Chapter 38: Surgical Patient

Chapter 38: Surgical Patient

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. Richard is a 57-year-old patient who is being admitted for an appendectomy. He is a 2-pack-a-day smoker and has a history of diabetes. In addition to his other risk factors, he is 20 pounds overweight. Which of the following potential postoperative complications should the nurse be most concerned with?

ANS:   A

There is a significant association between smoking and postoperative pulmonary complications, specifically pneumonia and atelectasis. Chronic smoking increases the amount and thickness of mucous secretions in the lungs. Patients who are obese are more susceptible to developing atelectasis.

PTS:    1                      DIF:    Cognitive Level: Analysis                  REF:    1131

OBJ:    List factors to include in the preoperative assessment of a surgical patient

TOP:    Nursing Process: Assessment            MSC:   Client Needs: Physiological Integrity

2. Misty is a nurse who works in surgery. She knows that pulmonary embolisms can be a deadly complication of surgery. Which of the following patients is most likely to develop a pulmonary embolism?

ANS:   A

Patients who are obese are more susceptible to developing embolism postoperatively than patients who are not obese.

PTS:    1                      DIF:    Cognitive Level: Analysis                  REF:    1132

OBJ:    Identify factors to assess in a patient in postoperative recovery

TOP:    Nursing Process: Assessment            MSC:   Client Needs: Physiological Integrity

3. Shawna is a 45-year-old woman with cancerous abdominal tumor. She has been on chemotherapy and is having radiotherapy to shrink the tumor. She will be undergoing surgery to remove the tumor. To best facilitate wound healing, when is the best time for her to undergo surgery?

ANS:   D

The patient with cancer may have radiotherapy before surgery to reduce the size of a cancerous tumor to remove it surgically. Radiation causes fibrosis and vascular scarring in the radiated area. This causes tissues to become fragile and poorly oxygenated, increasing the risk for wound infection. Ideally surgery takes place 4 to 6 weeks after the completion of radiation treatments to avoid wound-healing problems.

PTS:    1                      DIF:    Cognitive Level: Application             REF:    1134

OBJ:    Identify factors to assess in a patient in postoperative recovery

TOP:    Nursing Process: Planning                 MSC:   Client Needs: Physiological Integrity

4. Which of the following patients is most at risk for hypovolemic shock after emergency surgery?

ANS:   A

Patients with preexisting renal, fluid and electrolyte, gastrointestinal, respiratory, or cardiovascular problems are at greatest risk for operative complications. For example, a patient who is dehydrated from vomiting preoperatively is at greater risk for hypovolemic shock.

PTS:    1                      DIF:    Cognitive Level: Analysis                  REF:    1134

OBJ:    Identify factors to assess in a patient in postoperative recovery

TOP:    Nursing Process: Assessment            MSC:   Client Needs: Physiological Integrity

5. Clara is a perioperative nurse. She is monitoring the blood glucose level of Harold, a 56-year-old patient without diabetes who is undergoing orthopedic surgery. What is the main rationale for monitoring his blood glucose level during surgery?

ANS:   B

Evidence has shown that there is a relationship between wound and tissue infection and blood glucose levels. Poor control of blood glucose levels (specifically hyperglycemia) during and after surgery increases the risk for wound infection and patient mortality in certain types of surgery.

PTS:    1                      DIF:    Cognitive Level: Analysis                  REF:    1134

OBJ:    Describe intraoperative factors that affect a patient’s postoperative course

TOP:    Nursing Process: Assessment            MSC:   Client Needs: Physiological Integrity