Review Preoperative Phase

Perioperative Nursing > Medical Surgical

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Preoperative Phase

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Total Questions : 5

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Question 1:

A nurse is reviewing the informed consent form of a client who is scheduled for surgery. Which of the following actions should the nurse take?

A. Explain the benefits and risks of the surgery to the client. B. Verify that the client's signature matches the one on the medical record. C. Ensure that the surgeon has answered all of the client's questions. D. Document the client's level of anxiety and coping strategies.

Answer and Explanation

Choice A:

Incorrect. Explaining the benefits and risks of the surgery to the client is not the nurse's responsibility, but the surgeon's. The nurse should verify that the surgeon has explained these to the client before obtaining the consent.

Choice B:

Incorrect. Verifying that the client's signature matches the one on the medical record is not a necessary action for the nurse to take. The nurse should witness the client's signature and confirm that the client is competent and consenting voluntarily.

Choice C:

Correct. Ensuring that the surgeon has answered all of the client's questions is an important action for the nurse to take. The nurse should clarify any doubts or concerns that the client might have about the surgery and reinforce the information provided by the surgeon.

Choice D:

Incorrect. Documenting the client's level of anxiety and coping strategies is a helpful action for the nurse to take, but it is not directly related to the informed consent process. The nurse should assess the client's emotional state and provide support as needed, but this does not affect the validity of the consent.

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Question 2:

A nurse is preparing a client for surgery and needs to obtain some blood samples for diagnostic tests. Which of the following tests are commonly done before surgery? (Select all that apply.).

A. Hemoglobin and hematocrit. B. Blood glucose. C. Blood urea nitrogen and creatinine. D. Thyroid stimulating hormone. E. Prothrombin time and international normalized ratio.

Answer and Explanation

Choice A:

Hemoglobin and hematocrit are blood tests that measure the amount of red blood cells in the blood. These tests are commonly done before surgery to check for anemia, which is a low level of red blood cells. Anemia can increase the risk of bleeding and infection during and after surgery.

Choice B:

Blood glucose is a blood test that measures the amount of sugar in the blood. This test is commonly done before surgery to check for diabetes, which is a high level of sugar in the blood. Diabetes can affect wound healing and increase the risk of infection and complications during and after surgery.

Choice C:

Blood urea nitrogen and creatinine are blood tests that measure the function of the kidneys. These tests are commonly done before surgery to check for kidney disease, which is a low function of the kidneys. Kidney disease can affect the metabolism and elimination of drugs used during and after surgery, and increase the risk of fluid and electrolyte imbalances.

Choice D:

Thyroid stimulating hormone is a blood test that measures the function of the thyroid gland. This test is not commonly done before surgery unless there is a specific indication, such as a history of thyroid disease or symptoms of thyroid dysfunction. Thyroid disease can affect the heart rate, blood pressure, and temperature regulation during and after surgery.

Choice E:

Prothrombin time and international normalized ratio are blood tests that measure the clotting ability of the blood. These tests are commonly done before surgery to check for bleeding disorders, such as hemophilia or liver disease, or to monitor the effect of anticoagulant drugs, such as warfarin or heparin. Bleeding disorders and anticoagulant drugs can increase the risk of bleeding and hematoma formation during and after surgery.

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Question 3:

A nurse is providing preoperative education to a client who is anxious about the surgery. Which of the following statements should the nurse make?

A. "You should avoid asking too many questions to the surgeon, as it may increase your anxiety.” B. "You can bring some personal items, such as music or a book, to help you relax before the surgery.” C. "You will not feel any pain during the surgery, as you will be under general anesthesia.” D. "You should not eat or drink anything after midnight, as it may cause nausea and vomiting during the surgery.”

Answer and Explanation

Choice A:

This is incorrect because the nurse should encourage the client to ask questions to the surgeon, as it may help reduce anxiety and increase understanding of the procedure.

Choice B:

This is correct because the nurse should suggest the client to bring some personal items, such as music or a book, to help them relax before the surgery. This can provide distraction and comfort for the client who is anxious.

