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AIIH MED-SURG 1 TEST 2 (QUESTIONS & ANSWERS ) LATEST UPDATE 2024
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AIIH MED-SURG 1 TEST 2 (QUESTIONS & ANSWERS ) LATEST UPDATE 2024
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AIIH MED -SURG 1 TEST 2 (QUES TIONS & ANSWERS ) LATEST UPDATE 2024 1. The client undergoing preoperative assessment before an elective procedure tells the nurse that she has been taking 10 mg of prednisone daily for rheumatoid arthritis. What is the nurse’s best action? A. Notify the surgeon and anesthesiologist. B. Document the information as the only action. C. Reschedule the surgery in 2 weeks when the client has cleared the drug from her system. D. Suggest that the client switch to a nonsteroidal anti-inflammatory agent for pain relief. ANS: A The surgery does not need to be delayed; however, corticosteroids have many adverse effects and will have an impact on the client’s responses. In addition, clients who have been taking corticosteroids on a daily basis need to continue this therapy through the perioperative period to prevent adrenal insufficiency from abrupt withdrawal. 2. How does palliative surgery differ from any other type of surgery? A. The main purpose is cosmetic in nature rather than functional repair or comfort. B. There are fewer risks associated with palliative surgery than with any other type of surgery. C. The outcomes of palliative surgery cannot be ensured to produce the desired effect or restoration of functional ability. D. Palliative surgery is performed to provide temporary relief of distressing symptoms rather than to cure a problem or condition. ANS: D The purpose of palliative surgery is to improve the client's quality of life by reducing or eliminating distressing symptoms. It does not cure a health problem and, often, does not prolong life. Although the exact outcomes of palliative surgery cannot be ensured, neither can the outcomes of any other type of surgery. 3. While examining the 82-year-old client's preoperative laboratory blood tests, the nurse finds the client's serum sodium level to be 139 mEq/mL. What is the nurse’s best action? A. Increase the IV flow rate. B. Initiate oxygen therapy by mask. C. Document the finding as the only action. D. Notify the surgeon and anesthesiologist. ANS: C The normal range for serum sodium in clients of this age is 135 to 145 mEq/L. DIF: Cognitive Level: Comprehension TOP: Nursing Process Step: Assessment MSC: Client Needs Category: Physiological Integrity 4. The client who is scheduled to have surgery cannot read or write. The surgeon obtaining the consent wants to have the client's spouse sign the consent instead. What is the nurse’s best action? A. Nothing; a signed informed consent statement does no t need to be obtained from this client. B. Locate the spouse, because the informed consent statement must be signed by the client's closest relative. C. Inform the surgeon that the client may sign the informed consent statement with an X in front of two witnesses. D. Notify the administration because the court must appoint a legal guardian to represent the client's best interests and give consent for all surgical procedures. ANS: C The lack of ability to read or write does not constitute incapacity t o give legal consent. If the client meets all other legal and clinical aspects of competence, he or she may use an X to demonstrate consent if the act is witnessed by two persons. 5. When asked about allergies, the preoperative client tells the nurse she has allergies to all of the following substances. Which allergy alerts the nurse to potential problems in relation to the scheduled surgery? A. Pollens B. Bee stings C. Shellfish D. Peanuts ANS: C Many people who have hypersensitivities or allergies to shellfish will have allergies to povidone -iodine, a substance commonly used to cleanse surgical sites. 6. The client is NPO for surgery scheduled to occur in 4 hours. It is now 9 AM and the client's normal oral medications (consisting of digoxin, 0.125 mg, Colace, 300 mg, and Feostat, 325 mg) are due to be administered. The physician will not be available until the time of surgery. What is the nurse’s best action? A. Hold all medications. B. Administer all medications orally. C. Administer all medications parenterally. D. Administer digoxin with minimal water and hold the other drugs. ANS: D Regularly scheduled cardiac medications should be administered on schedule. If taken with a few small sips of water at least 2 hours before surgery, this medication should not increase the risk of intraoperative or postoperative aspiration. 7. Twenty minutes after the client has received a preoperative injection of atropine and midazolam (Versed), the client tells the nurse that he must be allergic to the medication because his mouth is dry and his heart seems to be beating faster than normal. What is the nurse’s best first action? A. Document the findings as the only action. B. Check the client's pulse and blood pressure. C. Prepare to administer epinephrine and diphenhydramine (Benadryl). D. Explain to the client that these symptoms are normal responses to the medication. ANS: B Although these are the expected physiologic responses to the preoperative medication, any time the client states that he or she can feel a change in normal cardiac fu nction, the system should be assessed. If the client's pulse and blood pressure are within normal limits, the nurse should then explain the responses to the client and document the change. 8. The client scheduled to have surgery within the next 2 hours tells the nurse during the admission interview the following information. Which piece of information should the nurse be certain to communicate on the outside of the chart for the entire surgical team to know? A. The client is allergic to cats. B. The client is hard of hearing. C. The client had a glass of wine 12 hours ago. D. The client takes 2000 mg of vitamin C each day. ANS: B The team will need to communicate with the client in the surgical holding area, the operating room, and the postanesthesia recovery unit. Any problem with communication, such as a hearing impairment, should be stressed so that team members can use alternative means to assure accurate communication with the client. 9. Which statement made by the client indicates a need for further teaching? A. “These exercises help prevent blood clots.” B. “Once I am up and walking around, I won't need to do these as often.” C. “Keeping my knees bent will prevent my arthritis from making me so stiff.” D. “If I feel pain in my calf when I bend my ankles up and down, I sho uld tell my nurse.” ANS: C The major purpose of the leg exercises is to promote venous return and prevent the formation of blood clots. Keeping the knees bent inhibits venous return and may promote blood clot formation. 10. The client’s surgery has been delayed because of hyperkalemia. The client doesn’t understand why. What is the nurse’s best response? A. “Potassium affects how the heart works and you could have a heart attack if this is not corrected.”The benefits of buying summaries with Stuvia:
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