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Fundamentals of Nursing Care 1st Edition Burton Ludwig Test Bank

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Fundamentals of Nursing Care 1st Edition Burton Ludwig Test Bank

ISBN-13: 978-0803619708

ISBN-10: 0803619707

 

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Fundamentals of Nursing Care 1st Edition Burton Ludwig Test Bank

ISBN-13: 978-0803619708

ISBN-10: 0803619707

 

 

 

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Free Nursing Test Questions:

Chapter 33. Care of the Surgical Patient

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____     1.   The nurse who is caring for patients on a surgical unit recognizes that which of the following individuals is having corrective surgery?

A. A 39-year-old scheduled for breast reduction.
B. A 14-year-old scheduled for tumor debulking.
C. A 4-month-old scheduled for cleft lip repair.
D. A 55-year-old scheduled for an exploratory laparotomy.

 

 

____     2.   Which of the following is most commonly taught to help prevent post-surgical respiratory complications?

A. Turning, coughing, and deep breathing.
B. Splinting incisions.
C. The use of post-surgical compression stockings.
D. How to measure intake and output.

 

 

____     3.   The nurse who is caring for a patient after a total hip replacement recognizes that further teaching is required if he or she observes that

A. The patient alternately flexes and extends his or her toes.
B. The patient circles his or her ankles clockwise and counterclockwise.
C. The patient bends the knees slightly and helps himself or herself up in bed while using the trapeze.
D. The patient turns on one side, lifts each leg with his or her toes pointed, and then returns to midline.

 

 

____     4.   While determining the appropriate size of thigh-high antithrombolic stockings to order, the nurse would obtain which of the following measurements?

A. Length from gluteal fold to the bottom of the heel.
B. Length from mid-thigh to the tip of the toe.
C. Circumference of the knee.
D. Amount of edema noted in the ankles.

 

 

____     5.   The nurse is providing care for a patient who is wearing antiembolic stockings. The patient’s plan of care should include

A. Turning the stockings off 4 hours each day.
B. Removing the stockings at bedtime and replacing them in the morning.
C. Rolling the stockings down 2 inches to create a band at the top.
D. Removing the stockings twice daily to wash and dry the legs.

 

 

____     6.   The wife of a patient who recently returned from a radical neck dissection asks the nurse why the patient was given Scopolamine. The best response by the nurse is

A. “It is important to dry secretions to reduce the bacteria in his saliva.”
B. “It helps keep him from drooling since it hurts to swallow.”
C. “By reducing the amount of saliva that his body makes, this medication will reduce the swelling in his lips and tongue.”
D. “The Scopolamine will help dry the oral secretions to reduce his chances of aspirating saliva into his lungs.”

 

 

____     7.   The nurse who is caring for a patient who is scheduled for an abdominal hysterectomy obtains the woman’s signature on the consent form and then signs the form himself. The nurse’s signature indicates that

A. The patient does not have any questions about the surgery.
B. The nurse verified that it was the patient who signed the form.
C. The patient understands the risks of the procedure.
D. The nurse has provided verbal and written information about the surgical procedure.

 

 

____     8.   Which of the following members of the surgical team is responsible for monitoring the patient’s vital signs during surgery?

A. The surgeon.
B. The circulating nurse.
C. The first surgical assistant.
D. The anesthesiologist.

 

 

____     9.   Which of the following is a primary benefit of conscious sedation?

A. The patient will remember the procedure.
B. The patient will not require airway support.
C. It will block reflexes such as coughing and gagging.
D. It can be used for procedures that take long periods of time.

 

 

____   10.   The nurse recognizes that which of the following patients may receive spinal anesthesia?

A. A 45-year-old scheduled for a wedge resection.
B. A 29-year-old scheduled for repair of a torn rotator cuff.
C. A 48-year-old scheduled for a hemorrhoidectomy.
D. A 66-year-old scheduled for a bone marrow biopsy.

