Chapter 9: Concepts of Care for Perioperative Patients - Answer-Chapter 9: Concepts of Care for Perioperative Patients
A preoperative nurse is assessing a client prior to surgery. Which information would be most important for the nurse to relay to the surgical team?
a. Allergy to bee and wasp s...
RN218 1 Exam Questions with Verified
Answers
Chapter 9: Concepts of Care for Perioperative Patients - Answer-Chapter 9: Concepts
of Care for Perioperative Patients
A preoperative nurse is assessing a client prior to surgery. Which information would be
most important for the nurse to relay to the surgical team?
a. Allergy to bee and wasp stings
b. History of lactose intolerance
c. No previous experience with surgery
d. Use of multiple herbs and supplements - Answer-d. Use of multiple herbs and
supplements
A nurse works on the postoperative floor and has four clients who are being discharged
tomorrow. Which one has the greatest need for the nurse to consult other members of
the health care team for postdischarge care?
a. Married young adult who is the primary caregiver for children.
b. Middle-age client who is post-knee replacement, and needs physical therapy.
c. Older adult who lives alone at home despite some memory loss.
d. Young client who lives alone, and has family and friends nearby. - Answer-b. Middle-
age client who is post-knee replacement, and needs physical therapy.
A clinic nurse is teaching a client prior to surgery. The client does not seem to
comprehend the teaching, forgets a lot of what is said, and asks the same questions
again and again. What action by the nurse is best?
a. Assess the client for anxiety.
b. Break the information into smaller bits.
c. Give the client written information.
d. Review the information again. - Answer-a. Assess the client for anxiety.
A preoperative nurse is reviewing morning laboratory values on four clients waiting for
surgery. Which result warrants immediate communication with the surgical team?
a. Creatinine: 1.2 mg/dL (106.1 umol/L)
b. Hemoglobin: 14.8 mg/dL (148 mmol/L)
c. Potassium: 2.9 mEq/L (2.9 mmol/L)
d. Sodium: 134 mEq/L (134 mmol/L) - Answer-c. Potassium: 2.9 mEq/L (2.9 mmol/L)
An inpatient nurse brings an informed consent form to a client for an operation
scheduled for tomorrow. The client asks about possible complications from the
operation. What response by the nurse is best?
a. Answer the questions and document that teaching was done.
b. Do not have the client sign the consent and call the primary health care provider.
c. Have the client sign the consent, and then call the primary health care provider.
,d. Remind the client of what teaching the primary health care provider has done. -
Answer-b. Do not have the client sign the consent and call the primary health care
provider.
A client has a great deal of pain when coughing and deep breathing after abdominal
surgery despite having pain medication. What action by the nurse is best?
a. Call the primary health care provider to request more analgesia.
b. Demonstrate how to splint the incision.
c. Have the client take shallower breaths.
d. Tell the client that a little pain is expected. - Answer-b. Demonstrate how to splint the
incision.
A nurse is giving a client instructions for showering the night before surgery. What
instruction is most appropriate?
a. "After you wash the surgical site, shave that area with your own razor."
b. "Use the prescribed solution and wash the area where you will have surgery very
thoroughly."
c. "Use a washcloth to wash the surgical site; do not take a full shower or bath."
d. "Use warm water and scrub the surgical area vigorously." - Answer-b. "Use the
prescribed solution and wash the area where you will have surgery very thoroughly."
A postoperative client has an abdominal drain. What assessment by the nurse indicates
that goals for the priority client problems related to the drain are being met?
a. Drainage from the surgical site is 30 mL less than yesterday.
b. There is no redness, warmth, or drainage at the insertion site.
c. The client reports adequate pain control with medications.
d. Urine is clear yellow and urine output is greater than 40 mL/hr. - Answer-b. There is
no redness, warmth, or drainage at the insertion site.
The perioperative nurse manager and the postoperative unit manager are concerned
about the increasing number of surgical infections in their hospital. What action by the
managers is best?
a. Audit charts to see if the Surgical Care Improvement Project (SCIP) outcomes were
met.
b. Encourage staff on both units to provide peer pressure to adhere to hand hygiene
policy.
c. Hold educational meetings with the nursing and surgical staff on infection prevention.
d. Monitor staff on both units for consistent adherence to established hand hygiene
practices. - Answer-a. Audit charts to see if the Surgical Care Improvement Project
(SCIP) outcomes were met.
