Care of Surgical Patients

Question 1

A 43-year-old client is scheduled to have a gastrectomy. Which of the following is a major
preoperative concern?

Answer 1

The client smokes a pack of cigarettes a day.

Question 2

An appendectomy is appropriately documented by the nurse as:

Answer 2

Ablative surgery

Question 3

An obese client is admitted for abdominal surgery. The nurse recognizes that this client is more
susceptible to the postoperative complication of:

Answer 3

Dehiscence

Question 4

The nurse is working in a postoperative care unit in an ambulatory surgery center. Of the following
clients that have come to have surgery, the client at the greatest risk during surgery is a:

Answer 4

27-year-old taking an anticoagulant agent

Question 5

A 92-year-old client is scheduled for a colectomy. Which normal physiological change that
accompanies the aging process increases this client’s risk for surgery?

Answer 5

Reduced glomerular filtration rate

Question 6

The nurse is completing the preoperative checklist for an adult female client who is scheduled for an
operative procedure later in the morning. Which of the following preoperative assessment findings for
this client indicates a need to contact the surgeon?

Answer 6

Serum creatinine 3.2 mg/100 mL

Question 7

The nurse is evaluating the outcome “Client describes surgical procedures and postoperative
treatment” and determines that the client has not achieved this outcome. The nurse should:

Answer 7

Inform the surgeon so that information can be provided

Question 8

Which of the following statements most accurately reflects nursing accountability in the intraoperative
phase?

Answer 8

“There seems to be a missing sponge, so a recount should be done of all the sponges
that have been removed.”

Question 9

The client will have an incision in the lower left abdomen. Which of the following measures by the
nurse will help decrease discomfort in the incisional area when the client coughs postoperatively?

Answer 9

Applying a splint directly over the lower abdomen

Question 10

The nurse is evaluating the client in the hospital’s postanesthesia care unit (PACU) and determines
that the Aldrete score is 8. Based on this assessment, the nurse anticipates that the client will:

Answer 10

Be discharged back to his or her room on the nursing unit

Question 11

A client is in the postanesthesia care unit (PACU) recovering from a vagotomy and pyloroplasty.
Which of the following is a normal expectation of the client in this stage of recovery?

Answer 11

A subdued level of consciousness and neurological function

Question 12

The client is scheduled for abdominal surgery and has just received the preoperative medications. The
nurse should:

Answer 12

Place the side rails up on the bed or stretcher

Question 13

The nurse is completing the preoperative checklist for an adult client who is scheduled for an
operative procedure later in the morning. Which of the following preoperative assessment findings for
this client indicates a need to contact the anesthesiologist?

Answer 13

Temperature is 100° F.

Question 14

In the postoperative period, the nurse recognizes that an early sign of malignant hyperthermia is:

Answer 14

Tachycardia

Question 15

The client tells the nurse that “blowing into this tube thing (incentive spirometer) is a ridiculous
waste of time.” The nurse explains that the specific purpose of the therapy is to:

Answer 15

Promote lung expansion

Question 16

The female client on the surgical unit is being prepared for abdominal surgery with general
anesthesia. In preparing this client for surgery, the nurse should:

Answer 16

Remove her makeup and nail polish

Question 17

The client asks the nurse the purpose of having medications (Demerol and Vistaril) given before
surgery. The nurse should inform the client that these particular medications:

Answer 17

Ease the induction of the anesthesia

Question 18

A client who receives general or regional anesthesia in an ambulatory surgery center:

Answer 18

Has to meet identified criteria in order to be discharged home

Question 19

Following abdominal surgery, the nurse suspects that the client may be having internal bleeding.
Which of the following findings is indicative of this complication?

Answer 19

Abdominal distention

Question 20

After discharge from the postanesthesia care unit (PACU), the client returned to the surgical nursing
unit at 10:00 AM. It is now 11:30 AM, and the client is not experiencing any complications or
difficulties. The nurse will plan to measure the client’s vital signs:

Answer 20

Every 1 hour

Question 21

The client had surgery in the morning that involved the right femoral artery. To assess the client’s
circulation status to the right leg, the nurse will make sure to check the pulse at the:

Answer 21

Dorsalis pedis artery

Question 22

Upon admission to the postanesthesia care unit (PACU), the client who has no orthopedic or
neurological restrictions is positioned with the:

Answer 22

Head of the bed slightly elevated with the client’s head to the side

Question 23

A client who is scheduled for surgery is found to have thrombocytopenia. A specific postoperative
concern for the nurse for this client is:

Answer 23

Hemorrhage

Question 24

A prostate biopsy is an acceptable procedure to be performed as an ambulatory surgery on an
otherwise healthy adult male because the American Society of Anesthesiologists (ASA) considers that
a:

Answer 24

Physical status class 1

Question 25

Which of the following statements made by a nurse reflects the greatest insight into the responsibility
an ambulatory care nurse has to the client’s family?

Answer 25

“I consider myself as having several clients: the surgical client and all the family
that’s present.”

Question 26

Which of the following statements made by a nurse reflects the greatest insight into the planning
needs of a same-day surgical experience?

Answer 26

“I take the time to review the client’s preadmission and preoperative data in order to
formulate the most individualized plan of care possible.”

Question 27

The perioperative nurse realizes that the most effective means of evaluating the client’s understanding
of previous teaching is to:

Answer 27

Discuss it with the client and family in the immediate preoperative period

Question 28

Which of the following preoperative assessment findings would most likely delay a planned
procedure requiring general anesthetic?