 

 

____   11.   The nurse is caring for a patient who received spinal anesthesia. The patient reports having a bad headache later that day. The nurse’s best response is

A. “You may have an allergy to the anesthetic used. Have you ever had spinal anesthesia before?”
B. “That can happen due to loss of spinal fluid during anesthesia.”
C. “I will need to call the physician immediately.”
D. “Do you have a history of migraines?”

 

 

____   12.   The nurse who is working in the post-anesthesia care unit (PACU) recognizes that a patient is most likely to experience which of the following complications while in the unit?

A. Hypoventilation
B. Deep vein thrombosis
C. Atelectasis
D. Pneumonia

 

 

____   13.   After assisting with the transfer of a patient from the post-anesthesia care unit into the bed on the unit, the nurse should first

A. Review the physician’s orders.
B. Determine the type and amount of intravenous fluid hanging.
C. Perform a physical assessment.
D. Reassure the patient that he will receive excellent care on the unit.

 

 

____   14.   The nurse is caring for a patient who returned from abdominal surgery 6 hours ago. The nurse notes that the abdominal dressing is nearly saturated with serosanguineous drainage, and a small amount of drainage is leaking from the lower edge of the dressing. The nurse’s best action is to

A. Reinforce the dressing with additional gauze pads.
B. Remove the surgical dressing to assess the site directly.
C. Replace the surgical dressing with fresh dressings.
D. Reinforce the tape edges of the dressing.

 

 

____   15.   The nurse is providing care to a 32-year-old who returned from a thyroidectomy 6 hours previously. The nurse notes that the patient’s temperature is 99.5°F, and that the patient has been taking sips of clear liquids, reports mild nausea, and is using a patient-controlled anesthesia to control her pain, which is 3/10. The nurse should

A. Order a low-salt diet.
B. Document the findings.
C. Contact the physician.
D. Assess the back of the patient’s throat.

 

 

____   16.   The nurse is caring for a 28-year-old man who returned from the repair of a broken jaw 3 hours earlier. The patient reports an urge to urinate and tried to use the urinal in the bed without success. The best action by the nurse is to

A. Call to obtain an order to catheterize the patient.
B. Perform a digital rectal exam.
C. Assist the patient to stand and use the urinal.
D. Use the bladder scanner to determine the degree of distention.

 

 

____   17.   The nurse who is providing care for a patient with a large abdominal wound removes the dressing and notes that the wound has dehisced. The nurse should

A. Cover the wound with a large sterile dressing.
B. Pour sterile saline into the wound bed.
C. Notify the supervisor.
D. Ask the patient, “Did you feel anything pop open?”

 

 

____   18.   The nurse is providing care for a patient with a nasogastric (NG) tube in place 10 hours after a vagotomy and an antrectomy. The patient’s plan of care would include

A. Providing mouth care every 4 hours.
B. Keeping NG to continuous suction.
C. Draping NG tubing over the patient’s shoulder.
D. Providing tube feeding every 3 hours.

 

 

____   19.   Prior to placing antiembolic stockings on a patient for the first time, the nurse should

A. Obtain baseline vital signs.
B. Have the patient lie supine for 15 minutes.
C. Ask the patient to sit at the side of the bed.
D. Instruct the patient to apply lotion to his or her legs.

 

 

____   20.   The nurse would expect an International Normalized Ratio (INR) to be ordered for which of the following patients?

A. A 32-year-old with a history of asthma.
B. A 29-year-old who takes Lanoxin (digoxin).
C. A 53-year-old with a history of cirrhosis.
D. A 71-year-old with a history of benign prostatic hypertrophy (BPH).

 

 

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

 

____     1.   The nurse recognizes that which of the following would be classified as an elective surgery? Select all that apply.

A. Tonsilectomy for a 10-year-old with a history of frequent pharyngitis.
B. Appendectomy for a 12-year-old with acute appendicitis.
C. Colectomy with colostomy for an 18-year-old with Crohn’s disease.
D. Mastectomy for a 56-year-old with recently diagnosed breast cancer.
E. Total hip replacement for an 87-year-old with a fractured femur.
F. Gastric bypass surgery for a 39-year-old with morbid obesity.

