Chapter 33 Care of the Surgical Patient

Chapter 33  Care of the Surgical Patient

Complete Chapter Questions And Answers
 

Sample Questions

Multiple Choice
Identify the choice that best completes the statement or answers the question.

____ 1. The nurse who is caring for patients on a surgical unit recognizes that which of the following individuals is having corrective surgery?
A.
A 39-year-old scheduled for breast reduction.
B.
A 14-year-old scheduled for tumor debulking.
C.
A 4-month-old scheduled for cleft lip repair.
D.
A 55-year-old scheduled for an exploratory laparotomy.

____ 2. Which of the following is most commonly taught to help prevent post-surgical respiratory complications?
A.
Turning, coughing, and deep breathing.
B.
Splinting incisions.
C.
The use of post-surgical compression stockings.
D.
How to measure intake and output.

____ 3. The nurse who is caring for a patient after a total hip replacement recognizes that further teaching is required if he or she observes that
A.
The patient alternately flexes and extends his or her toes.
B.
The patient circles his or her ankles clockwise and counterclockwise.
C.
The patient bends the knees slightly and helps himself or herself up in bed while using the trapeze.
D.
The patient turns on one side, lifts each leg with his or her toes pointed, and then returns to midline.

____ 4. While determining the appropriate size of thigh-high antithrombolic stockings to order, the nurse would obtain which of the following measurements?
A.
Length from gluteal fold to the bottom of the heel.
B.
Length from mid-thigh to the tip of the toe.
C.
Circumference of the knee.
D.
Amount of edema noted in the ankles.

____ 5. The nurse is providing care for a patient who is wearing antiembolic stockings. The patient’s plan of care should include
A.
Turning the stockings off 4 hours each day.
B.
Removing the stockings at bedtime and replacing them in the morning.
C.
Rolling the stockings down 2 inches to create a band at the top.
D.
Removing the stockings twice daily to wash and dry the legs.

Chapter 33. Care of the Surgical Patient
Answer Section

MULTIPLE CHOICE

1. ANS: C

Feedback
A
Cosmetic surgery may be performed to change or improve one’s physical appearance.
B
Palliative surgery alleviates symptoms and provides comfort, but it does not necessarily cure the disease or heal the injury.
C
Corrective surgery is done to repair an anatomic or congenital defect, such as repairing a cleft palate so that a child can nurse or eat normally. Chapter Objective: Differentiate between types of surgery by purpose, degree of urgency, and degree of risk.
D
Exploratory surgery is done to provide further data and determine a diagnosis for a problem.

PTS: 1 REF: Chapter: 33 | Page: 770 OBJ: Chapter Objective: 33-2
KEY: Content Area: Potential for Complications of Diagnostic Tests/Treatments/Procedures/Surgery or Health Alterations | Integrated Process: Nursing Process/Evaluation | Client Need: Reduction of Risk Potential | Cognitive Level: Analysis

2. ANS: A

Feedback
A
The most common thing that the nurse will teach to help prevent these respiratory complications is how to effectively turn, cough, and deep breathe. Chapter Objective: Specify the important components of preoperative patient teaching.
B
This will aid in pain control and mobility, and it will support coughing and deep breathing.
C
This is used to prevent the formation of deep vein thrombosis.
D
This is used to monitor kidney function and fluid status.

PTS: 1 REF: Chapter: 33 | Page: 776 OBJ: Chapter Objective: 33-6
KEY: Content Area: Potential for Complications of Diagnostic Tests/Treatments/Procedures/Surgery or Health Alterations | Integrated Process: Teaching/Learning | Client Need: Reduction of Risk Potential | Cognitive Level: Application

3. ANS: D

Feedback
A
These actions are ankle pumps, which involve alternating ankle flexion and extension for a total of 10 times each.
B
These actions are ankle circles with toes extended, 10 times in each direction, both clockwise and counterclockwise
C
This is an appropriate action provided that the patient does not flex at the hip more than 90 degrees.
D
This is not a normal postoperative exercise/action—abduction should be avoided with total hip replacement. Chapter Objective: Identify potential postsurgical complications, with emphasis on prevention and intervention.

PTS: 1 REF: Chapter: 33 | Page: 777 OBJ: Chapter Objective: 33-15
KEY: Content Area: Potential for Complications of Diagnostic Tests/Treatments/Procedures/Surgery or Health Alterations | Integrated Process: Teaching/Learning | Client Need: Reduction of Risk Potential | Cognitive Level: Application

4. ANS: A

Feedback
A
For thigh-high hose, it is important to measure the length of the leg from the gluteal fold to the bottom of the heel. Then one must measure the circumference of the calf and the thigh at their largest diameters. These measurements must be cross-referenced on the TED chart to determine which size to select. Chapter Objectives: Prioritize nursing care during immediate postoperative and postanesthesia care. Identify potential postsurgical complications, with emphasis on prevention and intervention.
B
This measurement is not necessary.
C
This measurement is not necessary.
D
This measurement is not necessary.

PTS: 1 REF: Chapter: 33 | Page: 778
OBJ: Chapter Objectives: 33-12| Chapter Objectives: 33-15
KEY: Content Area: Potential for Complications of Diagnostic Tests/Treatments/Procedures/Surgery or Health Alterations | Integrated Process: Nursing Process/Assessment | Client Need: Reduction of Risk Potential | Cognitive Level: Application

5. ANS: D

Feedback
A
Pneumatic stockings must be turned on/off—they are generally removed to allow the patient to ambulate.
B
Stockings should remain in place throughout the night.
C
If allowed to bunch together or the tops to roll down, those areas will work like a tourniquet and restrict venous blood return.
D
The hose should be removed at least twice per day to prevent excessive pressure or tension on any one spot. Chapter Objective: Develop a care plan for a patient who has had abdominal surgery.

PTS: 1 REF: Chapter: 33 | Page: 778 OBJ: Chapter Objective: 33-16
KEY: Content Area: Potential for Complications of Diagnostic Tests/Treatments/Procedures/Surgery or Health Alterations | Integrated Process: Nursing Process/Implementation | Client Need: Reduction of Risk Potential | Cognitive Level: Application