Answer 28

A cough and low-grade fever

Question 29

A 74-year-old is accompanied by his daughter to the ambulatory surgery department for the surgical
removal of a suspicious skin lesion. The client has experienced dysphasia since a cerebral vascular
accident 3 years ago. The most effective way for the nurse to secure the necessary preoperative
interview information is to:

Answer 29

Question the client’s daughter

Question 30

A client who has type 2 diabetes is scheduled for the removal of a skin lesion on his right shoulder at
an ambulatory surgery unit. The nursing diagnosis the client is at greatest risk for postoperatively is:

Answer 30

Impaired wound healing

Question 31

A client with a history of sleep apnea has had a same-day surgery procedure that will require the
administration of morphine postoperatively to manage pain. This client will be assessed most
appropriately by the perioperative nurse for the risk for respiratory complications by frequently:

Answer 31

Listening to breath sounds

Question 32

A client scheduled for an ambulatory surgery procedure requiring anesthetics arrives with a low-grade
fever and a productive sough. The postponement of the procedure is most likely a result of the:

Answer 32

Possibility of a respiratory complication during anesthesia

Question 33

Which of the following goals is most appropriate for a preoperative client with a nursing diagnosis of
deficient knowledge regarding preoperative requirements related to lack of exposure to information?

Answer 33

Client will understand the preoperative routines of surgical care before leaving
provider’s office.

Question 34

Which of the following client outcomes is most therapeutic for a preoperative client with a nursing
diagnosis of deficient knowledge regarding preoperative requirements related to lack of exposure to
information?

Answer 34

Client will present for drawing of preoperative laboratory blood at least 48 hours
before scheduled surgery.

Question 35

Which of the following client evaluations is most reflective of compliance for a preoperative client
with a nursing diagnosis of deficient knowledge regarding preoperative requirements related to lack
of exposure to information?

Answer 35

Client’s preoperative blood laboratory work results are present on preoperative
chart.

Question 36

Which of the following best describes the primary nursing role regarding a client’s consent to surgery
immediately before surgery?

Answer 36

Reviewing the client’s surgical consent as a part of the routine preoperative
checklist

Question 37

The initial client education–related nursing action by the preadmission nurse is to:

Answer 37

Call the client before the surgery to restate presurgery routine

Question 38

Which of the following statements made by the nurse shows the most informed understanding of the
role of family in the client’s postoperative recovery?

Answer 38

“Teaching the family what they need to know before the surgery will maximize
their effectiveness regarding the client’s postoperative care.”

Question 39

The nurse recognizes which of the following as the greatest barrier to meeting a preoperative client’s
nursing diagnosis of deficient knowledge regarding surgical procedure?

Answer 39

Fear or anxiety regarding the procedure

Question 40

The nurse knows that the client is most likely going to arrive for the surgical procedure having
adhered to the required bowel preparation if:

Answer 40

The client understands the need for the laxative

Question 41

Which surgical classification would be the most appropriate for a cardiac catheterization scheduled on
a 44-year-old male client who is in the hospital with chest pain?

Answer 41

Major

Question 42

A 36-year-old female diabetic client is having an elective breast augmentation procedure done. Which
of the following tests must be done on the day of surgery?

Answer 42

Blood glucose

Question 43

A 48-year-old male client with a history of chronic obstructive pulmonary disease (COPD) is
scheduled for an inguinal hernia repair. The nurse instructs that client that he can expect the health
care provider to order which of the following tests before surgery?

Answer 43

Pulmonary function test

Question 44

A 64-year-old male client has been scheduled to undergo surgery for a total knee replacement. The
client would like to be able to use his own blood for the surgery, if needed. The nurse explains that
there are several advantages to the client’s having an autologous infusion, but there are some
drawbacks as well. Which of the following would be considered a drawback to an autologous
infusion?

Answer 44

The client may have a decreased hemoglobin and hematocrit level on the day of
surgery.

Question 45

A 24-year-old male client has been scheduled to undergo surgery for an ACL repair of his right knee.
The client states that he is confused about what the surgeon will be doing. The best response from the
nurse is:

Answer 45

“Let me get the surgeon to talk with you before we proceed so that you fully
understand what will be happening”

Question 46

A 47-year-old female client has been scheduled to undergo surgery for removal of her gallbladder.
Preoperatively the nurse is teaching the client what to expect when she wakes up in the postanesthesia
care center. The nurse tells the client that her vision may be blurry due to which of the following
reasons?

Answer 46

The anesthesia provider applies ointment to clients’ eyes to prevent corneal damage.

Question 47

Given a rationale for preoperative and postoperative procedures, the client is better prepared to
participate in care. For which of the following should the nurse provide instruction and rationale?

Answer 47

Incentive spirometry

Question 48

The nurse is very busy and needs to delegate some tasks to the nursing assistive personnel (NAP).
Which of the following would be the most appropriate task to delegate?

Answer 48

Transporting the preoperative client from the unit to the holding area

Question 49

When discussing the details of having a procedure done in a facility’s ambulatory surgery department,
the nurse includes which of the following as advantages? (Select all that apply.)

Answer 49

Facilitates faster postsurgical recovery

Reduces hospital-oriented expenses

Minimizes risk for acquiring a nosocomial infection

The anesthetic drugs used result in faster “wake-up” time