Chapter 36: Preoperative and Postoperative Care

Chapter 36: Preoperative and Postoperative Care

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. When planning care for a surgical patient, the nurse recognizes that surgical site infections account for what percentage of hospital-acquired infection?

ANS:  A

The National Nosocomial Infections Surveillance (NNIS) system of the Centers for Disease Control and Prevention (CDC) reports that surgical site infections (SSIs) account for up to 16% of hospital-acquired infections. Current research indicates that 38% of hospital-acquired infections are surgical site infections.

DIF:    Cognitive Level: Application           REF:   Text reference: p. 881

OBJ:   Explain the rationale for preoperative procedures.              TOP:   Hospital-Acquired Infections

KEY:  Nursing Process Step: Assessment   MSC:  NCLEX: Physiological Integrity

2. The goal of prophylactic antibiotic therapy is to protect the patient from infection with as little risk as possible. To achieve this goal, the nurse recognizes that antibiotics should be administered when they will be most beneficial. When would that be?

ANS:  C

Overall, it is recommended that prophylactic antibiotics be given as close to the time of incision as possible (within 30 to 60 minutes) and not be given for longer than 24 hours postoperatively. However, vancomycin and fluoroquinolones may be given up to 2 hours before incision because of their longer infusion times. The goal of prophylactic antibiotic therapy is to protect the patient from infection with as little risk as possible. To achieve this goal, antibiotics must be administered when they will be most beneficial.

DIF:    Cognitive Level: Application           REF:   Text reference: pp. 881-882

OBJ:   Describe the activities needed to prepare a patient for surgery.

TOP:   Hospital-Acquired Infections           KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity

3. While planning care for a surgical patient, the nurse recognizes that which of the following effects of hyperglycemia is seen in the immediate postoperative period?

ANS:  C

The presence of hyperglycemia in the immediate postoperative period increases the risk for infection in both diabetic and nondiabetic patients. The higher the serum glucose, the greater the potential for infection in both patient groups. Hyperglycemia has been shown to inhibit the body’s ability to fight infection. Immediate postoperative glucose control also has been correlated with a reduction in surgical infection.

DIF:    Cognitive Level: Application           REF:   Text reference: p. 882

OBJ:   Explain the rationale for preoperative procedures.              TOP:   Hyperglycemia

KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity

4. The nurse is to obtain an informed consent for a patient before surgery is performed. The nurse recognizes that which of the following statements is true?

ANS:  D

The surgeon should give the patient information about the extent and type of surgery, alternative therapies, usual risks and benefits, and consequences of not having surgery in a nonthreatening manner, as outlined in The Patient Care Partnership developed by the American Hospital Association (AHA). Informed consent is required by law to help protect patients’ rights, their autonomy, and their privacy. The patient or the patient’s legal guardian must sign a surgical consent form that includes this information. If the patient’s cultural practices include male dominance, the husband, father, or oldest brother of a female patient also may need to sign the consent form. It is the nurse’s ethical (not legal) responsibility, acting as the patient’s advocate, to ensure that the patient understands the information. See institutional policy regarding consent.

DIF:    Cognitive Level: Application           REF:   Text reference: p. 883

OBJ:   Explain the rationale for preoperative procedures.              TOP:   Informed Consent

KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity