NSG 502_WK 4_PERIOPERATIVE CARE
NSG 502 Exam 2 Perioperative Care
Harding
Chapters 17, 18 & 19 (emphasis on 19)
NSG 502 Exam 2 Perioperative Care
Harding
Chapters 17, 18 & 19 (emphasis on 19)
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."
ANS: A
The patient's 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 patient's concerns, but further assessment is needed
first
We have an expert-written solution to this problem!
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 patient's insurance does not cover outpatient surgery.
d. The patient has not had surgery using general anesthesia before.
ANS: A
,After outpatient surgery, the patient should not drive home and will need assistance with
transportation and home care. The patient's experience with surgery is assessed, but it does not
have as much application to the patient's physiologic safety. The patient's insurance coverage is
important to establish, but this is not usually the nurse's 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 patient's lack of knowledge about postoperative pain control measures
b. The patient's statement that her last menstrual period was 8 weeks previously
c. The patient's history of a postoperative infection following a prior cholecystectomy
d. The patient's concern that she will be unable to care for her children postoperatively
ANS: 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.
ANS: 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
ANS: A
The value-belief pattern includes information about conflicts between a patient's 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 patient's 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. John's wort to prevent
depression. Which complication would the nurse expect in the postanesthesia care unit?
a. Increased pain
b. Hypertensive episodes
c. Longer time to recover from anesthesia
d. Increased risk for postoperative bleeding
ANS: C
St. John's 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
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?
a. Auscultate for adventitious breath sounds.
b. Obtain the patient's blood pressure and temperature.
c. Remind the patient about harmful effects of smoking.
d. Ask the health care provider about prescribing a nicotine patch.
ANS: A
The nurse should first ensure a patent airway and check for breathing and circulation (airway,
breathing, and circulation [ABCs]). Circulation and temperature can be assessed after a patent
airway and breathing have been established. The immediate postoperative period is not the
optimal time for patient teaching about the harmful effects of surgery. Requesting a nicotine
patch may be appropriate, but is not a priority at this time
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?
a. Ascertain that there will be no interactions with anesthetic agents.
b. Teach the patient that these products may be continued preoperatively.
, c. Advise the patient to stop the use of all herbs and supplements at this time.
d. Discuss the herb and supplement use with the patient's health care provider.
ANS: D
Both garlic and ginkgo biloba increase a patient's risk for bleeding. The nurse should discuss
the herb and supplement use with the patient's health care provider. The nurse should not
advise the patient to stop the supplements or to continue them without consulting with the health
care provider. Determining the interactions between the supplements and anesthetics is not
within the nurse's scope of practice
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?
a. Provide an explanation of the planned surgical procedure.
b. Notify the surgeon that the informed consent process is not complete.
c. Administer the prescribed preoperative antibiotics and withhold any ordered sedative
medications.
d. Notify the operating room staff that the surgeon needs to give a more complete explanation of
the procedure.
ANS: B
The surgeon is responsible for explaining the surgery to the patient, and the nurse should wait
until the surgeon has clarified the surgery before having the patient sign the consent form. The
nurse should communicate directly with the surgeon about the consent form rather than asking
other staff to pass on the message. It is not within the nurse's legal scope of practice to explain
the surgical procedure. No preoperative medications should be administered until the patient
understands the surgical procedure and signs the consent form.
We have an expert-written solution to this problem!
Which topic is most important for the nurse to discuss preoperatively with a patient who is
scheduled for abdominal surgery for an open cholecystectomy?
a. Care for the surgical incision
b. Medications used during surgery
c. Deep breathing and coughing techniques
d. Oral antibiotic therapy after discharge home
ANS: C
Preoperative teaching, demonstration, and redemonstration of deep breathing and coughing are
needed on patients having abdominal surgery to prevent postoperative atelectasis. Incisional
care and the importance of completing antibiotics are better discussed after surgery, when the
patient will be more likely to retain this information. The patient does not usually need
information about medications that are used intraoperatively
NSG 502 Exam 2 Perioperative Care
Harding
Chapters 17, 18 & 19 (emphasis on 19)
NSG 502 Exam 2 Perioperative Care
Harding
Chapters 17, 18 & 19 (emphasis on 19)
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."