 

 

____     2.   The nurse who is completing a pre-surgical assessment would include which of the following questions? Select all that apply.

A. “Have you had any prior surgeries?”
B. “Is there a possibility you may be pregnant?”
C. “Are you taking any medications at this time?”
D. “Do you smoke or use tobacco in any form?”
E. “What surgery is planned? Why are you having surgery?”
F. “Do you know the name of your surgeon?”

 

 

____     3.   While caring for a patient in the surgical center, which of the following preoperative lab values would the nurse expect to be included in the orders? Select all that apply.

A. White blood cell (WBC) count
B. Hemoglobin (Hgb)
C. Alcohol level
D. Alkaline phosphatase (Alk Phos)
E. Platelet count (PLT)
F. Urinalysis (UA)

 

 

____     4.   The plan of care for a patient at risk for cardiac complications during the immediate postoperative period would include (select all that apply):

A. Monitoring the patient’s heart rate continuously.
B. Administering intravenous fluids as ordered.
C. Assessing the patient’s skin color and capillary refill frequently.
D. Assessing the patient’s peripheral pulses bilaterally.
E. Evaluating for bowel sounds hourly.
F. Monitoring for evidence of bleeding.

 

 

____     5.   After sending a patient to have a bowel resection, the nurse prepares the room for the patient’s return. Preparations would include (select all that apply):

A. Obtaining nasogastric suction equipment.
B. Placing the bed in the lowest position.
C. Placing a lift sheet on the bed.
D. Moving bedside tables away from the bedside.
E. Putting the bed in high-Fowler position.
F. Raising the side rails of the bed.

 

Chapter 33. Care of the Surgical Patient

Answer Section

 

MULTIPLE CHOICE

 

  1. ANS:  C

 

  Feedback
A Cosmetic surgery may be performed to change or improve one’s physical appearance.
B Palliative surgery alleviates symptoms and provides comfort, but it does not necessarily cure the disease or heal the injury.
C Corrective surgery is done to repair an anatomic or congenital defect, such as repairing a cleft palate so that a child can nurse or eat normally. Chapter Objective: Differentiate between types of surgery by purpose, degree of urgency, and degree of risk.
D Exploratory surgery is done to provide further data and determine a diagnosis for a problem.

 

 

PTS:   1                    REF:   Chapter: 33 | Page: 770                    OBJ:   Chapter Objective: 33-2

KEY:  Content Area: Potential for Complications of Diagnostic Tests/Treatments/Procedures/Surgery or Health Alterations | Integrated Process: Nursing Process/Evaluation | Client Need: Reduction of Risk Potential | Cognitive Level: Analysis

 

  1. ANS:  A

 

  Feedback
A The most common thing that the nurse will teach to help prevent these respiratory complications is how to effectively turn, cough, and deep breathe. Chapter Objective: Specify the important components of preoperative patient teaching.
B This will aid in pain control and mobility, and it will support coughing and deep breathing.
C This is used to prevent the formation of deep vein thrombosis.
D This is used to monitor kidney function and fluid status.

 

 

PTS:   1                    REF:   Chapter: 33 | Page: 776                    OBJ:   Chapter Objective: 33-6

KEY:  Content Area: Potential for Complications of Diagnostic Tests/Treatments/Procedures/Surgery or Health Alterations | Integrated Process: Teaching/Learning | Client Need: Reduction of Risk Potential | Cognitive Level: Application

 

  1. ANS:  D

 

  Feedback
A These actions are ankle pumps, which involve alternating ankle flexion and extension for a total of 10 times each.
B These actions are ankle circles with toes extended, 10 times in each direction, both clockwise and counterclockwise
C This is an appropriate action provided that the patient does not flex at the hip more than 90 degrees.
D This is not a normal postoperative exercise/action—abduction should be avoided with total hip replacement. Chapter Objective: Identify potential postsurgical complications, with emphasis on prevention and intervention.

