Question 1

Which topic is most important for the nurse to discuss preoperatively with a patient who is scheduled for a colon resection?

Accepted Answer

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

Question 2

A patient is to receive atropine before surgery. The nurse teaches the patient to expect

Accepted Answer

A)   dizziness.
B)   weakness.
C)   dry mouth.
D)   forgetfulness. C

Question 3

A patient arrives at the ambulatory surgery center for a scheduled outpatient surgery. Which information is of most concern to the nurse?

Accepted Answer

A)   The patient has not had outpatient surgery before.
B)   The patient is planning to drive home after surgery.
C)   The patient's insurance does not cover outpatient surgery.
D)   The patient had a glass of water a few hours before arriving. B

Question 4

Which information about medication use in a preoperative patient is most important to communicate to the health care provider?

Accepted Answer

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.

Question 5

A patient is seen at the health care provider's office several weeks before hip surgery for preoperative assessment. The patient reports use of echinacea, saw palmetto, and glucosamine/chondroitin. The nurse should

Accepted Answer

A)   ascertain that there will be no interactions with anesthetic agents.
B)   discuss the supplement use with the patient's health care provider.
C)   teach the patient that these products may be continued preoperatively.
D)   advise the patient to stop the use of all herbs and supplements at this time.

Question 6

Ten minutes after receiving the ordered preoperative opioid by intravenous (IV) injection, the patient asks to get up to go to the bathroom to urinate. The most appropriate action by the nurse is to

Accepted Answer

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 the onset of the medication takes more than 10 minutes.
D)   ask the patient to wait because catheterization is performed at the beginning of the surgical procedure.

Question 7

During the preoperative interview, 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?

Accepted Answer

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."

Question 8

A 24-year-old who takes a diuretic and a ?-blocker to control blood pressure is scheduled for abdominal surgery. Which patient information is most important to communicate to the health care provider before surgery?

Accepted Answer

A)   Pulse rate 59
B)   Hematocrit 35%
C)   Blood pressure 142/78
D)   Serum potassium 3.3 mEq/L

Question 9

During the preoperative assessment of a patient scheduled for a colon resection, the patient tells the nurse about using St. John's wort to prevent depression. The nurse should alert the staff in the postanesthesia recovery area that the patient may

Accepted Answer

A)   experience increased pain.
B)   have hypertensive episodes.
C)   take longer to recover from the anesthesia.
D)   have more postoperative bleeding than expected.

Question 10

A diabetic patient who uses insulin to control blood glucose has been NPO since midnight before having a mastectomy. The nurse will anticipate the need to

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)   administer a lower dose of insulin because there will be no oral intake before surgery.

Question 11

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

Accepted Answer

A)   Send the CBC results to the surgery facility.
B)   Call the surgeon and anesthesiologist immediately.
C)   Ask the patient about any symptoms of a recent infection.
D)   Discuss the possibility of blood transfusion with the patient.

Question 12

On the day of surgery, the nurse is admitting a patient with a history of cigarette smoking. Which action is most important at this time?

Accepted Answer

A)   Auscultate for adventitious breath sounds.
B)   Ask whether the patient has smoked recently.
C)   Remind the patient about harmful effects of smoking.
D)   Calculate the cigarette smoking history in pack-years.

Question 13

A patient who is scheduled for surgery in a week tells the nurse doing the preoperative assessment about an allergy to bananas, kiwifruit, and latex products. Which action is most important for the nurse to take?

Accepted Answer

A)   Notify the dietitian about the food allergies.
B)   Alert the surgery center about the 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.

Question 14

The nurse is obtaining the health history for a patient who is scheduled for outpatient knee surgery. Which statement by the patient is most important to report to the health care provider?

Accepted Answer

A)   "I had a heart valve replacement last year."
B)   "I had bacterial pneumonia 6 months ago."
C)   "I have knee pain whenever I walk or jog."
D)   "I have a strong family history of breast cancer."

Question 15

Before the administration of preoperative medications, 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?

Accepted Answer

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.

Question 16

A 36-year-old woman is admitted for an outpatient surgery. Which information obtained by the nurse during the preoperative assessment is most important to report to the anesthesiologist before surgery?

Accepted Answer

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

Question 17

Any patient guilt about having a therapeutic abortion may be identified when the nurse assesses the functional health pattern of

Accepted Answer

A)   value-belief.
B)   cognitive-perceptual.
C)   sexuality-reproductive.
D)   coping-stress tolerance.

Question 18

When the nurse interviews a patient who is to have outpatient surgery using a general anesthetic, which information is most important to communicate to the surgeon and anesthesiologist before surgery?

Accepted Answer

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.

Question 19

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." The nurse should

Accepted Answer

A)   have the patient sign a release and leave 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.

Question 20

An alert 82-year-old who has poor hearing and vision is receiving preoperative teaching from the nurse. His wife response most questions 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 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.

Exam 18: Nursing Management: Preoperative Care