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. The nurse understands that this patient will likely:

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 cause difficulty with clotting or cause an electrolyte imbalance.

DIF:    Cognitive Level: Application           REF:   64                  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 a history of drinking 2 glasses of wine daily, smoking cigarettes for 20 years, completing a round of corticosteroids for asthma control 2 days ago, and taking the last dose of passion flower extract yesterday. The nurse’s best action is:

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 2 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.

DIF:    Cognitive Level: Analysis                REF:   65-67 | Table 4-2

OBJ:   2 (theory)       TOP:   Perioperative Management

KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity: Reduction of Risk Potential

3. The presurgical patient asks why it is that her height and weight are recorded. The nurse replies that the information is essential for:

ANS:  A

Height and weight are used to calculate anesthesia dosages.

DIF:    Cognitive Level: Comprehension     REF:   64                  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 lab reports and notes an elevated aspartate aminotransferase (AST) and bilirubin. The nurse is most concerned that this patient is at risk for:

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.

DIF:    Cognitive Level: Analysis                REF:   66 | Box 4-2, 67  | Table 4-2

OBJ:   2 (theory)       TOP:   Preoperative Lab Studies

KEY:  Nursing Process Step: Planning

MSC:  NCLEX: Physiological Integrity: Reduction of Risk Potential

5. The patient received a preoperative dose of lorazepam (Ativan) 20 minutes ago. The safety precaution the nurse should take in regard to this drug is to:

ANS:  B

Raising the bed rails is a safety precaution against the dizziness and hypotension caused by this drug.

DIF:    Cognitive Level: Application           REF:   72 | Safety Alert

OBJ:   4 (clinical)      TOP:   Preoperative Medication

KEY:  Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity: Reduction of Risk Potential