 

 

PTS:   1                    REF:   Chapter: 33 | Page: 777                    OBJ:   Chapter Objective: 33-15

KEY:  Content Area: Potential for Complications of Diagnostic Tests/Treatments/Procedures/Surgery or Health Alterations | Integrated Process: Teaching/Learning | Client Need: Reduction of Risk Potential | Cognitive Level: Application

 

  1. ANS:  A

 

  Feedback
A For thigh-high hose, it is important to measure the length of the leg from the gluteal fold to the bottom of the heel. Then one must measure the circumference of the calf and the thigh at their largest diameters. These measurements must be cross-referenced on the TED chart to determine which size to select. Chapter Objectives: Prioritize nursing care during immediate postoperative and postanesthesia care. Identify potential postsurgical complications, with emphasis on prevention and intervention.
B This measurement is not necessary.
C This measurement is not necessary.
D This measurement is not necessary.

 

 

PTS:   1                    REF:   Chapter: 33 | Page: 778

OBJ:   Chapter Objectives: 33-12| Chapter Objectives: 33-15

KEY:  Content Area: Potential for Complications of Diagnostic Tests/Treatments/Procedures/Surgery or Health Alterations | Integrated Process: Nursing Process/Assessment | Client Need: Reduction of Risk Potential | Cognitive Level: Application

 

  1. ANS:  D

 

  Feedback
A Pneumatic stockings must be turned on/off—they are generally removed to allow the patient to ambulate.
B Stockings should remain in place throughout the night.
C If allowed to bunch together or the tops to roll down, those areas will work like a tourniquet and restrict venous blood return.
D The hose should be removed at least twice per day to prevent excessive pressure or tension on any one spot. Chapter Objective: Develop a care plan for a patient who has had abdominal surgery.

 

 

PTS:   1                    REF:   Chapter: 33 | Page: 778                    OBJ:   Chapter Objective: 33-16

KEY:  Content Area: Potential for Complications of Diagnostic Tests/Treatments/Procedures/Surgery or Health Alterations | Integrated Process: Nursing Process/Implementation | Client Need: Reduction of Risk Potential | Cognitive Level: Application

 

  1. ANS:  D

 

  Feedback
A reason for the use of anticholinergics.
B reason for the use of anticholinergics.
C reason for the use of anticholinergics.
D Anticholinergics such as atropine, scopolamine, and glycopyrrolate may be given preoperatively to dry secretions in a patient whose surgery will result in stimulation of oral mucous membranes; stimulation of the oral mucosa can increase salivation tenfold, potentially placing the patient’s airway at risk for aspiration.Chapter Objective: Explain the various purposes of preoperative medications.

 

 

PTS:   1                    REF:   Chapter: 33 | Page: 779                    OBJ:   Chapter Objective: 33-7

KEY:  Content Area: Potential for Complications of Diagnostic Tests/Treatments/Procedures/Surgery or Health Alterations | Integrated Process: Teaching/Learning | Client Need: Reduction of Risk Potential | Cognitive Level: Analysis

 

  1. ANS:  B

 

  Feedback
A This is not what the nurse’s signature means.
B The nurse generally signs the consent only as a witness to the fact that it was the patient’s or authorized person’s signature. Chapter Objective: Describe the process of informed consent.
C This is not what the nurse’s signature means.
D This is not what the nurse’s signature means.

