Test Bank Chapter 4 Nursing Care Of Patients Having Surgery - Medical Surgical Nursing 7e | Test Bank by LeMone, Burke, Bauldoff by LeMone, Burke, Gerene Bauldoff. DOCX document preview.
LeMone & Burke's Medical-Surgical Nursing, 7e (Bauldoff/Gubrud/Carno)
Chapter 4 Nursing Care of Patients Having Surgery
1) A patient believes that scheduled surgery is minor since it will be done as an outpatient. How should the nurse respond to this patient?
1. "Every surgical procedure is serious, and I will make sure you have information to have a successful recovery."
2. "You are right."
3. "If it were more serious, you would be admitted to the hospital."
4. "Your insurance plan does not cover inpatient surgical procedures. That's why your surgery is being done as an outpatient."
Page Ref: 74
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively; listen openly and cooperatively | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 4.1 Compare various methods of and settings for surgical procedures, types of anesthesia, and perioperative patient safety.
MNL Learning Outcome: 1. Recognize settings, types of anesthesia, and safety for patients undergoing surgery.
2) A patient scheduled for outpatient surgery asks why admission to the hospital is not required. What should the nurse explain as an advantage of having outpatient surgery?
1. Reduced risk of healthcare-associated infections.
2. Ability to use home care for postoperative care in the home.
3. Reduced use of postoperative medications.
4. Inadequate staffing on the surgical care areas.
Page Ref: 75
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively; listen openly and cooperatively | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 4.1 Compare various methods of and settings for surgical procedures, types of anesthesia, and perioperative patient safety.
MNL Learning Outcome: 1. Recognize settings, types of anesthesia, and safety for patients undergoing surgery.
3) The nurse is preparing to discharge a patient after having outpatient surgery. Which criteria should the nurse use to determine whether the patient is eligible to be discharged? Select all that apply.
1. Stable vital signs
2. No nausea or dizziness
3. Pain controlled
4. Adequate urine output
5. Patient's expressed readiness to go home
Page Ref: 92
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.10. Facilitate patient-centered transitions of care, including discharge planning and ensuring the caregiver's knowledge of care requirements to promote safe care | NLN Competencies: Context and Environment; Practice-Know-How; Read and interpret data; apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 4.5 Describe postoperative nursing care including postanesthesia care, extended care, and transfers.
MNL Learning Outcome: 4. Apply the nursing process to the care of the patient during the postoperative and postsurgical stages.
4) The nurse in the same-day surgical care area is preparing a patient for surgery. What should the nurse do to ensure that this patient has a successful recovery from the surgery?
1. Provide teaching and additional resources to help the patient when at home.
2. Measure intake and output.
3. Assess vital signs.
4. Limit pain control measures since the patient will need to ambulate when leaving after the surgery.
Page Ref: 92
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Learn continuously, learn cooperatively | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 4.5 Describe postoperative nursing care including postanesthesia care, extended care, and transfers.
MNL Learning Outcome: 4. Apply the nursing process to the care of the patient during the postoperative and postsurgical stages.
5) A patient recovering from surgery, experiences a deep vein thrombosis (DVT). Which preoperative exercise should the nurse identify as being ineffective for this patient?
1. Leg exercises
2. Deep breathing and coughing
3. Use of incentive spirometry
4. Splinting when coughing
Page Ref: 81
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Evaluation/Teaching/Learning
Learning Outcome: 4.3 Describe the preanesthesia phase, preadmission testing, and procedures for the day of surgery.
MNL Learning Outcome: 2. Apply the nursing process to the care of the patient during the preoperative stage.
6) The nurse is assessing a patient who has returned to the care area after surgery. What should the nurse do to ensure the patient receives appropriate care?
1. Check the physician's orders to see if preoperative orders have been reordered.
2. Schedule the patient for vital signs assessments every four hours.
3. Orient the patient to person, place, and time.
4. Assess the patient's mental status.
Page Ref: 95
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 4.5 Describe postoperative nursing care including postanesthesia care, extended care, and transfers.
