Chapter 17: Preoperative Care

Chapter 17: Preoperative Care

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A patient scheduled for an elective hysterectomy tells the nurse, “I am afraid that I will die in surgery like my mother did!” Which initial response by the nurse is appropriate?

a.	“Surgical techniques have improved in recent years.”
b.	“Tell me more about what happened to your mother.”
c.	“You will receive medication to reduce your anxiety.”
d.	“You should talk to the doctor again about the surgery.”

 

 

ANS:  B

The patient’s statement may indicate an unusually high anxiety level or a family history of problems such as malignant hyperthermia, which will require precautions during surgery. The other statements may also address the patient’s concerns, but further assessment is needed first.

 

DIF:    Cognitive Level: Analyze (analysis)                                  REF:   302

TOP:   Nursing Process: Assessment           MSC:  NCLEX: Psychosocial Integrity

 

2. A patient arrives at the outpatient surgical center for a scheduled laparoscopy under general anesthesia. Which information requires the nurse’s preoperative intervention to maintain patient safety?

a.	The patient has never had general anesthesia.
b.	The patient is planning to drive home after surgery.
c.	The patient had a sip of water 4 hours before arriving.
d.	The patient’s insurance does not cover outpatient surgery.

 

 

ANS:  B

After outpatient surgery, the patient should not drive that day and will need assistance with transportation and home care. Clear liquids only require a minimum preoperative fasting period of 2 hours. The patient’s experience with anesthesia and the patient’s insurance coverage are important to establish, but these are not safety issues.

 

DIF:    Cognitive Level: Apply (application)           REF:               308

TOP:   Nursing Process: Assessment           MSC:  NCLEX: Safe and Effective Care Environment

 

3. A 38-yr-old woman is admitted for an elective surgical procedure. Which information obtained by the nurse during the preoperative assessment is most important to communicate to the anesthesiologist and surgeon before surgery?

a.	The patient’s lack of knowledge about postoperative pain control
b.	The patient’s history of an infection following a cholecystectomy
c.	The patient’s report that her last menstrual period was 8 weeks ago
d.	The patient’s concern about being able to resume lifting heavy items

 

 

ANS:  C

This statement suggests that the patient may be pregnant and pregnancy testing is needed before administration of anesthetic agents. Although the other data may also be communicated with the surgeon and anesthesiologist, they will affect postoperative care and do not indicate a need for further assessment before surgery.

 

DIF:    Cognitive Level: Analyze (analysis)                                  REF:   306

TOP:   Nursing Process: Assessment           MSC:  NCLEX: Safe and Effective Care Environment

 

4. A patient who has not had any prior surgeries tells the nurse doing the preoperative assessment about allergies to avocados and bananas. Which action is most important for the nurse to take?

a.	Notify the dietitian about the specific food allergies.
b.	Alert the surgery center about a possible latex allergy.
c.	Reassure the patient that all allergies are noted on the health record.
d.	Ask whether the patient uses antihistamines to reduce allergic reactions.

 

 

ANS:  B

Certain food allergies (e.g., eggs, avocados, bananas, chestnuts, potatoes, peaches) are related to latex allergies. When a patient is allergic to latex, special nonlatex materials are used during surgical procedures. The staff will need to know about the allergy in advance to obtain appropriate nonlatex materials and have them available during surgery. The other actions also may be appropriate, but prevention of allergic reaction during surgery is the most important action.

 

DIF:    Cognitive Level: Analyze (analysis)                                  REF:   305

OBJ:   Special Questions: Prioritization      TOP:   Nursing Process: Assessment

MSC:  NCLEX: Safe and Effective Care Environment