Lewis's Medical Surgical Nursing Test Bank 11th Edition [Harding]
Chapter 17 - 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.
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.
Answer: A
Explanation: The patient's statement may indicate a high level of anxiety or a family history
of a serious complication like malignant hyperthermia. The nurse should first assess the
situation further by encouraging the patient to elaborate, which provides critical information
for ensuring patient safety and addressing specific fears.
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.
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.
Answer: A
Explanation: After receiving sedation or anesthesia, a patient must not drive. Planning to
drive home poses a serious safety risk. The nurse must ensure the patient has arranged for a
responsible adult to provide transportation.
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?
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
Answer: B
,Explanation: A missed menstrual period suggests the patient may be pregnant. Anesthesia
and surgery can pose risks to a fetus, so this must be confirmed and communicated to the
anesthesiologist immediately.
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?
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.
Answer: B
Explanation: Allergies to certain foods like bananas and avocados are associated with latex
allergy. Alerting the surgical team allows them to use latex-free supplies and prevent a
potential intraoperative allergic reaction.
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
B. Cognitive-perceptual
C. Sexuality-reproductive
D. Coping-stress tolerance
Answer: A
Explanation: The patient's statement indicates a potential conflict between her personal
values and the planned procedure. Assessing the value-belief pattern helps identify ethical or
spiritual distress that needs to be addressed.
6. A patient undergoing an emergency appendectomy has been using St. Johns
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
Answer: C
,Explanation: St. John's wort can prolong the effects of anesthetic agents by inducing liver
enzymes that metabolize drugs, potentially delaying awakening 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?
A. Auscultate for adventitious breath sounds.
B. Obtain the patients blood pressure and temperature.
C. Remind the patient about harmful effects of smoking.
D. Ask the health care provider about prescribing a nicotine patch.
Answer: A
Explanation: The immediate postoperative priority is assessing airway, breathing, and
circulation (ABCs). A smoking history increases the risk for respiratory complications, so
auscultating breath sounds is essential.
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?
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 patients health care provider.
Answer: D
Explanation: Both garlic and ginkgo biloba can increase the risk of bleeding. The nurse
should communicate this information to the healthcare provider, who can determine if the
supplements should be discontinued before surgery.
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?
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.
Answer: B
, Explanation: Informed consent requires that the patient fully understands the procedure. The
nurse should not proceed with signing and must notify the surgeon to return and provide a
complete explanation.
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?
A. Care for the surgical incision
B. Medications used during surgery
C. Deep breathing and coughing techniques
D. Oral antibiotic therapy after discharge home
Answer: C
Explanation: Preoperative teaching of deep breathing and coughing is critical for patients
undergoing abdominal surgery to prevent postoperative atelectasis and pneumonia.
11. 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?
A. Assist the patient to the bathroom and stay with the patient to prevent falls.
B. Offer a urinal or bedpan and position the patient in bed to promote voiding.
C. Allow the patient up to the bathroom because medication onset is 10 minutes.
D. Ask the patient to wait because catheterization is performed just before the surgery.
Answer: B
Explanation: Midazolam causes sedation and impairs coordination, increasing fall risk. The
safest action is to have the patient use a bedpan or urinal while remaining in bed.
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?
A. Use printed materials for instruction so that the patient will have more time to
review the material.
B. Direct the teaching toward the wife because she is the obvious support and
caregiver for the patient.
C. Provide additional time for the patient to understand preoperative instructions and
carry out procedures.
D. Ask the patients wife to wait in the hall in order to focus preoperative teaching
with the patient himself.
Answer: C
Chapter 17 - 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.
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.
Answer: A
Explanation: The patient's statement may indicate a high level of anxiety or a family history
of a serious complication like malignant hyperthermia. The nurse should first assess the
situation further by encouraging the patient to elaborate, which provides critical information
for ensuring patient safety and addressing specific fears.
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.
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.
Answer: A
Explanation: After receiving sedation or anesthesia, a patient must not drive. Planning to
drive home poses a serious safety risk. The nurse must ensure the patient has arranged for a
responsible adult to provide transportation.
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?
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
Answer: B
,Explanation: A missed menstrual period suggests the patient may be pregnant. Anesthesia
and surgery can pose risks to a fetus, so this must be confirmed and communicated to the
anesthesiologist immediately.
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?
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.
Answer: B
Explanation: Allergies to certain foods like bananas and avocados are associated with latex
allergy. Alerting the surgical team allows them to use latex-free supplies and prevent a
potential intraoperative allergic reaction.
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
B. Cognitive-perceptual
C. Sexuality-reproductive
D. Coping-stress tolerance
Answer: A
Explanation: The patient's statement indicates a potential conflict between her personal
values and the planned procedure. Assessing the value-belief pattern helps identify ethical or
spiritual distress that needs to be addressed.
6. A patient undergoing an emergency appendectomy has been using St. Johns
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
Answer: C
,Explanation: St. John's wort can prolong the effects of anesthetic agents by inducing liver
enzymes that metabolize drugs, potentially delaying awakening 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?
A. Auscultate for adventitious breath sounds.
B. Obtain the patients blood pressure and temperature.
C. Remind the patient about harmful effects of smoking.
D. Ask the health care provider about prescribing a nicotine patch.
Answer: A
Explanation: The immediate postoperative priority is assessing airway, breathing, and
circulation (ABCs). A smoking history increases the risk for respiratory complications, so
auscultating breath sounds is essential.
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?
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 patients health care provider.
Answer: D
Explanation: Both garlic and ginkgo biloba can increase the risk of bleeding. The nurse
should communicate this information to the healthcare provider, who can determine if the
supplements should be discontinued before surgery.
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?
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.
Answer: B
, Explanation: Informed consent requires that the patient fully understands the procedure. The
nurse should not proceed with signing and must notify the surgeon to return and provide a
complete explanation.
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?
A. Care for the surgical incision
B. Medications used during surgery
C. Deep breathing and coughing techniques
D. Oral antibiotic therapy after discharge home
Answer: C
Explanation: Preoperative teaching of deep breathing and coughing is critical for patients
undergoing abdominal surgery to prevent postoperative atelectasis and pneumonia.
11. 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?
A. Assist the patient to the bathroom and stay with the patient to prevent falls.
B. Offer a urinal or bedpan and position the patient in bed to promote voiding.
C. Allow the patient up to the bathroom because medication onset is 10 minutes.
D. Ask the patient to wait because catheterization is performed just before the surgery.
Answer: B
Explanation: Midazolam causes sedation and impairs coordination, increasing fall risk. The
safest action is to have the patient use a bedpan or urinal while remaining in bed.
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?
A. Use printed materials for instruction so that the patient will have more time to
review the material.
B. Direct the teaching toward the wife because she is the obvious support and
caregiver for the patient.
C. Provide additional time for the patient to understand preoperative instructions and
carry out procedures.
D. Ask the patients wife to wait in the hall in order to focus preoperative teaching
with the patient himself.
Answer: C