 

 

PTS:   1                    REF:   Chapter: 33 | Page: 781                    OBJ:   Chapter Objective: 33-4

KEY:  Content Area: Potential for Complications of Diagnostic Tests/Treatments/Procedures/Surgery or Health Alterations | Integrated Process: Nursing Process | Client Need: Reduction of Risk Potential | Cognitive Level: Application

 

  1. ANS:  D

 

  Feedback
A The surgeon is a physician who has been granted surgical privileges to perform a surgical procedure.
B The circulating nurse is a registered nurse; this role cannot be delegated to a licensed practical nurse/licensed vocational nurse. The circulating nurse is responsible for management of the care of the patient throughout the surgical procedure.
C The first surgical assistant may be another physician, a physician assistant, or a registered nurse who assists the surgeon throughout the procedure, which may include controlling hemostasis, assisting with instrumentation, manipulating and incising tissue, and suturing or stapling and closing the incision.
D The anesthesiologist has the responsibility for sustaining the patient’s life and ensuring that the patient remains comfortable. Chapter Objective: Compare the various roles and responsibilities of operative personnel.

 

 

PTS:   1                    REF:   Chapter: 33 | Page: 781                    OBJ:   Chapter Objective: 33-9

KEY:  Content Area: Potential for Complications of Diagnostic Tests/Treatments/Procedures/Surgery or Health Alterations | Integrated Process: Nursing Process | Client Need: Reduction of Risk Potential | Cognitive Level: Application

 

  1. ANS:  B

 

  Feedback
A This may or may not be true with conscious sedation.
B Conscious sedation provides a controlled minimal level of sedation that allows the patient to be relaxed and in twilight asleep while still being able to maintain his or her own airway and yet respond purposefully. Chapter Objective: Differentiate between the different types of anesthesia and rationales for selection.
C General anesthesia blocks reflexes such as coughing and gagging, as well as endocrine and autonomic responses.
D An advantage of general anesthesia is that it can be used for procedures that take longer to complete.

 

 

PTS:   1                    REF:   Chapter: 33 | Page: 784                    OBJ:   Chapter Objective: 33-10

KEY:  Content Area: Potential for Complications of Diagnostic Tests/Treatments/Procedures/Surgery or Health Alterations | Integrated Process: Teaching/Learning | Client Need: Reduction of Risk Potential | Cognitive Level: Comprehension

 

  1. ANS:  C

 

  Feedback
A This surgery involves the lung, and spinal anesthesia would not be appropriate.
B This surgery involves the shoulder, and spinal anesthesia would not be appropriate.
C Spinal anesthesiaRemember,metimes called spinal block, involves injection of the anesthetic into the subarachnoid space into the cerebrospinal fluid. (See Figure 33-8.) The nerves below the site of injection are blocked from central nervous system transmissions. It is commonly used for delivery of a baby, perirectal surgery, and abdominal or lower extremity surgery. Chapter Objective: Differentiate between the different types of anesthesia and rationales for selection.
D Local anesthesia is used for this diagnostic test.

 

 

PTS:   1                    REF:   Chapter: 33 | Page: 785                    OBJ:   Chapter Objective: 33-10

KEY:  Content Area: Potential for Complications of Diagnostic Tests/Treatments/Procedures/Surgery or Health Alterations | Integrated Process: Nursing Process/Evaluation | Client Need: Reduction of Risk Potential | Cognitive Level: Analysis

 

  1. ANS:  B

 

  Feedback
A The headache is not due to an allergy.
B Some patients develop a post-spinal headache due to leakage of spinal fluid during the spinal anesthetic. Chapter Objective: Differentiate between the different types of anesthesia and rationales for selection.
C This is not an emergency situation.
D The headache is most likely due to the anesthesia.

 

 

PTS:   1                    REF:   Chapter: 33 | Page: 785                    OBJ:   Chapter Objective: 33-10

KEY:  Content Area: Potential for Complications of Diagnostic Tests/Treatments/Procedures/Surgery or Health Alterations | Integrated Process: Communication and Documentation | Client Need: Reduction of Risk Potential | Cognitive Level: Application

 

  1. ANS:  A

 

  Feedback
A Potential respiratory problems common to the PACU after general anesthesia include obstruction of airway, hypoxemia, and hypoventilation. Chapter Objective: Identify potential postsurgical complications, with emphasis on prevention and intervention.
B This complication is more likely to be seen later in the postoperative period.
C This complication is more likely to be seen later in the postoperative period.
D This complication is more likely to be seen later in the postoperative period.

