Question 1

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?

Accepted Answer

A)  Teach the patient that these products may be continued preoperatively.
B)  Advise the patient to stop the use of herbs and supplements at this time.
C)  Discuss the herb and supplement use with the patient's health care provider.
D)  Reassure the patient that there will be no interactions with anesthetic agents. C

Question 2

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?

Accepted Answer

A)  Auscultate for adventitious breath sounds.
B)  Obtain the blood pressure and temperature.
C)  Remind the patient about harmful effects of smoking.
D)  Ask the health care provider to prescribe a nicotine patch. A

Question 3

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

Accepted Answer

A)  Notify the surgeon and anesthesiologist immediately.
B)  Ask the patient about any symptoms of a recent infection.
C)  Continue to prepare the patient for the surgical procedure.
D)  Discuss the possibility of blood transfusion with the patient. C

Question 4

Five minutes after receiving the ordered preoperative midazolam by IV injection,the patient asks to get up to go to the bathroom to urinate. Which action by the nurse is most appropriate?

Accepted Answer

A)  Assist the patient to the bathroom.
B)  Offer the patient a urinal or bedpan.
C)  Ask the patient to wait until the drug has been fully metabolized.
D)  Tell the patient that a bladder catheter will be placed in the operating room.

Question 5

The nurse is preparing a patient on the morning of surgery. The patient refuses to remove a wedding ring,saying,"I've never taken it off since the day I was married." Which response by the nurse is best?

Accepted Answer

A)  Have the patient sign a release form and leave the ring on.
B)  Tell the patient that the hospital is not liable for loss of the ring.
C)  Suggest that the patient give the ring to a family member to keep.
D)  Inform the operating room personnel that the patient is wearing a ring.

Question 6

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?

Accepted Answer

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)  Give half the usual dose of insulin because there will be no oral intake before surgery.

Question 7

A patient who is scheduled for a therapeutic abortion tells the nurse,"Having an abortion is wrong." Which functional health pattern should the nurse further assess?

Accepted Answer

A)  Value-belief
B)  Cognitive-perceptual
C)  Sexuality-reproductive
D)  Coping-stress tolerance

Question 8

A patient who takes a diuretic and a b-blocker 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?

Accepted Answer

A)  Hematocrit 36%
B)  Blood pressure 144/82
C)  Serum potassium 3.2 mEq/L
D)  Pulse rate 54-58 beats/minute

Question 9

The nurse plans to provide preoperative teaching to an alert older man who has hearing and vision deficits. His wife answers most questions that are directed to the patient. Which action should the nurse take when doing the teaching?

Accepted Answer

A)  Use printed materials for instruction so that the patient will have more time to review the material.
B)  Direct all 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 teaching with the patient himself.

Question 10

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

Accepted Answer

A)  The patient's father died after general anesthesia for abdominal surgery.
B)  The patient drinks 3 cups of coffee every morning before going to work.
C)  The patient takes a baby aspirin daily but stopped taking aspirin 10 days ago.
D)  The patient drank 4 ounces of apple juice 3 hours before coming to the hospital.

Question 11

A patient arrives at the outpatient surgical center for a scheduled laparoscopy under general anesthesia. Which information requires the nurse's preoperative intervention to maintain patient safety?

Accepted Answer

A)  The patient has never had general anesthesia.
B)  The patient is planning to drive home after surgery.
C)  The patient had a sip of water 4 hours before arriving.
D)  The patient's insurance does not cover outpatient surgery.

Question 12

A patient who has not had any prior surgeries tells the nurse doing the preoperative assessment about allergies to avocados and bananas. Which action is most important for the nurse to take?

Accepted Answer

A)  Notify the dietitian about the specific food allergies.
B)  Alert the surgery center about a possible latex allergy.
C)  Reassure the patient that all allergies are noted on the health record.
D)  Ask whether the patient uses antihistamines to reduce allergic reactions.

Question 13

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

Accepted Answer

A)  Check for skin tenting.
B)  Notify the health care provider.
C)  Ask the patient about any weakness or dizziness.
D)  Explain that dry mouth is an expected side effect.

Question 14

When caring for a preoperative patient on the day of surgery,which actions included in the plan of care can the nurse delegate to unlicensed assistive personnel (UAP)?

Accepted Answer

A)  Teach incentive spirometer use.
B)  Explain routine preoperative care.
C)  Obtain and document baseline vital signs.
D)  Remove nail polish and apply pulse oximeter.
E)  Transport the patient by stretcher to the operating room.

Question 15

The nurse is preparing to witness the patient signing the operative consent form when the patient says,"I don't understand what the doctor said about the surgery." Which action should the nurse take next?

Accepted Answer

A)  Provide a thorough explanation of the planned surgical procedure.
B)  Notify the surgeon that the informed consent process is not complete.
C)  Give the prescribed preoperative antibiotics and withhold sedative medications.
D)  Notify the operating room nurse to give a more complete explanation of the procedure.

Question 16

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?

Accepted Answer

A)  Increased discomfort
B)  Increased blood pressure
C)  Increased anesthesia recovery time
D)  Increased postoperative wound bleeding

Question 17

A patient scheduled for an elective hysterectomy tells the nurse,"I am afraid that I will die in surgery like my mother did!" Which initial response by the nurse is appropriate?

Accepted Answer

A)  "Surgical techniques have improved in recent years."
B)  "Tell me more about what happened to your mother."
C)  "You will receive medication to reduce your anxiety."
D)  "You should talk to the doctor again about the surgery."

Question 18

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

Accepted Answer

A)  "I have a strong family history of cancer."
B)  "I had a heart valve replacement last year."
C)  "I had bacterial pneumonia 3 months ago."
D)  "I have knee pain whenever I walk or jog."

Question 19

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

Accepted Answer

A)  The patient takes garlic capsules every day.
B)  The patient quit using cocaine 10 years ago.
C)  The patient took a prescribed sedative the previous night.
D)  The patient uses acetaminophen (Tylenol)  for aches and pains.

Question 20

A 38-yr-old woman is admitted for an elective surgical procedure. Which information obtained by the nurse during the preoperative assessment is most important to communicate to the anesthesiologist and surgeon before surgery?

Accepted Answer

A)  The patient's lack of knowledge about postoperative pain control
B)  The patient's history of an infection following a cholecystectomy
C)  The patient's report that her last menstrual period was 8 weeks ago
D)  The patient's concern about being able to resume lifting heavy items

Exam 17: Preoperative Care