Choice C:

This is incorrect because the nurse should not make false reassurances or promises to the client, as it may undermine trust and credibility. The nurse should explain the risks and benefits of general anesthesia and how pain will be managed after the surgery.

Choice D:

This is incorrect because the nurse should not focus on the negative outcomes of eating or drinking before surgery, as it may increase anxiety and fear. The nurse should explain the rationale for fasting before surgery, such as preventing aspiration and reducing nausea and vomiting.

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Question 4:

A nurse is assessing a client's physical status before surgery. Which of the following findings should the nurse report to the surgeon?

A. A heart rate of 72 beats per minute. B. A temperature of 37.2°C (99°F). C. A blood pressure of 160/90 mm Hg. D. A respiratory rate of 16 breaths per minute.

Answer and Explanation

Choice A:

A heart rate of 72 beats per minute is within the normal range of 60 to 100 beats per minute for an adult. Therefore, this finding does not need to be reported to the surgeon.

Choice B:

A temperature of 37.2°C (99°F) is slightly elevated but not considered a fever. A fever is usually defined as a temperature of 38°C (100.4°F) or higher. Therefore, this finding does not need to be reported to the surgeon.

Choice C:

A blood pressure of 160/90 mm Hg is considered high and indicates hypertension. High blood pressure before surgery can increase the risk of complications such as heart attack, stroke, or kidney problems. Therefore, this finding should be reported to the surgeon.

Choice D:

A respiratory rate of 16 breaths per minute is within the normal range of 12 to 20 breaths per minute for an adult. Therefore, this finding does not need to be reported to the surgeon.

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Question 5:

A nurse is planning care for a client who will undergo surgery. Which of the following interventions should the nurse include in the plan?

A. Administer an anticholinergic medication to reduce secretions. B. Apply sequential compression devices to prevent deep vein thrombosis. C. Shave the surgical site with a razor to prevent infection. D. Insert a nasogastric tube to decompress the stomach.

Answer and Explanation

Choice A:

Administering an anticholinergic medication to reduce secretions is not a necessary intervention for a client who will undergo surgery. Anticholinergic medications are used to block the action of acetylcholine, a neurotransmitter that stimulates the production of saliva, mucus, and other secretions. Anticholinergics can be used in certain surgical and emergency procedures to help relax the client, decrease salivation, and prevent nausea and vomiting. However, they are not routinely given to all clients who will undergo surgery, and they have side effects such as dry mouth, blurred vision, constipation, and urinary retention. Therefore, this choice is incorrect.

Choice B:

Applying sequential compression devices to prevent deep vein thrombosis is a correct intervention for a client who will undergo surgery. Sequential compression devices are pneumatic cuffs that inflate and deflate around the legs to improve blood circulation and prevent blood clots from forming in the deep veins of the lower extremities. Deep vein thrombosis (DVT) is a serious complication that can occur after surgery, especially in clients who are immobile, dehydrated, or have a history of clotting disorders. DVT can lead to pulmonary embolism, which is a life-threatening condition where a blood clot travels to the lungs and blocks the blood flow. Therefore, this choice is correct.

Choice C:

Shaving the surgical site with a razor to prevent infection is not a correct intervention for a client who will undergo surgery. Shaving the surgical site with a razor can cause skin irritation, abrasions, and micro-cuts that increase the risk of infection. The current recommendation is to use clippers or depilatory creams to remove hair from the surgical site if necessary. Alternatively, hair can be left intact if it does not interfere with the surgical procedure. Therefore, this choice is incorrect.

Choice D:

Inserting a nasogastric tube to decompress the stomach is not a routine intervention for a client who will undergo surgery. A nasogastric tube is a flexible tube that is inserted through the nose and into the stomach to remove gas, fluid, or stomach contents. Nasogastric tubes can be used in some surgical procedures to prevent nausea, vomiting, aspiration, or abdominal distension. However, they are not indicated for all types of surgery, and they have risks such as nasal bleeding, throat irritation, sinusitis, and esophageal perforation. Therefore, this choice is incorrect.

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Total Questions : 5

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Preoperative Phase

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