MNL Learning Outcome: 4. Apply the nursing process to the care of the patient during the postoperative and postsurgical stages.
7) After providing a preoperative sedative, the nurse notes that the surgical consent form has not been signed by the patient. What should the nurse do?
1. Contact the surgeon.
2. Ask the patient to sign the consent form.
3. Send the patient for surgery with an unsigned consent form.
4. Phone the operating room suite to notify the nurse that the patient has not signed the consent form.
Page Ref: 74
Cognitive Level: Applying
Client Need & Sub: Safe and Effective Care Environment: Management of Care
Standards: QSEN Competencies: I.B.10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management | AACN Essentials Competencies: II.7. Promote factors that create a culture of safety and caring | NLN Competencies: Quality & Safety; Practice-Know-How; Communicate effectively with different individuals (team members, other care providers, patients, families, etc.) so as to minimize risks associated with handoffs among providers and across transitions in care | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 4.1 Compare various methods of and settings for surgical procedures, types of anesthesia, and perioperative patient safety.
MNL Learning Outcome: 1. Recognize settings, types of anesthesia, and safety for patients undergoing surgery.
8) A patient being prepared for surgery has been diagnosed with dehydration. Which laboratory values support the diagnosis for this patient?
1. Hemoglobin and hematocrit
2. Glucose
3. White blood cell count
4. Platelet count
Page Ref: 82
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Practice-Know-How; Read and interpret data | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 4.3 Describe the preanesthesia phase, preadmission testing, and procedures for the day of surgery.
MNL Learning Outcome: 2. Apply the nursing process to the care of the patient during the preoperative stage.
9) A patient diagnosed with emphysema is being prepared for surgery. What laboratory value should the nurse review to obtain information about the patient's respiratory status?
1. Carbon dioxide
2. White blood cell count
3. Serum creatinine
4. Blood urea nitrogen
Page Ref: 82
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Practice-Know-How; Read and interpret data | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 4.3 Describe the preanesthesia phase, preadmission testing, and procedures for the day of surgery.
MNL Learning Outcome: 2. Apply the nursing process to the care of the patient during the preoperative stage.
10) An older adult patient being prepared for surgery is scheduled for an electrocardiogram. What should the nurse explain to the patient regarding the purpose of this test?
1. It is routine for all patients having general anesthesia.
2. It is used to diagnose preexisting cardiac disease.
3. It is one way to validate laboratory values
4. It is a predictor of surgical procedure success.
Page Ref: 82
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Practice-Know-How; Read and interpret data | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 4.3 Describe the preanesthesia phase, preadmission testing, and procedures for the day of surgery.
MNL Learning Outcome: 2. Apply the nursing process to the care of the patient during the preoperative stage.
11) An older patient, being prepared for surgery, has a low glomerular filtration rate. Which aspect of the patient's care should the nurse realize this finding will impact?
1. Medication dosages
2. Postoperative activity level
3. Intraoperative bleeding
4. Oxygenation status
Page Ref: 82
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.19. Manage the interaction of multiple functional problems affecting patients across the lifespan, including common geriatric syndromes | NLN Competencies: Context and Environment; Practice-Know-How; Read and interpret data | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 4.3 Describe the preanesthesia phase, preadmission testing, and procedures for the day of surgery.
MNL Learning Outcome: 2. Apply the nursing process to the care of the patient during the preoperative stage.
12) A patient is scheduled for total hip replacement surgery. What medication should the nurse provide to the patient prior to the surgical procedure?
1. Antibiotic
2. Antacid
3. Antiemetic
4. Anticholinergic
Page Ref: 84
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Quality & Safety; Knowledge; Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 4.3 Describe the preanesthesia phase, preadmission testing, and procedures for the day of surgery.
MNL Learning Outcome: 2. Apply the nursing process to the care of the patient during the preoperative stage.
13) A patient received lorazepam (Ativan) as preoperative medication. What should the nurse assess when caring for this patient?
1. Respiratory depression
2. Nausea and vomiting
3. Confusion
4. Rash
Page Ref: 84
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Quality & Safety; Knowledge; Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 4.3 Describe the preanesthesia phase, preadmission testing, and procedures for the day of surgery.
