Chapter 37 - deWit - Care of the Surgical Patient - Nov 22 test

Question 1

voluntary

Answer 1

elective

Question 2

This surgery is to relieve pain or complications

Answer 2

Palliative surgery

Question 3

This type of surgery is often necessary in trauma cases in which serious consequences will occur if surgery is not done immediately

Answer 3

Emergency surgery

Question 4

This type of surgery is done to provide data for a diagnosis of a problem

Answer 4

Diagnostic surgery

Question 5

This type of surgery alleviates a problem

Answer 5

Curative surgery

Question 6

This type of surgery is done to restore appearance or function

Answer 6

Reconstructive surgery

Question 7

Which age groups are at higher risk for complications of surgery because of either immature body systems or a decline in function of various body systems?

Answer 7

Infant and elderly persons

Question 8

This type of nursing refers to care of the patient from the time of the decision to have surgery through recovery from the procedure

Answer 8

Perioperative nursing

Question 9

The loss of sensory perception

Answer 9

Anesthesia

Question 10

What are the goals of anesthesia?

Answer 10

1) To prevent pain
2) To achieve adequate muscle relaxation
3) To calm fear, ease anxiety, and induce forgetfulness of an unpleasant experience

Question 11

Incapable of responding to sensory stimuli

Answer 11

Unconscious

Question 12

Awareness of one’s surroundings

Answer 12

Conscious

Question 13

What does PACU stand for?

Answer 13

Postanesthesia care recovery unit

Question 14

Who is responsible for obtaining an informed surgical consent?

Answer 14

The surgeon

Question 15

If the patient does not understand the procedure or has further questions, who should the nurse refer back to?

Answer 15

The surgeon

Question 16

Stoppage of flow

Answer 16

stasis

Question 17

Blood clot causing inflammation of a vessel

Answer 17

thrombophlebitis

Question 18

How often should vital signs and careful assessment be perfomed? (1st hour, next 2 hours, next 4 hours, until patient is totally recovered)

Answer 18

• 1st hour - every 15 minutes
• next 2 hours - every 30 minutes
• next 4 hours - every hour
• Until patient is totally recovered - every 4 hours

Question 19

What is always a priority measure to prevent the patient from injury?

Answer 19

Maintaining an open airway

Question 20

Collapse of alveoli in the lungs

Answer 20

Atelectasis

Question 21

What type of instrument is used to determine blood oxygenation?

Answer 21

A pulse oximeter

Question 22

If the patient has an indwelling catheter, the urine in the bag should be observed ______ in the early postoperative period

Answer 22

every hour

Question 23

If the urine flow is less than __mL/kg/hr, report it to the charge nurse

Answer 23

5 mL/kg/hr

Question 24

Blood clot

Answer 24

thrombosis

Question 25

Failure of forward movement of bowel contents

Answer 25

Paralytic ileus

Question 26

Clot that travels and lodges in a vessel

Answer 26

embolus

Question 27

Inflammation and consolidation of the lung with exudate

Answer 27

Pneumonia

Question 28

Separation of the layers of the surgical wound

Answer 28

Dehiscence

Question 29

Extrusion of the viscera through the surgical incision

Answer 29

Evisceration

Question 30

What are the 3 types of anesthesia used for many surgical procedures?

Answer 30

Regional anesthesia, moderate sedation, or local anesthesia

Question 31

When witnessing the signing of an informed surgical consent form, the nurse is verifying that:

1) the correct operation is entered on the form
2) the risks and alternatives for the surgical procedure have been explained
3) all possible consequences of having or not having the procedure are understood
4) the patient noted on the form has signed it

Answer 31

4) the patient noted on the form has signed it

Question 32

Your patient had an appendectomy 2 days ago. To properly auscultate for bowel sounds you would:

1) listen in the lower right quadrant for 2 minutes
2) listen in all four quadrants for at least 1 minute each
3) listen in each quadrant for 3 minutes
4) listen in both lower quadrants for 2 minutes

Answer 32

2) listen in all four quadrants for at least 1 minute each

Question 33

A similarity of roles for the scrub person and the circulating nurse is that they both:

1) set up initial sterile instruments and supplies
2) position lights and step stools
3) are communication links with personnel outside the room
4) advise the team of breaks in sterile technique

Answer 33

4) advise the team of breaks in sterile techniques

Question 34

When a patient arrives in the PACU with a surgical dressing, an intravenous infusion, and a urinary catheter. The priority action of the nurse is assessment of:

1) urine output
2) IV line patency
3) airway patency
4) wound drainage

Answer 34

3) airway patency

Question 35

As part of a patient’s immediate care in the PACU, the nurse would: (select all that apply)

1) check vital signs every 15 minutes
2) assess adequacy of respirations
3) monitor the dressing
4) observe the drainage from the NG tube
5) note the amount of urine output

Answer 35

all

Question 36

A patient returns to his room after surgery. When he arrives, you notice that he is still groggy from anesthesia and that he has an IV running in one arm. As you help settle him in bed, you: (select all that apply)

1) assess the IV for patency and correct fluid and rate
2) position to prevent aspiration while still groggy
3) quickly medicate for pain
4) take his vital signs every 15 minutes for 1 hour
5) reassure him that the surgery is over

Answer 36

1, 2, 4, 5

Question 37

If your fresh postoperative patient has not voided within 8 hours of the end of surgery, you would FIRST:

1) seek an order to catheterize the patient
2) assist the patient to attempt to void using measures to encourage voiding
3) allow another hour in which the patient might spontaneously void
4) obtain catheterization equipment and bring it to the bedside

Answer 37

2) assist the patient to attempt to void using measures to encourage voiding

Question 38

Since your surgery patient returned to her room, you have assisted her in turning and encouraged her to breathe deeply, to cough, and to move her legs at least every 2 hours. By deep breathing and coughing, the patient will be less likely to develop the postoperative complication of _______

Answer 38

atelectasis

Question 39

The second day after surgery , the nasogastric tube is removed and an order is written for fluids as tolerated and a liquid diet. The patient is eager to try taking fluids. What should the nurse recommend that he do?

1) What until his liquid diet tray arrives at mealtime
2) Start with small sips of water at first to see if they are retained
3) Take in a variety of fluids totaling 3000 mL/day
4) Go ahead and drink all the water he wants

Answer 39

2) Start with small sips of water at first to see if they are retained

Question 40

The patient has a PCA pump to be used for pain control. Should his pain not be adequately controlled with the use of the pump, the nurse would first: (select all that apply)

1) administer an oral analgesic in addition to the pump medication
2) seek a medication order change from the physician
3) use nonpharmacologic comfort measures
4) be certain that none of the drainage tubes are kinked
5) encourage the use of distraction

Answer 40

3, 4, 5

Question 41

On his third postoperative day, a patient states that he does not feel well and that he has a lot more pain in the incision area. You inspect the incision and notice that the lower end of it is very red. From these symptoms, you suspect that this patient has developed:

1) an embolus
2) an ileus
3) a wound infection
4) an evisceration

Answer 41

3) a wound infection

Question 42

On the sixth postoperative day, a patient complains of malaise and pain in her lower right leg. The lower leg is warm to the touch and slightly swollen. You suspect that she may have ______

Answer 42

a DVT (deep vein thrombosis)