Chapter 31 Perioperative Nursing

Chapter 31 Perioperative Nursing

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.1)Postoperative assessment is being done for a client who has had a total gastrectomy. The client hasa nasogastric tube connected to low intermittent suction. Twelve hours after surgery, the nurseassesses the client for bowel sounds, and does not hear anything. What is the most appropriateaction by the nurse at this time based on this information?1)A)Document the findings and continue postoperative assessments.B)Reposition the client on the right side and reassess the bowel sounds.C)Check the suction to make sure it is working correctly.D)Irrigate the nasogastric tube with 30 milliliters of normal saline.Answer:AExplanation:A)Bowel sounds are unlikely to be present in a client 12 hours after abdominalsurgery, so this answer choice indicates an appropriate action based upon anexpected finding. Checking the suction and irrigating the nasogastric tube implysomething is wrong, or that the client’s position was influential in the finding.ImplementationPhysiological Integrity-Reduction of Risk PotentialAnalysisB)Bowel sounds are unlikely to be present in a client 12 hours after abdominalsurgery, so this answer choice indicates an appropriate action based upon anexpected finding. Checking the suction and irrigating the nasogastric tube implysomething is wrong, or that the client’s position was influential in the finding.ImplementationPhysiological Integrity-Reduction of Risk PotentialAnalysisC)Bowel sounds are unlikely to be present in a client 12 hours after abdominalsurgery, so this answer choice indicates an appropriate action based upon anexpected finding. Checking the suction and irrigating the nasogastric tube implysomething is wrong, or that the client’s position was influential in the finding.ImplementationPhysiological Integrity-Reduction of Risk PotentialAnalysisD)Bowel sounds are unlikely to be present in a client 12 hours after abdominalsurgery, so this answer choice indicates an appropriate action based upon anexpected finding. Checking the suction and irrigating the nasogastric tube implysomething is wrong, or that the client’s position was influential in the finding.ImplementationPhysiological Integrity-Reduction of Risk PotentialAnalysis2)A nurse is told in morning shift report that skin preparation orders have just been written for aclient who is scheduled for open reduction and internal fixation of fractures of the left fibula andtibia. The nurse expects that these orders will include:2)A)Marking the locations of the left and right pedal pulses.B)Shaving the affected extremity from the knee to the ankle.C)Using sterile technique to cleanse the left lower extremity and foot.D)Assessing and documenting circulation, sensation, and motion of the affected extremity.Answer:C1
Explanation:A)The question is about skin preparation prior to surgery. Only using steriletechnique to cleanse the area and shaving the extremity address skin preparation.Of these two possible choices, it is less likely that a shave prep will be done on thenursing unit. Shave preps are more frequently done in the surgical areaimmediately before the operation to reduce chances of infection from small cuts.Surgery personnel are also more likely to have experience with this aspect of skinpreparation. Sterile technique is used when cleansing the skin to reduce theintroduction of additional microorganisms. The area is wrapped in a sterile towelafter cleaning. The other choices are related to preoperative assessments.AssessmentSafe, Effective Care Environment-Safety and Infection ControlApplicationB)The question is about skin preparation prior to surgery. Only using steriletechnique to cleanse the area and shaving the extremity address skin preparation.Of these two possible choices, it is less likely that a shave prep will be done on thenursing unit. Shave preps are more frequently done in the surgical areaimmediately before the operation to reduce chances of infection from small cuts.Surgery personnel are also more likely to have experience with this aspect of skinpreparation. Sterile technique is used when cleansing the skin to reduce theintroduction of additional microorganisms. The area is wrapped in a sterile towelafter cleaning. The other choices are related to preoperative assessments.AssessmentSafe, Effective Care Environment-Safety and Infection ControlApplicationC)The question is about skin preparation prior to surgery. Only using steriletechnique to cleanse the area and shaving the extremity address skin preparation.Of these two possible choices, it is less likely that a shave prep will be done on thenursing unit. Shave preps are more frequently done in the surgical areaimmediately before the operation to reduce chances of infection from small cuts.Surgery personnel are also more likely to have experience with this aspect of skinpreparation. Sterile technique is used when cleansing the skin to reduce theintroduction of additional microorganisms. The area is wrapped in a sterile towelafter cleaning. The other choices are related to preoperative assessments.AssessmentSafe, Effective Care Environment-Safety and Infection ControlApplicationD)The question is about skin preparation prior to surgery. Only using steriletechnique to cleanse the area and shaving the extremity address skin preparation.Of these two possible choices, it is less likely that a shave prep will be done on thenursing unit. Shave preps are more frequently done in the surgical areaimmediately before the operation to reduce chances of infection from small cuts.Surgery personnel are also more likely to have experience with this aspect of skinpreparation. Sterile technique is used when cleansing the skin to reduce theintroduction of additional microorganisms. The area is wrapped in a sterile towelafter cleaning. The other choices are related to preoperative assessments.AssessmentSafe, Effective Care Environment-Safety and Infection ControlApplication2
3)A nursing staff is planning the client assignments for the 7:00 a.m. to 7:00 p.m. shift. Three clientsare scheduled for discharge and three are scheduled for surgery. To provide continuity of care forthe surgical clients, it will be most helpful if the plan is to assign:3)A)Each surgical client the same primary nurse throughout the shift.B)The same nurse to all of the surgical clients.C)The nurses whose clients will be discharged to the surgical clients.D)A different nurse for each of the surgical clients.Answer:AExplanation:A)Providing the same primary nurse for a client pre-and postoperatively promotescontinuity of care. The client will see the same face before and after surgery. Thenursing shift is a 12-hour shift, so it is likely that the same nurse will still be onduty when the client returns from surgery. Assigning nurses whose clients will bedischarged to the surgical clients focuses on workload. Assigning the same nurseto all of the surgical clients and assigning a different nurse to each surgical clientdo not address the continuity for each client; rather, they address the continuity forthe nursing staff.PlanningSafe, Effective Care Environment-Coordinated CareAnalysisB)Providing the same primary nurse for a client pre-and postoperatively promotescontinuity of care. The client will see the same face before and after surgery. Thenursing shift is a 12-hour shift, so it is likely that the same nurse will still be onduty when the client returns from surgery. Assigning nurses whose clients will bedischarged to the surgical clients focuses on workload. Assigning the same nurseto all of the surgical clients and assigning a different nurse to each surgical clientdo not address the continuity for each client; rather, they address the continuity forthe nursing staff.PlanningSafe, Effective Care Environment-Coordinated CareAnalysisC)Providing the same primary nurse for a client pre-and postoperatively promotescontinuity of care. The client will see the same face before and after surgery. Thenursing shift is a 12-hour shift, so it is likely that the same nurse will still be onduty when the client returns from surgery. Assigning nurses whose clients will bedischarged to the surgical clients focuses on workload. Assigning the same nurseto all of the surgical clients and assigning a different nurse to each surgical clientdo not address the continuity for each client; rather, they address the continuity forthe nursing staff.PlanningSafe, Effective Care Environment-Coordinated CareAnalysisD)Providing the same primary nurse for a client pre-and postoperatively promotescontinuity of care. The client will see the same face before and after surgery. Thenursing shift is a 12-hour shift, so it is likely that the same nurse will still be onduty when the client returns from surgery. Assigning nurses whose clients will bedischarged to the surgical clients focuses on workload. Assigning the same nurseto all of the surgical clients and assigning a different nurse to each surgical clientdo not address the continuity for each client; rather, they address the continuity forthe nursing staff.PlanningSafe, Effective Care Environment-Coordinated CareAnalysis