MNL Learning Outcome: 2. Apply the nursing process to the care of the patient during the preoperative stage.
14) A patient with a history of sleep apnea is experiencing difficulty maintaining an airway during conscious sedation. What should the nurse do to assist this patient?
1. Prepare to administer a reversal agent.
2. Begin artificial ventilations.
3. Measure oxygen saturation.
4. Apply prescribed oxygen via face mask.
Page Ref: 74
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Quality & Safety; Knowledge; Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 4.1 Compare various methods of and settings for surgical procedures, types of anesthesia, and perioperative patient safety.
MNL Learning Outcome: 1. Recognize settings, types of anesthesia, and safety for patients undergoing surgery.
15) The nurse is caring for a patient recovering from surgery conducted in the previous 24 hours. What should the nurse do to assist this patient with pain control?
1. Administer prescribed analgesics around the clock.
2. Administer prescribed analgesics when the patient requests something for pain.
3. Assist the patient to a more comfortable position to reduce the amount of pain.
4. Offer the patient a back rub to reduce the amount of pain.
Page Ref: 93
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Quality & Safety; Knowledge; Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 4.5 Describe postoperative nursing care including postanesthesia care, extended care, and transfers.
MNL Learning Outcome: 4. Apply the nursing process to the care of the patient during the postoperative and postsurgical stages.
16) An older patient is recovering from a surgical procedure. What should the nurse do to ensure the patient is comfortable?
1. Provide warm blankets.
2. Limit movement to once every eight hours.
3. Explain all activities using a loud voice.
4. Limit fluids.
Page Ref: 79
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Basic Care and Comfort
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Quality & Safety; Knowledge; Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 4.2 Differentiate patient risks that can be mitigated in the preoperative stage.
MNL Learning Outcome: 4. Apply the nursing process to the care of the patient during the postoperative and postsurgical stages.
17) An older patient, recovering from surgery, is prescribed a soft diet. Which age-related change does this type of diet support?
1. Decline in gastric motility
2. Reduced intestinal absorption
3. Lactose intolerance
4. Gall bladder insufficiency
Page Ref: 100
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Quality & Safety; Knowledge; Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 4.7 Differentiate considerations for perioperative care of older adults and transgender adults.
MNL Learning Outcome: 4. Apply the nursing process to the care of the patient during the postoperative and postsurgical stages.
18) The nurse is planning care to support the cognitive-psychosocial status for an older patient having surgery. Which intervention would be appropriate for this patient?
1. Provide time for teaching and learning.
2. Set limits with the patient.
3. Tell the patient that his physician will make all care decisions.
4. Remind the patient that the call bell is for emergencies only.
Page Ref: 100
Cognitive Level: Applying
Client Need & Sub: Psychosocial Integrity: Sensory/Perceptual Alterations
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively; listen openly and cooperatively | Nursing/Integrated Concepts: Nursing Process: Planning/Teaching/Learning
Learning Outcome: 4.7 Differentiate considerations for perioperative care of older adults and transgender adults.
MNL Learning Outcome: 1. Recognize settings, types of anesthesia, and safety for patients undergoing surgery.
19) A patient recovering from surgery reports a pain level of 6 on a 0-10 pain scale but refuses additional pain medication to avoid becoming addicted. On which concept should the nurse focus when responding to this patient?
1. Physical dependence on pain medication is uncommon during the short-term postoperative use.
2. This patient already might have an addiction problem.
3. This patient might benefit from a placebo dose.
4. The physician should be notified to discuss pain management.
Page Ref: 93
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.3. Demonstrate comprehensive understanding of the concepts of pain and suffering, including physiologic models of pain and comfort | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health; family dynamics | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 4.5 Describe postoperative nursing care including postanesthesia care, extended care, and transfers.
MNL Learning Outcome: 4. Apply the nursing process to the care of the patient during the postoperative and postsurgical stages.
20) An older patient is receiving an NSAID for postoperative pain. What should the nurse assess in this patient?
