Chapter 18: Nursing Management: Preoperative Care

Chapter 18: Nursing Management: Preoperative Care

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE
1. During the preoperative interview, a patient scheduled for an elective hysterectomy tells
the nurse, “I am afraid that I will die in surgery like my mother did!” Which response by
the nurse is most appropriate?
a. “Tell me more about what happened to your mother.”
b. “You will receive medications to reduce your anxiety.”
c. “You should talk to the doctor again about the surgery.”
d. “Surgical techniques have improved a lot in recent years.”
ANS: A
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 also may address the patient’s concerns, but further
assessment is needed first.
DIF: Cognitive Level: Application REF: 335-337
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity
2. A patient arrives at the ambulatory surgery center for a scheduled outpatient surgery.
Which information is of most concern to the nurse?
a. The patient has not had outpatient surgery before.
b. The patient is planning to drive home after surgery.
c. The patient’s insurance does not cover outpatient surgery.
d. The patient had a glass of water a few hours before arriving.
ANS: B
After outpatient surgery, the patient should not drive home and will need assistance with
transportation and home care. The patient’s experience with outpatient surgery is
assessed, but it does not have as much application to the patient’s physiologic safety. The
patient’s insurance coverage is important to establish, but this is not usually the nurse’s
role or a priority in nursing care. Having clear liquids a few hours before surgery does not
usually increase risk for aspiration.
DIF: Cognitive Level: Application REF: 343
TOP: Nursing Process: Assessment MSC: NCLEX: Safe and Effective Care
Environment
3. A 36-year-old woman is admitted for an outpatient surgery. Which information obtained
by the nurse during the preoperative assessment is most important to report to the
anesthesiologist before surgery?
a. The patient’s lack of knowledge about postoperative pain control measures
Test Bank 18-2
b. The patient’s statement that her last menstrual period was 8 weeks previously
c. The patient’s history of a postoperative infection following a prior
cholecystectomy
d. The patient’s concern that she will be unable to care for her children
postoperatively
ANS: B
This statement suggests that the patient may be pregnant, and pregnancy testing is needed
before administration of anesthetic agents. Although the other data also may 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: Application REF: 339
TOP: Nursing Process: Assessment MSC: NCLEX: Safe and Effective Care
Environment
4. A patient who is scheduled for surgery in a week tells the nurse doing the preoperative
assessment about an allergy to bananas, kiwifruit, and latex products. Which action is
most important for the nurse to take?
a. Notify the dietitian about the food allergies.
b. Alert the surgery center about the latex allergy.
c. Reassure the patient that all allergies are noted on the medical record.
d. Ask whether the patient uses antihistamines to reduce allergic reactions.
ANS: B
When a patient is allergic to latex, special nonlatex materials are used during surgical
procedures and the staff will need to know about the allergy in advance to obtain
appropriate nonlatex materials and have them available on the surgical date. The other
actions also may be appropriate, but prevention of allergic reaction (either contact
dermatitis or anaphylaxis) during surgery is the most important action.
DIF: Cognitive Level: Application REF: 338
TOP: Nursing Process: Assessment MSC: NCLEX: Safe and Effective Care