Chapter 17 Medical Surgical Nursing Preparation For Practice 2nd Edition

Chapter 17  Medical Surgical Nursing Preparation For Practice 2nd Edition

Complete Chapter Questions And Answers
 

Sample Questions

Question 1
Type: MCSA
During preoperative assessment, the patient says, “My surgery must be minor because it’s being done on an outpatient basis.” How should the nurse respond?
1. “Every surgical procedure is serious, and I will make sure you have the information you need for 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 on an outpatient basis.”
Correct Answer: 1
Rationale 1: The outpatient surgical patient must cope with the additional stress of needing to learn a great deal of information in a short span of time. The nurse should explain that every surgical procedure is serious and that the patient will be given information to have a successful recovery.
Rationale 2: The nurse should not agree with the patient that the surgery is minor just because it is scheduled as an outpatient procedure.
Rationale 3: Patients are admitted to the hospital for monitoring and nursing care. The “seriousness” of the surgery is not the determining factor.
Rationale 4: Outpatient surgery is less expensive and is preferred by insurance companies if patient safety can be assured. However, most plans allow for admission to the hospital after surgery if the patient’s condition warrants admission.
Global Rationale:

Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 17-1

Question 2
Type: MCSA
Prior to surgery, the nurse instructed the patient on exercises that should be done prior to and after surgery. The patient is currently recovering from surgery and is experiencing a deep vein thrombosis. Which preoperative exercise instruction was not adequate for this patient?
1. Leg exercises
2. Deep breathing and coughing
3. Use of incentive spirometry
4. Splinting when coughing
Correct Answer: 1
Rationale 1: Leg exercises reduce the risk of the complication deep vein thrombosis.
Rationale 2: Deep breathing and coughing are helpful to prevent complications of pneumonia and atelectasis.
Rationale 3: Incentive spirometry is helpful to prevent complications of pneumonia and atelectasis.
Rationale 4: Splinting when coughing is taught so that thoracic and abdominal incisions are protected from the increase in intra-abdominal pressure that occurs with coughing.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 17-5

Question 3
Type: MCSA
After administering a preoperative sedative, the nurse notes that the surgical consent form has not been signed by the patient. What is the nurse’s priority intervention?
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.
Correct Answer: 1
Rationale 1: The patient should be aware and alert before signing the consent form. The nurse should contact the surgeon in the event the patient receives preoperative sedative medication and has not yet signed the consent for surgery form.
Rationale 2: The nurse should not ask the patient to sign the consent form while under the influence of a sedative.
Rationale 3: The nurse should not send the patient for surgery with an unsigned consent form.
Rationale 4: While this intervention may be performed, it is not the priority.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 17-3

Question 4
Type: MCSA
A chart review reveals that a patient being prepared for surgery has been diagnosed with dehydration. Which laboratory results would the nurse review to evaluate the effect of treatment of this condition?
1. Hemoglobin and hematocrit
2. Glucose
3. White blood cell count
4. Platelet count
Correct Answer: 1
Rationale 1: An increase in hemoglobin and hematocrit levels would indicate dehydration. As treatment progresses, the H&H should normalize.
Rationale 2: Glucose does not reflect hydration status.
Rationale 3: An alteration in white blood cell count could indicate an infection or immune deficiencies.
Rationale 4: An alteration in platelet count could indicate a malignancy or clotting deficiency disorder.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 17-2