 

 

PTS:   1                    REF:   Chapter: 33 | Page: 788                    OBJ:   Chapter Objective: 33-15

KEY:  Content Area: Potential for Complications of Diagnostic Tests/Treatments/Procedures/Surgery or Health Alterations | Integrated Process: Nursing Process/Assessment | Client Need: Reduction of Risk Potential | Cognitive Level: Application

 

  1. ANS:  C

 

  Feedback
A highest priority.
B highest priority.
C Once the patient is in the bed, the nurse’s immediate priority is to complete an initial assessment with vital signs to determine the patient’s condition and establish a baseline for subsequent comparisons. Chapter Objective: Prioritize nursing care during immediate postoperative and postanesthesia care.
D highest priority.

 

 

PTS:   1                    REF:   Chapter: 33 | Page: 791                    OBJ:   Chapter Objective: 33-12

KEY:  Content Area: Potential for Complications of Diagnostic Tests/Treatments/Procedures/Surgery or Health Alterations | Integrated Process: Nursing Process/Implementation | Client Need: Reduction of Risk Potential | Cognitive Level: Application

 

  1. ANS:  A

 

  Feedback
A If the dressing is saturated with blood, the nurse should reinforce the dressing with sterile gauze abdominal combine dressings that are 4” ´ 4” or larger, also known as ABD pads, and notify the surgeon. Chapter Objectives: Prioritize nursing care during immediate postoperative and postanesthesia care. Develop a care plan for a patient who has had abdominal surgery.
B Many surgeons prefer to remove the original surgical dressing.
C Many surgeons prefer to remove the original surgical dressing.
D Additional dressing material should be used to reinforce the dressing.

 

 

PTS:   1                    REF:   Chapter: 33 | Page: 791

OBJ:   Chapter Objectives: 33-12| Chapter Objectives: 33-16

KEY:  Content Area: Potential for Complications of Diagnostic Tests/Treatments/Procedures/Surgery or Health Alterations | Integrated Process: Nursing Process/Implementation | Client Need: Reduction of Risk Potential | Cognitive Level: Application

 

  1. ANS:  B

 

  Feedback
A Usually a patient is advanced from ice chips and sips of clear liquid to a full liquid diet and then a regular diet. There is no indication that a low-salt diet is needed.
B It is somewhat common for the postoperative patient to run a low-grade temperature within the range of 99°F to 99.8°F (37.1°C to  37.6°C) after surgery. Chapter Objective: Describe the admission process of a postsurgical patient to the hospital unit.
C There is no need to contact the physician.
D This assessment will not direct patient care.

 

 

PTS:   1                    REF:   Chapter: 33 | Page: 793                    OBJ:   Chapter Objective: 33-13

KEY:  Content Area: Potential for Complications of Diagnostic Tests/Treatments/Procedures/Surgery or Health Alterations | Integrated Process: Nursing Process/Implementation | Client Need: Reduction of Risk Potential | Cognitive Level: Application

 

  1. ANS:  C

 

  Feedback
A This is not necessary at this time.
B This assessment will not direct patient care.
C If the patient is unable to void, the nurse should assess the bladder for distention. If distention is present, the nurse should try to assist the patient to void by helping him or her to the bathroom unless contraindicated; if the patient is male, the nurse may help him stand to void. Water may also be helpful. Chapter Objective: Identify postsurgical complications, with emphasis on prevention and intervention.
D The patient should be given an opportunity to void in a typical position first.

