Recording activations of the system.
c. Administering the analgesia to the patient.
d. Monitoring the patient's pain.
ANS: C
With the PCA system of medication administration, the patient can
self-administer an analgesic by pressing a control button. The nurse should
not give medication doses by pushing the control button.
REF: Page 1286 TOP: Medication administration
A 73-year-old patient with diabetes was admitted for below-the-knee
amputation of his right leg. Removal of his right leg is an example of which
type of surgery?
a. Palliative
b. Diagnostic
c. Reconstructive
d. Ablative
ANS: D
Ablative is a type of surgery where an amputation, excision of any part of the
body, or removal of a growth and harmful substance is performed.
REF: Page 1254, Table 42-1 TOP: Types of surgery
We have an expert-written solution to this problem!
The Patient's Bill of Rights states that a patient must give his or her
permission for any specific test or procedure to be performed. What is the
legal term for this permission?
a. Verbal consent
b. Medical documentation
,c. Informed consent
d. Informed decision
ANS: C
The Patient's Bill of Rights affirms that the patients must give informed
consent (permission obtained from the patient to perform a specific test or
procedure) before the beginning of any procedure.
REF: Page 1260
TOP: Informed consent
An informed consent was to be obtained from the patient for his scheduled
open cholecystectomy. Which circumstance could prevent the patient from
signing his informed consent?
a. Pain radiating to the scapula
b. An injection of Demerol, 75 mg IM, 1 hour ago
c. The presence of jaundice and scleral icterus
d. His concern over his insurance company not covering the procedure
ANS: B
Informed consent should not be obtained if the patient is disoriented and
under the influence of sedatives.
REF: Page 1261 TOP: Informed consent
The anesthesiologist provides anesthesia by inhalation and IV administration
routes.
a. general
b. regional
c. specific
d. preoperative
ANS: A
An anesthesiologist gives general anesthetics by IV and inhalation routes
through four stages of anesthesia.
REF: Page 1273 TOP: Anesthesia
A type of anesthesia that requires a depressed level of consciousness is
a. regional anesthesia.
, b. specific anesthesia.
c. optional sedation.
d. conscious sedation.
ANS: D
Conscious sedation is routinely used for procedures that do not require
complete anesthesia but rather a depressed level of consciousness.
REF: Page 1276
TOP: Conscious sedation
The older adult patient may not respond to surgical treatment as well as a
younger adult because of
a. poor skin turgor resulting in dehydration.
b. disturbed body image related to surgical incision.
c. his or her body's response to physiological changes.
d. decreased peristalsis related to general anesthesia.
ANS: C
Of specific concern in older adults is the body's response to temperature
changes, cardiovascular shifts, respiratory needs, and renal function.
REF: Page 1256
TOP: Older adult patient
A 45-year-old patient has had a repair of a cerebral aneurysm and is
presenting signs of increased intracranial pressure (ICP). Which postoperative
nursing interventions would be contraindicated?
a. Coughing every 2 hours
b. Leg exercises every 2 hours
c. Monitoring intravenous therapy at 50 ml/hr
d. Assessing vital signs every 2 hours
ANS: A
Coughing increases ICP.
REF: Page 1268, Box 42-6 TOP: Postoperative complications
The patient is 38 years old and is in her second postoperative day after
placement of an intramedullary rod in her left femur. She is receiving
analgesia via a patient- controlled analgesia (PCA) device. The inappropriate
intervention related to caring for a patient with a PCA is:
a. Maintaining the system.
b. Recording activations of the system.
c. Administering the analgesia to the patient.
d. Monitoring the patient's pain.
ANS: C
With the PCA system of medication administration, the patient can
self-administer an analgesic by pressing a control button. The nurse should
not give medication doses by pushing the control button.
REF: Page 1286 TOP: Medication administration
A 73-year-old patient with diabetes was admitted for below-the-knee
amputation of his right leg. Removal of his right leg is an example of which
type of surgery?
a. Palliative
b. Diagnostic
c. Reconstructive
d. Ablative
ANS: D
Ablative is a type of surgery where an amputation, excision of any part of the
body, or removal of a growth and harmful substance is performed.
REF: Page 1254, Table 42-1 TOP: Types of surgery
We have an expert-written solution to this problem!
The Patient's Bill of Rights states that a patient must give his or her
permission for any specific test or procedure to be performed. What is the
legal term for this permission?
a. Verbal consent
b. Medical documentation
,c. Informed consent
d. Informed decision
ANS: C
The Patient's Bill of Rights affirms that the patients must give informed
consent (permission obtained from the patient to perform a specific test or
procedure) before the beginning of any procedure.
REF: Page 1260
TOP: Informed consent
An informed consent was to be obtained from the patient for his scheduled
open cholecystectomy. Which circumstance could prevent the patient from
signing his informed consent?
a. Pain radiating to the scapula
b. An injection of Demerol, 75 mg IM, 1 hour ago
c. The presence of jaundice and scleral icterus
d. His concern over his insurance company not covering the procedure
ANS: B
Informed consent should not be obtained if the patient is disoriented and
under the influence of sedatives.
REF: Page 1261 TOP: Informed consent
The anesthesiologist provides anesthesia by inhalation and IV administration
routes.
a. general
b. regional
c. specific
d. preoperative
ANS: A
An anesthesiologist gives general anesthetics by IV and inhalation routes
through four stages of anesthesia.
REF: Page 1273 TOP: Anesthesia
A type of anesthesia that requires a depressed level of consciousness is
a. regional anesthesia.
, b. specific anesthesia.
c. optional sedation.
d. conscious sedation.
ANS: D
Conscious sedation is routinely used for procedures that do not require
complete anesthesia but rather a depressed level of consciousness.
REF: Page 1276
TOP: Conscious sedation
The older adult patient may not respond to surgical treatment as well as a
younger adult because of
a. poor skin turgor resulting in dehydration.
b. disturbed body image related to surgical incision.
c. his or her body's response to physiological changes.
d. decreased peristalsis related to general anesthesia.
ANS: C
Of specific concern in older adults is the body's response to temperature
changes, cardiovascular shifts, respiratory needs, and renal function.
REF: Page 1256
TOP: Older adult patient
A 45-year-old patient has had a repair of a cerebral aneurysm and is
presenting signs of increased intracranial pressure (ICP). Which postoperative
nursing interventions would be contraindicated?
a. Coughing every 2 hours
b. Leg exercises every 2 hours
c. Monitoring intravenous therapy at 50 ml/hr
d. Assessing vital signs every 2 hours
ANS: A
Coughing increases ICP.
REF: Page 1268, Box 42-6 TOP: Postoperative complications