ANS: A
The patient's 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 patient's concerns, but further assessment is needed
first
We have an expert-written solution to this problem!
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 patient's insurance does not cover outpatient surgery.
d. The patient has not had surgery using general anesthesia before.
ANS: A
,After outpatient surgery, the patient should not drive home and will need assistance with
transportation and home care. The patient's experience with surgery is assessed, but it does not
have as much application to the patient's physiologic safety. The patient's insurance coverage is
important to establish, but this is not usually the nurse's 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 patient's lack of knowledge about postoperative pain control measures
b. The patient's statement that her last menstrual period was 8 weeks previously
c. The patient's history of a postoperative infection following a prior cholecystectomy
d. The patient's concern that she will be unable to care for her children postoperatively
ANS: 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.
ANS: 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
ANS: A
The value-belief pattern includes information about conflicts between a patient's 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 patient's 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. John's wort to prevent
depression. Which complication would the nurse expect in the postanesthesia care unit?
a. Increased pain
b. Hypertensive episodes
c. Longer time to recover from anesthesia
d. Increased risk for postoperative bleeding
ANS: C
St. John's 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
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?
a. Auscultate for adventitious breath sounds.
b. Obtain the patient's blood pressure and temperature.
c. Remind the patient about harmful effects of smoking.
d. Ask the health care provider about prescribing a nicotine patch.
ANS: A
The nurse should first ensure a patent airway and check for breathing and circulation (airway,
breathing, and circulation [ABCs]). Circulation and temperature can be assessed after a patent
airway and breathing have been established. The immediate postoperative period is not the
optimal time for patient teaching about the harmful effects of surgery. Requesting a nicotine
patch may be appropriate, but is not a priority at this time
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?
a. Ascertain that there will be no interactions with anesthetic agents.
b. Teach the patient that these products may be continued preoperatively.
, c. Advise the patient to stop the use of all herbs and supplements at this time.
d. Discuss the herb and supplement use with the patient's health care provider.
ANS: D
Both garlic and ginkgo biloba increase a patient's risk for bleeding. The nurse should discuss
the herb and supplement use with the patient's health care provider. The nurse should not
advise the patient to stop the supplements or to continue them without consulting with the health
care provider. Determining the interactions between the supplements and anesthetics is not
within the nurse's scope of practice
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?
a. Provide an explanation of the planned surgical procedure.
b. Notify the surgeon that the informed consent process is not complete.
c. Administer the prescribed preoperative antibiotics and withhold any ordered sedative
medications.
d. Notify the operating room staff that the surgeon needs to give a more complete explanation of
the procedure.
ANS: B
The surgeon is responsible for explaining the surgery to the patient, and the nurse should wait
until the surgeon has clarified the surgery before having the patient sign the consent form. The
nurse should communicate directly with the surgeon about the consent form rather than asking
other staff to pass on the message. It is not within the nurse's legal scope of practice to explain
the surgical procedure. No preoperative medications should be administered until the patient
understands the surgical procedure and signs the consent form.
We have an expert-written solution to this problem!
Which topic is most important for the nurse to discuss preoperatively with a patient who is
scheduled for abdominal surgery for an open cholecystectomy?
a. Care for the surgical incision
b. Medications used during surgery
c. Deep breathing and coughing techniques
d. Oral antibiotic therapy after discharge home
ANS: C
Preoperative teaching, demonstration, and redemonstration of deep breathing and coughing are
needed on patients having abdominal surgery to prevent postoperative atelectasis. Incisional
care and the importance of completing antibiotics are better discussed after surgery, when the
patient will be more likely to retain this information. The patient does not usually need
information about medications that are used intraoperatively