 

 

PTS:   1                    REF:   Chapter: 33 | Page: 794                    OBJ:   Chapter Objective: 33-15

KEY:  Content Area: Potential for Complications of Diagnostic Tests/Treatments/Procedures/Surgery or Health Alterations | Integrated Process: Nursing Process/Implementation | Client Need: Reduction of Risk Potential | Cognitive Level: Application

 

  1. ANS:  A

 

  Feedback
A If dehiscence occurs, the wound should be covered with a large sterile dressing or sterile surgical towel that has been moistened with sterile normal saline. Chapter Objective: Identify postsurgical complications, with emphasis on prevention and intervention.
B priority.
C priority.
D priority.

 

 

PTS:   1                    REF:   Chapter: 33 | Page: 794                    OBJ:   Chapter Objective: 33-15

KEY:  Content Area: Potential for Complications of Diagnostic Tests/Treatments/Procedures/Surgery or Health Alterations | Integrated Process: Nursing Process/Implementation | Client Need: Reduction of Risk Potential | Cognitive Level: Application

 

  1. ANS:  A

 

  Feedback
A Mouth care should be provided and the lips should be kept moist with petroleum-free lip moisturizer at least every 4 hours. Chapter Objective: Prioritize nursing care during immediate postoperative and postanesthesia care.
B The NG tube should be kept to low, intermittent suction.
C Tubing should be pinned to the patient’s gown to avoid hanging weight on the nose.
D Tube feeding would not be part of the patient’s plan of care at this time.

 

 

PTS:   1                    REF:   Chapter: 33 | Page: 796                    OBJ:   Chapter Objective: 33-12

KEY:  Content Area: Potential for Complications of Diagnostic Tests/Treatments/Procedures/Surgery or Health Alterations | Integrated Process: Nursing Process/Implementation | Client Need: Reduction of Risk Potential | Cognitive Level: Application

 

  1. ANS:  B

 

  Feedback
A This is not necessary.
B The patient should lie supine for a minimum of 15 minutes prior to the application of hose. Chapter Objective: Prioritize nursing care during immediate postoperative and postanesthesia care.
C The stocking will be easiest to place if the patient is lying down.
D Lotion will make the legs sticky and make the placement of the stockings difficult.

 

 

PTS:   1                    REF:   Chapter: 33 | Page: 799                    OBJ:   Chapter Objective: 33-12

KEY:  Content Area: Potential for Complications of Diagnostic Tests/Treatments/Procedures/Surgery or Health Alterations | Integrated Process: Nursing Process/Implementation | Client Need: Reduction of Risk Potential | Cognitive Level: Application

 

  1. ANS:  C

 

  Feedback
A There is no indication that an INR should be checked for this patient.
B There is no indication that an INR should be checked for this patient. Chapter Objective: Explain the purpose of various preoperative laboratory tests.
C INR should be performed for a patient with a history of liver disease.
D There is no indication that an INR should be checked for this patient.

 

 

PTS:   1                    REF:   Chapter: 33 | Page: 775                    OBJ:   Chapter Objective: 33-5

KEY:  Content Area: Potential for Complications of Diagnostic Tests/Treatments/Procedures/Surgery or Health Alterations | Integrated Process: Nursing Process/Evaluation | Client Need: Reduction of Risk Potential | Cognitive Level: Analysis

 

MULTIPLE RESPONSE

 

  1. ANS:  A, C, D, F

Feedback: Elective surgery is any surgery that is voluntary and scheduled a week or more in advance. Acute appendicitis and a fractured femur would require urgent surgery. Chapter Objective: Differentiate between types of surgery by purpose, degree of urgency, and degree of risk.

 

PTS:   1                    REF:   Chapter: 33 | Page: 770                    OBJ:   Chapter Objective: 33-2

KEY:  Content Area: Potential for Complications of Diagnostic Tests/Treatments/Procedures/Surgery or Health Alterations | Integrated Process: Nursing Process/Evaluation | Client Need: Reduction of Risk Potential | Cognitive Level: Analysis

 

  1. ANS:  A, B, C, D, E

Feedback: Prior to a patient’s surgery, it is important for the nurse to explore the patient’s understanding of the need for surgery to be performed. It is also important to ask questions about any previous surgeries and anesthetics; the patient’s family health history; medication allergies and intolerances; alcohol and illegal drug use, abuse, and addiction; and tobacco use. The nurse should ask female patients about the possibility of pregnancy. While most patients will know the names of their surgeons, this is not routinely part of the pre-surgical assessment. Chapter Objective: Explain the purpose for and the various data included on a preoperative checklist.

