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Chapter 39. Perioperative Care NCLEX Questions Questions and Answers 2024
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Chapter 39. Perioperative Care NCLEX Questions
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Chapter 39. Perioperative Care NCLEXQuestions
The preoperative phase encompasses which period of time?
a) Entry to the operating suite until admission to post anesthesia care
b) Entry into the operating suite until discharge from the hospital
c) The decision to have surgery until admission to post anesthesia care
d) The decision to have surgery until entry to the operating suite - answer ANS: D
The preoperative phase begins with the decision to have surgery and ends when the
patient enters the
operating room. The intraoperative phase begins when the patient enters the operating
suite and ends
when the patient is admitted to the post anesthesia care unit.
A 2-year-old child is scheduled for a tonsillectomy. When determining the plan of care,
the nurse should:
a) Include the parents or caregivers in the plan of care
b) Explain to the child that she will have a sore throat after surgery
c) Tell the child that she can have her favorite foods for the first 24 hours after surgery
d) Prepare the child for discharge from the hospital as soon as she is alert -
answerANS: A
It is developmentally normal for toddlers to experience anxiety with separation from
parents or
caregivers. Be sure to include these people in the plan of care. Developmentally, a 2-
year-old lives in the
"here and now" and wouldn't grasp an intangible concept, such as pain in the future.
The toddler would
take liquids and soft foods within the first 24 hours when her throat is sore during
swallowing. She should
not eat foods that are rough and crunchy because they may scratch her throat and
cause bleeding. After a
tonsillectomy, the child will need to be monitored for bleeding and stable vital signs;
therefore, she will
not be discharged as soon as she is alert.
Which of the following is the most appropriate nursing goal for a 2-year-old who is to
have a tonsillectomy?
a) Separation anxiety will be minimal.
,b) The child will verbalize understanding of expected pain.
c) The child will tolerate a normal diet 24 hours after surgery.
d) The parent will indicate readiness to assume the child's care. - answerANS: A
The only concrete information in this question is that the child is 2 years old. Therefore,
the only problem
the nurse can reasonably predict from this would be developmental in nature. It is
developmentally
normal for toddlers to experience anxiety with separation from parents or caregivers.
Minimizing anxiety by involving the parents or caregivers would be the appropriate goal
for separation anxiety. A 2-year-old child would not be expected to verbalize
understanding of expected pain. The toddler would take liquids and soft foods within the
first 24 hours when her throat is sore during swallowing. She should not eat
foods that are rough and crunchy because they may scratch her throat and cause
bleeding. Nurses should
encourage parental involvement, but parents should not be expected to assume the
child's care.
The focus of nursing activities in the preoperative phase is to:
a) Admit the patient to the surgical suite
b) Prepare the patient mentally and physically for surgery
c) Set up the sterile field in the operating room
d) Perform the primary surgical scrub to the surgical site - answerANS: B
The nursing focus in the preoperative phase is to prepare the patient mentally and
physically for surgery.
The patient is in the intraoperative phase when admitted to the surgical suite. The sterile
field and the
surgical scrub would be performed in the surgery suite during the intraoperative phase.
A patient is scheduled for abdominal surgery tomorrow. While gathering preoperative
data, the nurse learns that the patient takes the following medications daily: an
anticoagulant, a multivitamin, and vitamin E. The patient reports that he stopped taking
the anticoagulant 4 days ago as instructed by the surgeon. He has continued to take the
multivitamin and vitamin E. Based on the information given, the nurse notifies the
surgeon because she:
a) Needs an order to restart the anticoagulant
b) Is concerned about continued use of the multivitamin
c) Is concerned about the vitamin E
d) Has canceled the surgery so more lab tests can be done. - answerANS: C
Both prescribed and over-the-counter medications may increase surgical risk. Many
herbs can cause
potassium loss and increase the risk for cardiac arrhythmias. Vitamin E may increase
the risk for bleeding. This patient's use of vitamin E daily should be discontinued 2
weeks prior to surgery, so the nurse should inform the surgeon of the vitamin E intake.
Generally, the surgeon or anesthesiologist instructs patients to continue or discontinue
, taking their prescribed medicines. However, it is important to assess use of
supplements and over-the-counter medicines. The nurse cannot cancel surgery without
an order from the surgeon, who determines whether the surgery should be delayed or
whether it is so urgent that it needs to continue as scheduled, even with the additional
risk factor of the vitamin E intake.
A patient is admitted for hip surgery. The patient usually takes the following medications
daily: an anticoagulant, a multivitamin, and vitamin E. He stopped taking his
anticoagulant 4 days ago as
instructed by his surgeon, but has continued to take the multivitamin and vitamin E. An
important collaborative problem or nursing diagnosis for this patient is which of the
following?
a) Potential complication: anemia
b) Risk for infection related to inadequate anticoagulant dosage
c) Risk for noncompliance related to inability to follow instructions
d) Potential complication: increased bleeding - answerANS: D
The patient is at an increased risk for bleeding due to his intake of vitamin E. He may be
at risk for
anemia if he experiences a large blood loss in surgery; however, this problem is not
appropriate before he
experiences the blood loss. This patient does not have a higher-than-average risk for
infection because he
is not having surgery involving a "contaminated" system (e.g., the gastrointestinal
system). There is no
evidence to suggest that this is noncompliant simply because he stopped taking his
anticoagulant as
ordered.
A patient is admitted from a local skilled nursing facility to the outpatient surgery center
for surgical debridement of a stage IV sacral pressure ulcer. The perioperative nurse
discovers that the
patient does not have a signed consent form for the surgery on the chart or in the
surgery center. The patient says that she has not talked to the surgeon and that she has
many questions regarding her surgery. When informed of this, the surgeon tells the
nurse to have the patient sign the informed consent form, and he will review it prior to
the surgery. What should the nurse do?
a) Follow the surgeon's orders, and ask the patient to sign the surgical consent form.
b) Inform the surgeon that she will have the patient sign after he discusses the surgery
with the patient.
c) Ensure that the signed surgical consent is witnessed by two nurses, because the
surgeon is not available.
d) Cancel the surgery and transfer the patien - answerANS: B
Informed surgical consent requires that the surgeon communicates information about
the surgery to the
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