Chapter 40 Nursing Care Of The Perioperative Client

Chapter 40  Nursing Care Of The Perioperative Client

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. The client is scheduled for a biopsy of a lung lesion. The nurse realizes this type of surgery is classified as being:
a.
exploratory.
c.
curative.
b.
reconstructive.
d.
palliative.

ANS: A
Exploratory surgery determines the origin of presenting symptoms and extent of a disease process. Reconstructive surgery corrects a disease process or improves cosmetic appearance. Curative surgery repairs or removes a diseased organ or restores normal physiological functioning. Palliative surgery decreases the spread of the disease process to prolong life or alleviate pain.

PTS: 1 DIF: Analysis
REF: Table 40-1 Surgical Interventions Based on Expected Outcomes

2. A client, scheduled for surgery in a week, is making a preadmission visit to the facility. During this visit, the client will probably not meet with the:
a.
surgeon.
c.
anesthetist.
b.
nurse.
d.
laboratory personnel.

ANS: A
During the preadmission visit, the circulating nurse and anesthesia provider will perform preoperative assessments and teaching. Diagnostic tests will be performed. The surgeon will most likely not be in attendance during this time.

PTS: 1 DIF: Analysis REF: Setting

3. A nurse in the same day admitting unit is reviewing the chart of a client who is scheduled for elective surgery. In reviewing the client’s lab and diagnostic test results, which lab report should be reported to the physician because it may mean the surgery will be postponed?
a.
Platelets: 210,000/mm3
c.
Serum potassium: 4.1 mEq/L
b.
Hgb: 8.4 g/dL
d.
Serum sodium: 141 mEq/L

ANS: B
The client is scheduled for elective surgery and a delay would cause no physiological harm. All of the laboratory results listed are within normal limits except for the hemoglobin which is low and could negatively affect the client’s hemodynamic status during and after surgery. This laboratory value should be reported to the physician.

PTS: 1 DIF: Application
REF: Surgical Interventions| Common Preoperative Diagnostic Tests

4. A preoperative client tells the nurse that he is anxious about the upcoming surgery. Which of the following responses would be the most appropriate for the nurse to make to this client?
a.
I will be happy to explain the procedure to you and answer any questions.
b.
Let me tell you what your care will be like after surgery and how we will help you deal with the pain.
c.
Don’t worry, everyone gets nervous before surgery.
d.
Can you tell me what you have been told about your surgery?

ANS: D
The best way to reduce anxiety in a preoperative client is to assess the client’s knowledge of the surgical procedure and the expected surgical outcome. The best response for the nurse to make to this client would be to ask “can you tell me what you have been told about your surgery?” since this will assess the client’s knowledge. Offering to explain the procedure and answer questions does not assess the client’s knowledge. Telling the client about postoperative care and pain management may or may not address the client’s anxiety. Telling the client not to worry is inappropriate and does not meet the client’s needs.

PTS: 1 DIF: Application REF: Psychosocial Status

5. The nurse is planning to instruct a perioperative client in ways to prevent the development of atelectasis. Which of the following would the nurse most likely instruct the client?
a.
Incentive spirometry
c.
Foot and ankle exercises
b.
Splinting incision
d.
Antiembolism stockings

ANS: A
Incentive spirometry is a device that assists a client to achieve sustained maximum inspirations in order to prevent atelectasis. Splinting the incision would be helpful when instructing the client in deep breathing and coughing exercises. Foot and ankle exercises and antiembolism stockings are helpful to prevent lower extremity blood pooling and the development of deep vein thromboses.

PTS: 1 DIF: Application REF: Postoperative Exercise Instruction