Chapter 17 Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition

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Chapter 17  Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

1. A patient is admitted to the ED complaining of severe abdominal pain, stating that he has been vomiting “coffee-ground” like emesis. The patient is diagnosed with a perforated gastric ulcer and is informed that he needs surgery. When can the patient most likely anticipate that the surgery will be scheduled?

  1. A)  Within 24 hours
  2. B)  Within the next week
  3. C)  Without delay because the bleed is emergent
  4. D)  As soon as all the day’s elective surgeries have been completed

Ans: C

Feedback:

Emergency surgeries are unplanned and occur with little time for preparation for the patient or the perioperative team. An active bleed is considered an emergency, and the patient requires immediate attention because the disorder may be life threatening. The surgery would not likely be deferred until after elective surgeries have been completed.

2. The nurse is performing a preoperative assessment on a patient going to surgery. The patient informs the nurse that he drinks approximately two bottles of wine each day and has for the last several years. What postoperative difficulties can the nurse anticipate for this patient?

  1. A)  Alcohol withdrawal syndrome immediately following surgery
  2. B)  Alcohol withdrawal syndrome 2 to 4 days after his last alcohol drink
  3. C)  Alcohol withdrawal syndrome upon administration of general anesthesia
  4. D)  Alcohol withdrawal syndrome 1 week after his last alcohol drink

Ans: B

Feedback:

Alcohol withdrawal syndrome may be anticipated between 48 and 96 hours after alcohol withdrawal and is associated with a significant mortality rate when it occurs postoperatively.

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3. In anticipation of a patient’s scheduled surgery, the nurse is teaching her to perform deep breathing and coughing to use postoperatively. What action should the nurse teach the patient?

  1. A)  The patient should take three deep breaths and cough hard three times, at least every 15 minutes for the immediately postoperative period.
  2. B)  The patient should take three deep breaths and exhale forcefully and then take a quick short breath and cough from deep in the lungs.
  3. C)  The patient should take a deep breath in through the mouth and exhale through the mouth, take a short breath, and cough from deep in the lungs.
  4. D)  The patient should rapidly inhale, hold for 30 seconds or as long as possible, and exhale slowly.

Ans: C

Feedback:

The patient assumes a sitting position to enhance lung expansion. The nurse then demonstrates how to take a deep, slow breath and how to exhale slowly. After practicing deep breathing several times, the patient is instructed to breathe deeply, exhale through the mouth, take a short breath, and cough from deep in the lungs.

4. The nurse is preparing a patient for surgery prior to her hysterectomy without oophorectomy. The nurse is witnessing the patient’s signature on a consent form. Which comment by the patient would best indicate informed consent?

  1. A)  “I know I’ll be fine because the physician said he has done this procedure hundreds of times.”
  2. B)  “I know I’ll have pain after the surgery but they’ll do their best to keep it to a minimum.”
  3. C)  “The physician is going to remove my uterus and told me about the risk of bleeding.”
  4. D)  “Because the physician isn’t taking my ovaries, I’ll still be able to have children.”

Ans: C

Feedback:

The surgeon must inform the patient of the benefits, alternatives, possible risks, complications, disfigurement, disability, and removal of body parts as well as what to expect in the early and late postoperative periods. The nurse clarifies the information provided, and, if the patient requests additional information, the nurse notifies the physician. In the correct response, the patient is able to tell the nurse what will occur during the procedure and the associated risks. This indicates the patient has a sufficient understanding of the procedure to provide informed consent. Clarification of information given may be necessary, but no additional information should be given. The other listed statements do not reflect an understanding of the surgery to be performed.

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5. The nurse is planning patient teaching for a patient who is scheduled for an open hemicolectomy. The nurse intends to address the topics of incision splinting and leg exercises during this teaching session. When is the best time for the nurse to provide teaching?

  1. A)  Upon the patient’s admission to the postanesthesia care unit (PACU)
  2. B)  When the patient returns from the PACU
  3. C)  During the intraoperative period
  4. D)  As soon as possible before the surgical procedure

Ans: D

Feedback:

Teaching is most effective when provided before surgery. Preoperative teaching is initiated as soon as possible, beginning in the physician’s office, clinic, or at the time of preadmission testing when diagnostic tests are performed. Upon admission to the PACU, the patient is usually drowsy, making this an inopportune time for teaching. Upon the patient’s return from the PACU, the patient may remain drowsy. During the intraoperative period, anesthesia alters the patient’s mental status, rendering teaching ineffective.

6. The nurse is caring for a hospice patient who is scheduled for a surgical procedure to reduce the size of his spinal tumor in an effort to relieve his pain. The nurse should plan this patient care with the knowledge that his surgical procedure is classified as which of the following?

  1. A)  Diagnostic
  2. B)  Laparoscopic
  3. C)  Curative
  4. D)  Palliative

Ans: D

Feedback:

A patient on hospice will undergo a surgical procedure only for palliative care to reduce pain, but it is not curative. The reduction of tumor size to relieve pain is considered a palliative procedure. A laparoscopic procedure is a type of surgery that is utilized for diagnostic purposes or for repair. The excision of a tumor is classified as curative. This patient is not having the tumor removed, only the size reduced.

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