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Flashcards in Ch.18 MD Deck (20):
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.”

a. “Tell me more about what happened to your mother.”

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 patient’s insurance does not coverd outpatient surgery
d. The patient has not had surgery using general anesthesia before.

a. The patient is planning to drive home after surgery

3

A 38­year­old 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 holecystectomy
d. The patient’s concern that she will be
unable to care for her children
postoperatively

b. The patient’s statement that her last menstrual period was 8 weeks previously

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 records.
d. Ask whether the patient uses
antihistamines to reduce allergic

reactions.

b. Alert the surgery center about a possible latex allergy.

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 urther assess?

a. Value­ belief
b. Cognitive perceptual
c. Sexuality reproductive
d. Coping stress tolerance

a. Value belief

6

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

c. Longer time to recover from anesthesia

7

7. The surgical unit nurse has just received a patient with a history of soking from the postanesthesia care unit. Which action is most important at this time?

a. Auscultate for adventitious breath sound.
b. Obtain the patient’s blood pressure and
tempature.
c. Remind the patient about harmful effects of smoking
d. Ask the health care provider about
prescribing a nicotine patch.

a. Auscultate for adventitious breath sound.

8

The nurse obtains a health history from a patient who is scheduled forelective 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 al herbs and supplements at this time.
d. Discuss the herb and supplement use
with the patient’s health care provider.

d. Discuss the herb and supplement use
with the patient’s health care provider.

9

The nurse is preparing to witness the patient signing the operative onsent 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.

b. Notify the surgeon that the informed
consent process is not complete.

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

c. Deep breathing and coughing techniques

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.

b. Offer a urinal or bedpan and position the patient in bed to promote voiding.

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 patient’s wife to wait in the hall
in order to focus preoperative teachin
with the patient himself.

c.Provide additional time for the patient to understand preoperative instructions
and carry out procedures.

13

A patient who has diabetes and uses insulin to control blood glucose
has been NPO since midnight before having a knee replacement surgery. Which
action should the nurse take?

a. Withhold the usual scheduled insulin dose because the patient is NPO.
b. Obtain a blood glucose measurement
before any insulin administration.
c. Give the patient the usual insulin dose because stress will increase the blood
glucose.
d. Administer a lower dose of insulin
because there will be no oral intake
before surgery.

b. Obtain a blood glucose measurement
before any insulin administration.

14

The outpatient surgery nurse reviews the complete blood cell (CBC) ount results for a patient who is scheduled for surgery in a few days. The results
are white blood cell (WBC) count 10.2 × 10
45%; platelets 150 × 103/μL; hemoglobin 15 g/dL; hematocrit3/μL. Which action should the nurse take?

a. Call the surgeon and anesthesiologist immediately.
b. Ask the patient about any symptoms of a recent infection.
c. Discuss the possibility of blood transfusion with the patient.
d. Send the patient to the holding area
when the operating room calls.

d. Send the patient to the holding area
when the operating room calls.

15

As the nurse prepares a patient the morning of surgery, the patient
refuses to remove a wedding ring, saying, “I have never taken it off since the day I
was married.” Which response by the nurse is best?

a. Have the patient sign a release andleave the ring on.
b. Tape the wedding ring securely to the patient’s finger.
c. Tell the patient that the hospital is not
liable for loss of the ring.
d. Suggest that the patient give the ring to
a family member to keep.

d. Suggest that the patient give the ring to
a family member to keep.

16

A patient has received atropine before surgery and complains of dry
mouth. Which action by the nurse is best?

a. Check for skin tenting.
b. Notify the health care provider.
c. Ask the patient about any dizziness
d. Tell the patient dry mouth is an
expected side effect.

d.. Tell the patient dry mouth is an
expected side effect.

17

Which statement by a patient scheduled for surgery is most importantto report to the health care provider?

a. “I had a heart valve replacement last year.”
b. “I had bacterial pneumonia 3 months ago."
c. “I have knee pain whenever I walk or jog.”
d. “I have a strong family history of breast
cancer.”

a. “I had a heart valve replacement last year.”

18

The nurse interviews a patient scheduled to undergo general
anesthesia for a hernia repair. Which information is most important to communicateto the surgeon and anesthesiologist before surgery?

a. The patient drinks 3 or 4 cups of coffee every morning before going to work.
b. The patient takes a baby aspirin daily but stopped taking aspirin 10 days ago.
c. The patient drank 4 ounces of apple juice 3 hours before coming to the hospital.
d. The patient’s father died after receiving
general anesthesia for abdominal
surgery.

d.The patient’s father died after receiving
general anesthesia for abdominal
surgery.

19

Which information in the preoperative patient’s medication history is
most important to communicate to the health care provider?

a. The patient uses acetaminophen (Tylenol) occasionally for aches and pains.
b. The patient takes garlic capsules daily but did not take any on the surgical day.
c. The patient has a history of cocaine use but quit using the drug over 10 years
ago.
d. The patient took a sedative medication
the previous night to assist in falling
asleep.

b.The patient takes garlic capsules daily but did not take any on the surgical day.

20

A patient who takes a diuretic and a β­blocker to control blood
pressure is scheduled for breast reconstruction surgery. Which patient information
is most important to communicate to the health care provider before surgery?

a. Hematocrit 36%
b. Blood pressure 144/8
c. Pulse rate 58 beats/minute
d. Serum potassium 3.2 mEq/L

d. Serum potassium 3.2 mEq/L