Chapter 04: Care of Preoperative and Intraoperative Surgical Patients

Chapter 04: Care of Preoperative and Intraoperative Surgical Patients

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The nurse is caring for a patient who has received epoetin alfa (Epogen) 2 to 3 weeks prior to a scheduled surgery. Which statement best explains the goal for Epogen administration prior to surgery?

a.	The patient will only require a single antibiotic immediately prior to surgery.
b.	The patient will have greater numbers of white blood cells (WBCs) following surgery.
c.	The patient will not require a blood transfusion during surgery.
d.	The patient will maintain stable potassium levels during surgery.

 

 

ANS:  C

Epoetin alfa (Epogen) is given to increase red blood cell production prior to surgery with the goal of having a bloodless surgery. Epoetin alfa (Epogen) will not affect the need for an antibiotic preoperatively, nor will it affect WBCs or serum potassium levels.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   62

OBJ:   1 (theory)       TOP:   Bloodless Surgery

KEY:  Nursing Process Step: Planning        MSC:  NCLEX: Health Promotion and Maintenance

 

2. The nurse is performing a preoperative assessment on a patient scheduled for surgery today. The patient reports drinking two glasses of wine daily, smoking one pack of cigarettes daily ´ 20 years, completing a round of corticosteroids for asthma control 2 days ago, and taking a dose of passion flower extract yesterday. Which action should the nurse take next?

a.	Supply the patient with information on a smoking cessation class.
b.	Educate the patient regarding the dangers of drinking alcohol on a daily basis.
c.	Provide the patient with information regarding the dangers of using herbal medications.
d.	Notify the physician immediately regarding the patient’s recent use of corticosteroids.

 

 

ANS:  D

The use of corticosteroids reduces the body’s response to infection and delays healing. Surgery may need to be delayed until the patient has been off the drug approximately 7 days. Providing the patient with information regarding smoking cessation is advisable but is not a priority at this time. Drinking two glasses of wine daily may not be a problem if not contraindicated by the patient’s health status. Passion flower extract does not interfere with the surgery and poses no apparent problems.

 

PTS:   1                    DIF:    Cognitive Level: Analysis                REF:   65, Table 4-2

OBJ:   2 (theory)       TOP:   Perioperative Management

KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity: Reduction of Risk Potential

 

3. The nurse is caring for a presurgical patient. The patient asks the nurse why her height and weight are recorded. How should the nurse respond?

a.	“This information helps us to correctly calculate the anesthesia dose.”
b.	“Height and weight are important predictors of blood loss.”
c.	“This information is used to assess respiratory volume.”
d.	“Height and weight help us anticipate your fluid needs.”

 

 

ANS:  A

Height and weight are used to calculate anesthesia dosages.

 

PTS:   1                    DIF:    Cognitive Level: Comprehension     REF:   76

OBJ:   3 (theory)       TOP:   Presurgical Assessment

KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity: Reduction of Risk Potential

 

4. The nurse is reviewing the presurgical patient’s laboratory reports and notes an elevated aspartate aminotransferase (AST) and bilirubin. The nurse understands that this patient is most at risk for which potential complication?

a.	Excessive bleeding during or after surgery
b.	An increased serum albumin level
c.	Postsurgical respiratory infection
d.	Delayed wound healing

 

 

ANS:  A

The AST and bilirubin are liver studies. Elevated levels may indicate a dysfunctional liver. The liver is directly involved with clotting factors; therefore, this patient would be at risk for excessive bleeding. The serum albumin level would most likely be decreased if the liver is not functioning properly. Postsurgical wound infection and delayed wound healing risks are not directly related to liver function.

 

PTS:   1                    DIF:    Cognitive Level: Analysis                REF:   64, Box 4-2, 65, Table 4-2

OBJ:   2 (theory)       TOP:   Preoperative Lab Studies

KEY:  Nursing Process Step: Planning

MSC:   NCLEX: Physiological Integrity: Reduction of Risk Potential