1. Urine output
2. Blood pressure
3. Respiratory rate
4. Heart rate
Page Ref: 92
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.3. Demonstrate comprehensive understanding of the concepts of pain and suffering, including physiologic models of pain and comfort | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health; family dynamics | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 4.5 Describe postoperative nursing care including postanesthesia care, extended care, and transfers.
MNL Learning Outcome: 4. Apply the nursing process to the care of the patient during the postoperative and postsurgical stages.
21) A patient is having an epidural catheter inserted for pain control after surgery. What should the nurse realize is an advantage of using this method of pain medication for this patient?
1. Improved bowel activity
2. Faster wound healing
3. Earlier ambulation
4. Improved appetite
Page Ref: 73
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.3. Demonstrate comprehensive understanding of the concepts of pain and suffering, including physiologic models of pain and comfort | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health; family dynamics | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 4.1 Compare various methods of and settings for surgical procedures, types of anesthesia, and perioperative patient safety.
MNL Learning Outcome: 1. Recognize settings, types of anesthesia, and safety for patients undergoing surgery.
22) A patient being discharged is concerned about being overmedicated because of receiving a prescription for Demerol 50 mg by mouth when 10 mg of morphine was given through the intravenous catheter in the hospital. How should the nurse respond to this patient?
1. "Oral doses need to be higher than those given through an IV."
2. "The doctor is making sure that you do not have any pain once you go home."
3. "I will get the doctor so he can explain what is going on with your condition."
4. "All patients have more pain when they go home so the doctor is making sure you have enough medication."
Page Ref: 93
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.3. Demonstrate comprehensive understanding of the concepts of pain and suffering, including physiologic models of pain and comfort | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health; family dynamics | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 4.5 Describe postoperative nursing care including postanesthesia care, extended care, and transfers.
MNL Learning Outcome: 4. Apply the nursing process to the care of the patient during the postoperative and postsurgical stages.
23) A patient is being transferred from the operating room to the recovery room. In which phase of the surgical process will the nurse in the recovery room provide care?
1. Postoperative
2. Preoperative
3. Intraoperative
4. Restorative
Page Ref: 91
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Practice-Know-How; apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 4.5 Describe postoperative nursing care including postanesthesia care, extended care, and transfers.
MNL Learning Outcome: 4. Apply the nursing process to the care of the patient during the postoperative and postsurgical stages.
24) An older patient is being prepared for orthopedic surgery. For what potential risk should the nurse plan care?
1. Decreased tolerance of general anesthesia
2. Prolonged effects of anesthesia because of herbal supplements
3. Wound dehiscence
4. Decreased cognitive acuity
Page Ref: 99
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health; family dynamics | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 4.7 Differentiate considerations for perioperative care of older adults and transgender adults.
MNL Learning Outcome: 1. Recognize settings, types of anesthesia, and safety for patients undergoing surgery.
25) An older patient having preoperative diagnostic testing has an elevated carbon dioxide level. What should the nurse be monitoring for this patient?
1. Respiratory status and arterial blood gases
2. Serum potassium level
3. Serum sodium level
4. Intake and output
Page Ref: 82
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 4.3 Describe the preanesthesia phase, preadmission testing, and procedures for the day of surgery.
MNL Learning Outcome: 2. Apply the nursing process to the care of the patient during the preoperative stage.
26) An older patient recovering from surgery is given an antiemetic for nausea. Which manifestation indicates to the nurse that this patient is experiencing a possible reaction to the medication?
1. Involuntary muscle movements
2. Confusion
3. Dry mouth
4. Breakthrough vomiting
Page Ref: 84
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 4.3 Describe the preanesthesia phase, preadmission testing, and procedures for the day of surgery.
MNL Learning Outcome: 4. Apply the nursing process to the care of the patient during the postoperative and postsurgical stages.
27) The nurse is assisting a postoperative patient in using an incentive spirometer. Which postoperative complication is this nurse attempting to avoid?