 

PTS:   1                    REF:   Chapter: 33 | Page: 772                    OBJ:   Chapter Objective: 33-8

KEY:  Content Area: Potential for Complications of Diagnostic Tests/Treatments/Procedures/Surgery or Health Alterations | Integrated Process: Nursing Process/Assessment | Client Need: Reduction of Risk Potential | Cognitive Level: Application

 

  1. ANS:  A, B, E, F

Feedback: A complete blood cell count is done to detect low hemoglobin and hematocrit, indicating anemia, which could place the patient at risk for hypoxia if there is heavy blood loss. It is also important to ensure that the WBC count does not indicate a current infection and that the platelet count is within normal range. UA is done to rule out urinary tract infection and to look for protein, which could indicate impaired renal function. Chpater Objective: Explain the purpose of various preoperative laboratory tests.

 

PTS:   1                    REF:   Chapter: 33 | Page: 774                    OBJ:   Chapter Objective: 33-5

KEY:  Content Area: Potential for Complications of Diagnostic Tests/Treatments/Procedures/Surgery or Health Alterations | Integrated Process: Nursing Process/Assessment | Client Need: Reduction of Risk Potential | Cognitive Level: Application

 

  1. ANS:  A, B, C, D, F

Feedback: To help prevent cardiac complications, the nurse should auscultate heart sounds, noting muffled or distant S1 or S2. The nurse should monitor the patient’s blood pressure, closely noting even small decreases. The nurse should administer IV fluids that are adjusted according to patient condition, as well as assess the patient’s skin color, temperature, and whether the skin is moist or dry. The nurse must also assess the strength of apical, radial, and pedal pulses; and capillary refill in all four extremities. The nurse must monitor for excessive bleeding from the surgical site and drains. Excessive blood loss may be visible or internal; because bleeding can be unseen, it is important to assess the size of the operative site and surrounding area for edema, or, if the abdomen, distention. It is important to always be alert to falling blood pressure and tachycardia that occurs suddenly, persists, or rapidly reoccurs even with fluid administration. Assessment of bowel sounds will not be indicative of cardiac complications.Chapter Objective: identify potential postsurgical complications, with emphasis on prevention and intervention.

 

PTS:   1                    REF:   Chapter: 33 | Page: 789                    OBJ:   Chapter Objective: 33-15

KEY:  Content Area: Potential for Complications of Diagnostic Tests/Treatments/Procedures/Surgery or Health Alterations | Integrated Process: Nursing Process/Assessment | Client Need: Reduction of Risk Potential | Cognitive Level: Application

 

  1. ANS:  A, C, D

Feedback: Room preparation includes obtaining needed supplies, as well as preparing a surgical bed with a lifting or draw sheet and disposable waterproof pads if needed. Room preparation also includes arranging the furniture so that the gurney can be positioned parallel to the bed so that the heads of the gurney and bed are aligned with each other. The bed is usually elevated to match the level of the gurney and the head of the bed is flat and then aligned to match the gurney upon arrival; side rails are down to allow for transfer of the patient from the gurney to the bed. Chapter Objective: Prioritize nursing care during immediate postoperative and postanesthesia care.

 

PTS:   1                    REF:   Chapter: 33 | Page: 790                    OBJ:   Chapter Objective: 33-12

KEY:  Content Area: Potential for Complications of Diagnostic Tests/Treatments/Procedures/Surgery or Health Alterations | Integrated Process: Nursing Process/Implementation | Client Need: Reduction of Risk Potential | Cognitive Level: Application

 

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