Chapter 37 Care of the Surgical Patient

Chapter 37  Care of the Surgical Patient

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. The circulating nurse notes that the anesthetized patient has tensed muscles and irregular respirations. The nurse is aware that the patient has reached stage:
a.
I and the patient’s hearing is amplified.
b.
II and the surgical environment should be kept quiet.
c.
III and the patient has depressed reflexes.
d.
IV and the patient will not depend on the anesthesia machine of oxygenations.

ANS: B
Quiet must be maintained while the patient is in stage II, because noise may cause the patient to become excited, resulting in instability of vital signs.

DIF: Cognitive Level: Comprehension REF: p. 736 OBJ: Theory #5
TOP: General Anesthesia KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

2. In order for the anesthesiologist to accurately calculate the amount of anesthesia needed for an 82-year-old patient, the nurse should have data available on the medical record, such as:
a.
time of last meal.
b.
pulse rate and blood pressure.
c.
respiratory rate and oxygen saturation.
d.
height and weight.

ANS: D
Accurate height and weight are significant for calculation of the anesthetic agents needed for older adult patients.

DIF: Cognitive Level: Comprehension REF: p. 736 OBJ: Theory #3
TOP: Anesthesia KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies

3. The illiterate patient signs the surgical consent form with an “X.” The nurse is aware that this “X” is:
a.
not an acceptable signature.
b.
required to be accompanied by a picture identification.
c.
legal if it is witnessed.
d.
acceptable if the surgeon is willing.

ANS: C
An “X” is an acceptable signature if it is witnessed.

DIF: Cognitive Level: Comprehension REF: p. 737 OBJ: Theory #8
TOP: Surgical Consent KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

4. A 16-year-old boy injured in a motorcycle accident is unconscious and cannot sign the emergency surgical consent form; no family members can be located. The nurse anticipates that:
a.
the hospital social worker can sign the permit.
b.
the surgeon will write a detailed note about the need for surgery and a registered nurse will then sign the consent.
c.
the opinion of a second surgeon is sought regarding the necessity of the surgery.
d.
the hospital attorney must authorize the surgery and sign the consent form.

ANS: C
If no family can be found to sign the permit for an unconscious person, a second surgeon can confirm the need for the immediate surgical intervention and the procedure will take place.

DIF: Cognitive Level: Application REF: p. 737 OBJ: Theory #8
TOP: Surgical Consent KEY: Nursing Process Step: Planning
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

5. The nurse discovers that the signed operative permit has misspelled the patient’s name. The nurse must:
a.
request a corrected consent form to be signed.
b.
inform the surgeon of the error.
c.
have the new form attached to the old incorrect one and document it.
d.
allow the patient to be taken to surgery after notifying the circulating nurse.

ANS: A
A new consent form must be made, signed, and witnessed, provided the patient has not been sedated already.

DIF: Cognitive Level: Application REF: p. 737 OBJ: Theory #8
TOP: Incorrect Surgical Consent Form KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care