1. Atelectasis
2. Deep vein thrombosis
3. Hemorrhage
4. Pulmonary embolism
Page Ref: 99
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: V.C.3.Value own role in preventing errors | AACN Essentials Competencies: II.7. Promote factors that create a culture of safety and caring | NLN Competencies: Quality & Safety; Practice-Know-How; Communicate effectively with different individuals (team members, other care providers, patients, families, etc.) so as to minimize risks associated with handoffs among providers and across transitions in care | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 4.6 Summarize postsurgical risks to patients including wound healing, cardiac events, respiratory events, and elimination issues.
MNL Learning Outcome: 4. Apply the nursing process to the care of the patient during the postoperative and postsurgical stages.
28) A patient's postoperative wound has sanguineous drainage with a thick, reddish appearance. In which phase of healing is this patient's wound?
1. Inflammatory
2. Proliferative
3. Stationary
4. Remodeling
Page Ref: 95
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Teamwork; Practice-Know-How; Function competently within one's own scope of practice as leader or member of the healthcare team | Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 4.6 Summarize postsurgical risks to patients including wound healing, cardiac events, respiratory events, and elimination issues.
MNL Learning Outcome: 4. Apply the nursing process to the care of the patient during the postoperative and postsurgical stages.
29) During the assessment of a postoperative patient's bowel sounds, the nurse auscultates absent sounds over all four abdominal quadrants. For which reason should the nurse identify interventions for this patient?
1. Paralytic ileus
2. Normal bowel function
3. The onset of flatus
4. The onset of stool
Page Ref: 99
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Practice-Know-How; Read and interpret data; apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 4.6 Summarize postsurgical risks to patients including wound healing, cardiac events, respiratory events, and elimination issues.
MNL Learning Outcome: 4. Apply the nursing process to the care of the patient during the postoperative and postsurgical stages.
30) A patient is scheduled for extraction of a cataract. How should the nurse classify this patient's surgical procedure?
1. Minor elective
2. Minor diagnostic
3. Major constructive
4. Major elective
Page Ref: 72
Cognitive Level: Applying
Client Need & Sub: Safe and Effective Care Environment: Management of Care
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Practice-Know-How; Read and interpret data; apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 4.1 Compare various methods of and settings for surgical procedures, types of anesthesia, and perioperative patient safety.
MNL Learning Outcome: 1. Recognize settings, types of anesthesia, and safety for patients undergoing surgery.
31) A patient who is being admitted for surgery asks why information is being collected about the use of herbal and natural supplements. How should the nurse respond to this patient?
1. "Herbal supplements may interact with anesthetic agents."
2. "Herbal remedies may cause pain relievers to be ineffective."
3. "The physician is in charge of medications."
4. "There is no need to take these preparations."
Page Ref: 76
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.17. Develop a beginning understanding of complementary and alternative modalities and their role in healthcare | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 4.2 Differentiate patient risks that can be mitigated in the preoperative stage.
MNL Learning Outcome: 2. Apply the nursing process to the care of the patient during the preoperative stage.
32) After complaining of discomfort from a surgical procedure, the patient voices fear of addiction with taking analgesics as prescribed. What information should be provided to the patient regarding these concerns? Select all that apply.
1. "Addiction to opioid analgesics is rare when used for short-term postoperative pain management."
2. "Psychological tolerance is not commonly experienced by patients who take narcotic analgesics during the postoperative experience."
3. "Pain tolerance and the need for opioid analgesics are individualized."
4. "Patients should be screened for addiction potential prior to being given narcotics."
5. "I'll turn the TV on to help distract you from your pain."
Page Ref: 93
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health; family dynamics | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 4.5 Describe postoperative nursing care including postanesthesia care, extended care, and transfers.
MNL Learning Outcome: 4. Apply the nursing process to the care of the patient during the postoperative and postsurgical stages.
33) An older patient who is preparing for surgery wants to wear glasses and keep a hearing aid in place until receiving anesthesia. Which nursing response demonstrates accurate therapeutic communication?
1. "I will contact the surgery department to discuss your requests."
2. "You cannot keep those in."
3. "The policies in the surgery unit will not allow it."
4. "Certainly, you can keep them for that time."
