Chapter 27 Perioperative Care

Chapter 27  Perioperative Care

Complete Chapter Questions And Answers
 

Sample Questions

1.
A client who is postoperative from day 1 following abdominal surgery experiences excruciating pain when he tries to perform the deep breathing and coughing exercises he was taught. What should the nurse do to reduce the client’s discomfort when coughing?
A)
Administer prescribed pain medication just before coughing.
B)
Ask the client to drink plenty of water before coughing.
C)
Ask the client to lie in a lateral position when coughing.
D)
Administer analgesia 30 minutes before attempting to cough.
Ans:
D

Feedback:

Coughing is painful for clients with abdominal or chest incisions. Administering pain medication approximately 30 minutes before coughing, or splinting the incision when coughing, can reduce discomfort. Making the client lie in a lateral position or asking the client to drink plenty of water is not helpful because it will make breathing and coughing even more difficult for the client.

2.
A nurse is completing the preoperative checklist of a client who will soon have a cholecystectomy (gallbladder removal). Which of the following observations listed in the preoperative checklist should the nurse verify?
A)
If the client’s allergies have been identified and documented
B)
If the client has explored alternative treatment options
C)
If the client has received his or her prescription for postdischarge medications
D)
If the client’s next of kin has been notified
Ans:
A

Feedback:

In a preoperative checklist, the nurse verifies the client’s allergy status. Alternative treatments are not addressed in the preoperative checklist and the prescription is normally provided in the postsurgical setting. A preoperative checklist does not require that a client’s next of kin be notified preoperatively.

3.
A nurse has begun to administer conscious sedation to a client who will undergo a bronchoscopy. Which of the following is an expected outcome after administering conscious sedation to a client?
A)
Client can respond verbally despite being unable to move.
B)
Client can tolerate invasive surgical procedures.
C)
Client is relaxed, emotionally comfortable, and conscious.
D)
Client’s consciousness level can be monitored by equipment.
Ans:
C

Feedback:

Conscious sedation refers to a state in which the client is sedated in a state of relaxation and emotional comfort, but is not unconscious. The client is free of pain, fear, and anxiety and can tolerate unpleasant diagnostic and short therapeutic surgical procedures, such as an endoscopy or bone marrow aspiration. The client can respond verbally and physically. However, no equipment can replace a nurse’s careful observations for monitoring clients.

4.
A nurse is caring for a client who has had antiembolism stockings applied to avoid thrombus formation. Which of the following measures can prevent thrombi?
A)
Drink plenty of fluids unless contraindicated.
B)
Keep legs crossed at knees whenever possible.
C)
Sit for 2 to 3 hours at a time.
D)
Avoid ambulating unless absolutely necessary.
Ans:
A

Feedback:

Drinking plenty of fluids can help to prevent thrombi because it promotes circulation by increasing the fluid component of blood. Avoiding long periods of sitting, avoiding keeping the legs crossed, especially at the knees, and ambulating are also methods to prevent thrombi.

5.
A nurse is taking care of a client during the immediate postoperative period. Which of the following actions performed during the immediate postoperative period is most important?
A)
Initiate rehabilitation measures.
B)
Monitor the client for complications.
C)
Prepare a room for the client.
D)
Assess the client’s readiness to learn.
Ans:
B

Feedback:

The immediate postoperative period refers to the first 24 hours after surgery. During this time, the nurse monitors the client for complications as he or she recovers from anesthesia. Once the client is stable, the nurse prepares a room for the client’s return and assesses the client to prevent or minimize potential complications. Rehabilitation and client education are important but are lesser priorities at this early stage of recovery.