A client has arrived in the inpatient postoperative unit. What action by the inpatient
nurse takes priority?
a. Assessing fluid and blood output
b. Checking the surgical dressings
c. Ensuring the client is warm
,d. Participating in hand-off report - Answer-d. Participating in hand-off report
A nurse assesses a client in the preoperative holding area and finds brittle nails and
hair, dry skin turgor, and muscle wasting. What action by the nurse is best?
a. Consult the primary health care provider about a dietitian referral.
b. Document the findings thoroughly in the client's chart.
c. Encourage the client to eat more after recovering from surgery.
d. Refer the client to Meals on Wheels after discharge. - Answer-a. Consult the primary
health care provider about a dietitian referral.
The postanesthesia care unit (PACU) charge nurse notes vital signs on four
postoperative clients. Which client would the nurse assess first?
a. Client with a blood pressure of 100/50 mm Hg
b. Client with a pulse of 118 beats/min
c. Client with a respiratory rate of 6 breaths/min
d. Client with a temperature of 96° F (35.6° C) - Answer-c. Client with a respiratory rate
of 6 breaths/min
A client had a surgical procedure with spinal anesthesia. The client's blood pressure
was 122/78 mm Hg 30 minutes ago and is now 138/60 and the client reports nausea.
What action by the nurse is best?
a. Call the Rapid Response Team.
b. Increase the IV fluid rate.
c. Notify the primary health care provider.
d. Nothing; this is expected. - Answer-c. Notify the primary health care provider.
A postoperative client vomited. After cleaning and comforting the a. Airwayclient, which
action by the nurse is most important?
a. Allow the client to rest.
b. Auscultate lung sounds.
c. Document the episode.
d. Encourage the client to eat dry toast. - Answer-b. Auscultate lung sounds.
A postoperative client has just been admitted to the postanesthesia care unit (PACU).
What assessment by the PACU nurse takes priority?
a. Airway
b. Bleeding
c. Breathing
d. Cardiac rhythm - Answer-a. Airway
A postoperative client has respiratory depression after receiving morphine for pain.
Which medication and dose does the nurse prepare to administer?
a. Flumazenil 0.2 to 1 mg
b. Flumazenil 2 to 10 mg
c. Naloxone 0.4 to 2 mg
d. Naloxone 4 to 20 mg - Answer-c. Naloxone 0.4 to 2 mg
, A nurse on the postsurgical inpatient unit is observing a client perform leg exercises.
What action by the client indicates a need for further instruction?
a. Client states "This will help prevent blood clots in my legs."
b. Bends both knees, pushes against the bed until calf and thigh muscles contract.
c. Dorsiflexes and plantar flexes each foot several times an hour.
d. Makes several clockwise then counterclockwise ankle circles with each foot. -
Answer-b. Bends both knees, pushes against the bed until calf and thigh muscles
contract.
A registered nurse (RN) is watching a new nurse change a dressing and perform care
around a Penrose drain. What action by the new nurse warrants intervention?
a. Cleaning around the drain per agency protocol
b. Placing a new sterile gauze under the drain
c. Securing the drain's safety pin to the sheets
d. Using sterile technique to empty the drain - Answer-c. Securing the drain's safety pin
to the sheets
A postoperative nurse is caring for a client who received a neuromuscular blocking
agent during surgery. On assessment the nurse notes the client has weak hand grasps.
What assessment does the nurse conduct next?
a. Ability to raise head off the bed
b. Blood pressure and pulse
c. Signs of oxygenation
d. Level of orientation - Answer-c. Signs of oxygenation
The postanesthesia care unit (PACU) nurse is caring for an older client following a
lengthy surgery. The client's pulse is 48 beats/min which is 20 beats/min lower than the
preoperative baseline. What assessment does the nurse make next?
a. Temperature
b. Level of consciousness
c. Blood pressure
d. Rate of IV infusion - Answer-a. Temperature
The postoperative nurse is caring for a client who reports feeling "something popped"
after vomiting. What action by the nurse is best?
a. Administer an antiemetic medication.
b. Call the primary health care provider.
c. Instruct client to avoid coughing.
d. Gather sterile nonadherent dressings. - Answer-d. Gather sterile nonadherent
dressings.
A new perioperative nurse is receiving orientation to the surgical area and learns about
the Surgical Care Improvement Project (SCIP) goals. What major areas do these
measures focus on? (Select all that apply.)
a. Hemorrhage prevention
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