Page Ref: 100
Cognitive Level: Analyzing
Client Need & Sub: Psychosocial Integrity: Therapeutic Communication
Standards: QSEN Competencies: I.A.9. Discuss principles of effective communication | AACN Essentials Competencies: II.2. Demonstrate leadership and communication skills to effectively implement patient safety and quality improvement initiatives within the context of the interprofessional team | NLN Competencies: Quality & Safety; Practice-Know-How; Communicate effectively with different individuals (team members, other care providers, patients, families, etc.) so as to minimize risks associated with handoffs among providers and across transitions in care | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 4.7 Differentiate considerations for perioperative care of older adults and transgender adults.
MNL Learning Outcome: 2. Apply the nursing process to the care of the patient during the preoperative stage.
34) A patient having a hernia repair as an outpatient asks why hospitalization afterward is not required. Which response is appropriate for the nurse to make? Select all that apply.
1. "You have less risk of getting an infection at home."
2. "You will probably be more comfortable in your own bed at home."
3. "It is cheaper for the insurance company if you go home today."
4. "The government won't let you stay."
5. "If you ask the healthcare provider, the hospital will probably let you stay."
Page Ref: 75
Cognitive Level: Applying
Client Need & Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Practice-Know-How; apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 4.1 Compare various methods of and settings for surgical procedures, types of anesthesia, and perioperative patient safety.
MNL Learning Outcome: 1. Recognize settings, types of anesthesia, and safety for patients undergoing surgery.
35) The nurse is reviewing the patient's current medications as a part of preparation for an elective surgery. What information should the nurse reinforce with the patient?
1. "Continue to take your regular prescribed dose of warfarin (Coumadin) until told otherwise."
2. "You may take your regular herbal supplements up until the day before surgery."
3. "Discontinue your antihypertensive medications two days prior to surgery."
4. "Stop taking your daily aspirin at least three days prior to surgery."
Page Ref: 78
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge: transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 4.2 Differentiate patient risks that can be mitigated in the preoperative stage.
MNL Learning Outcome: 2. Apply the nursing process to the care of the patient during the preoperative stage.
36) The nurse suspects that a patient recovering from surgery in the postanesthesia recovery unit (PACU) is developing malignant hyperthermia. Place these interventions in the order in which they should be performed.
Choice 1. Administer oxygen with a nonrebreather mask.
Choice 2. Check IV access.
Choice 3. Notify the anesthesia provider.
Choice 4. Administer Dantrolene.
Page Ref: 73
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge: transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 4.1 Compare various methods of and settings for surgical procedures, types of anesthesia, and perioperative patient safety.
MNL Learning Outcome: 1. Recognize settings, types of anesthesia, and safety for patients undergoing surgery.
37) The nurse is preparing to teach a patient scheduled for surgery on performing diaphragmatic breathing. Place the steps of this breathing technique in the order in which the nurse should teach the patient.
Choice 1. Sit up straight in bed.
Choice 2. Place hands lightly on the abdomen.
Choice 3. Breathe in deeply through the nose.
Choice 4. Hold breath for five seconds.
Choice 5. Completely exhale through pursed lips.
Page Ref: 80
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health; family dynamics | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 4.3 Describe the preanesthesia phase, preadmission testing, and procedures for the day of surgery.
MNL Learning Outcome: 2. Apply the nursing process to the care of the patient during the preoperative stage.
38) A patient is having a surgical procedure with conscious sedation. Which patient information should be provided to the healthcare provider before administering the anesthesia to the patient? Select all that apply.
1. The patient has a history of snoring.
2. The patient drank a cup of coffee two hours ago.
3. The patient wants to be asleep for the procedure.
4. The patient's father was hypertensive.
5. The patient has a history of gout.
Page Ref: 74
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health; family dynamics | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 4.1 Compare various methods of and settings for surgical procedures, types of anesthesia, and perioperative patient safety.
MNL Learning Outcome: 1. Recognize settings, types of anesthesia, and safety for patients undergoing surgery.
39) A patient being prepared for surgery has a history of chronic obstructive pulmonary disease. Which diagnostic test may be completed prior to this patient's surgical procedure?
1. Pulmonary function tests
2. CT scan of the brain
3. Lumbar puncture
4. Abdominal MRI
Page Ref: 82
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 4.3 Describe the preanesthesia phase, preadmission testing, and procedures for the day of surgery.
MNL Learning Outcome: 2. Apply the nursing process to the care of the patient during the preoperative stage.
40) An older patient recovering from total hip replacement surgery 8 hours ago has not been able to void spontaneously. Which actions should the nurse take to assist this patient? Select all that apply.
1. Increase fluids.
2. Turn onto the left side.
3. Palpate the bladder for distention.
4. Insert an indwelling urinary catheter.
5. Complete a bladder scan at the bedside.
Page Ref: 99
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health; family dynamics | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 4.6 Summarize postsurgical risks to patients including wound healing, cardiac events, respiratory events, and elimination issues.
MNL Learning Outcome: 4. Apply the nursing process to the care of the patient during the postoperative and postsurgical stages.
41) The intraoperative nurse is caring for a patient in the maintenance phase of anesthesia. Which actions should the nurse prepare to provide to the patient at this time? Select all that apply.
1. Prepare the skin.
2. Assess oxygen saturation level.
3. Participate in the surgical procedure.
4. Position the patient for the surgical procedure.
5. Measure blood pressure and heart rate.
Page Ref: 88
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health; family dynamics | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 4.4 Outline aseptic practices, safety, and patient care during surgery.
MNL Learning Outcome: 3. Apply the nursing process to the care of the patient during the intraoperative stage.
42) A patient who has reacted poorly to general anesthesia in the past is scheduled for surgery to repair a rotator cuff tear. For which types of anesthesia should the nurse prepare educational materials for this patient? Select all that apply.
1. Spinal
2. Topical
3. Epidural
4. Nerve block
5. Local nerve infiltration
Page Ref: 73
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively; listen openly and cooperatively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 4.1 Compare various methods of and settings for surgical procedures, types of anesthesia, and perioperative patient safety.
MNL Learning Outcome: 1. Recognize settings, types of anesthesia, and safety for patients undergoing surgery.
43) The nurse determines that a patient recovering from spinal anesthesia is experiencing complications from the anesthesia. Which should the nurse expect to be provided to this patient? Select all that apply.
1. Caffeine
2. Analgesics
3. Intravenous fluids
4. Epidural blood patch
5. Vasoactive medication
Page Ref: 73
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Practice-Know-How; Communicate information effectively; listen openly and cooperatively | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 4.1 Compare various methods of and settings for surgical procedures, types of anesthesia, and perioperative patient safety.
MNL Learning Outcome: 1. Recognize settings, types of anesthesia, and safety for patients undergoing surgery.
44) While the nurse is assisting a patient recovering from epidural anesthesia to ambulate, the patient becomes dizzy and has a blood pressure of 78/48 mmHg. What actions should the nurse take? Select all that apply.
1. Notify the anesthesiologist.
2. Notify the pharmacy to obtain atropine.
3. Continuously monitor blood pressure.
4. Prepare to administer intravenous fluids.
5. Prepare to administer vasoactive medications.
Page Ref: 73
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health; family dynamics | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 4.1 Compare various methods of and settings for surgical procedures, types of anesthesia, and perioperative patient safety.
MNL Learning Outcome: 1. Recognize settings, types of anesthesia, and safety for patients undergoing surgery.
45) The nurse is preparing to assist during a surgical procedure. For which reason should the surgical scrub be completed? Select all that apply.
1. Sterilize the skin.
2. Apply an antimicrobial residue on the skin.
3. Prevent the need to wear surgical gloves during the procedure.
4. Remove dirt, skin oils, and transient microorganisms from the skin.
5. Improve patient safety by removing the number of organisms on personnel.
Page Ref: 87
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health; family dynamics | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 4.4 Outline aseptic practices, safety, and patient care during surgery.
MNL Learning Outcome: 3. Apply the nursing process to the care of the patient during the intraoperative stage.
Document Information
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Medical Surgical Nursing 7e | Test Bank by LeMone, Burke, Bauldoff
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