Quiz 87: Preoperative and Postoperative Care
Perry et al.: Clinical Nursing Skills & Techniques, 9th Edition
Instructor Verified Answers Included
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1. Surgical site infections (SSIs) are the most prevalent hospital associated infection. Which of the following evidence-based practice guidelines is effective at reducing surgical site infections?
a. Remove all hair at the surgical site so it does not interfere with the surgical incision.
b. Maintain the patient’s core temperature slightly hypothermic to reduce the risk of fever post-operatively.
c. Insert urinary catheter devices only when necessary and leave in only as long as necessary.
d. Administer prophylactic antibiotics 24 to 48 hours prior to the time of the incision.
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?
a. Twenty-four hours before surgery
b. For 2 weeks after surgery
c. For no longer than 24 hours after surgery
d. When signs of infection first appear
3. 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?
a. Informed consent is required by law to protect the surgeon in case of an adverse outcome.
b. Only the patient can sign a surgical consent.
c. The nurse’s legal responsibility is to ensure that the patient understands the information presented.
d. The surgeon should give the patient information about the surgery.
4. The nurse is planning care for a preoperative patient. Which intervention is implemented to ensure safe nursing care?
a. Allowing the patient to have ice chips
b. Always keeping the patient NPO for 12 to 14 hours before
c. Allowing the patient to brush teeth and swallow water
d. Allowing the patient to take specifically ordered oral medications with small amounts of water
5. The nurse is providing the patient with preoperative education. When the nurse informs the patient that she will not be able to wear makeup, the patient states, “But I never go anywhere without my makeup.” The nurse’s response is based on what rationale?
a. She will speak with the surgeon to see if he will make an exception.
b. The patient may wear makeup if she insists.
c. Makeup makes it difficult for the surgeon to assess the patient.
d. Makeup impedes circulation.
6. The patient is in the hospital awaiting surgery. When asked to remove her jewelry, the patient asks why she needs to remove her navel ring. What explanation should the nurse provide?
a. The navel ring may impede assessment of the skin.
b. The navel ring may decrease circulation.
c. She may leave it in place if she chooses.
d. The navel ring may cause injury.
7. The nurse is helping the patient prepare for surgery. The patient has removed her jewelry and glasses. Which action should the nurse take to keep the jewelry safe?
a. Put these items in the patient’s bedside stand.
b. Inventory the items and give them to the family.
c. Place the items in a plastic bag and send them to the OR with the patient.
d. Keep these items with her until the patient returns.
8. In planning care for a surgical patient, the patient asks the nurse what may be “left on” during the surgery. Understanding patient safety, the nurse tells the patient that which item may remain in place?
a. Hearing aid
b. Artificial limb
c. Pair of eyeglasses
d. Pair of contact lenses
9. In planning surgical care for an older-adult patient, the nurse recognizes which of the following as causing the greatest risk for surgery?
a. Increased tactile sense
b. Decreased glomerular filtration rate
c. Increased numbers of red blood cells
d. Decreased rigidity of arterial walls
10. When providing care for an ambulatory surgical patient, the nurse recognizes that which assessment indicates that the patient meets discharge criteria?
a. The patient is able to drive home alone.
b. Some respiratory depression is evident.
c. The oxygen saturation level is at 85%.
d. No intravenous (IV) narcotics have been given in the past 30 minutes.
11. The patient has been taught how to use diaphragmatic breathing. When the patient returns from surgery, however, he cannot be placed upright and must remain flat. What does the nurse tell the patient about performing the diaphragmatic exercises?
a. Diaphragmatic breathing cannot be done in this position.
b. Alternative breathing exercises need to be found.
c. Diaphragmatic breathing exercises still can be performed.
d. Diaphragmatic breathing exercises may be postponed.
12. When teaching the patient about positive expiratory pressure therapy (PEP) and “huff” coughing, the nurse incorporates which of the following in the plan of care?
a. Instruct the patient to remain flat in bed.
b. Place a nose clip on the patient’s nose.
c. Instruct the patient to breathe through his nose.
d. Instruct the patient to exhale with long slow breaths.
13. When providing teaching to a patient, which action is important to help the patient in performing controlled coughing?
a. Repeat the breathing exercises twice.
b. Cough 2 to 3 times and inhale between coughs.
c. Place a pillow over the incisional site for splinting.
d. Use the chest and shoulder muscles while inhaling during diaphragmatic breathing.
14. When providing care for a postoperative patient, it is important for the nurse to include which postoperative exercise?
a. Turning every 4 hours
b. Completing leg exercises once daily
c. Repeating individual leg exercises 20 times
d. Performing exercises with the unaffected extremities
15. When planning care for a post anesthesia care unit (PACU) or recovery room patient, how often should the nurse plan to assess the patient?
a. Every 5 minutes
b. Every 15 minutes
c. Every 30 minutes
16. When providing care for a patient who has received spinal anesthesia, the nurse recognizes that which position prevents spinal headaches?
b. Lying on the side
c. Supine, with the head flat
d. Trendelenburg’s position
17. While providing care for a postsurgical patient who has not received spinal anesthesia, the nurse recognizes that which position is required to maintain a patent airway in the recovery phase?
a. On his side with head facing down and neck slightly extended
b. On his side with head facing down and neck slightly flexed
c. On his back with hands over the chest
d. On his side with head facing up and neck slightly extended
18. The nurse is providing care for a patient who is recovering in the postanesthesia care unit (PACU). Given that the patient is restricted to the supine position, which intervention provides the patient with adequate chest expansion?
a. Keeping the bed flat during recovery
b. Positioning the patient’s hands over his chest
c. Flexing the neck and turning the head to the side
d. Extending the neck and turning the head to the side
19. A patient is being transferred to a room from the postanesthesia care unit (PACU). What should the nurse do upon transfer?
a. Remove the indwelling urinary catheter.
b. Turn off the nasogastric tube suction.
c. Use a black pen to note drainage on the dressing.
d. Change the dressing immediately when the patient reaches the room.
20. The nurse explains to the patient that the incentive spirometer is used to promote which of the following outcomes?
a. Lung expansion
b. Reduced likelihood of vascular complications
c. Incisional healing
d. Expectoration of mucus
21. When assessing a postoperative patient, the nurse notes tenderness, redness, and swelling in the left calf. What should the nurse do next?
a. Massage the lower leg.
b. Contact the surgeon and prepare for heparin therapy.
c. Keep the leg in a dependent position.
d. Have the patient exercise that extremity.
22. The nurse understands that postop ileus is a possible postoperative complication. Which assessment provides the nurse with information about this postoperative complication?
a. Auscultating for bowel sounds every 4 hours
b. Checking blood pressure while sitting and standing
c. Observing the patient’s performance of leg exercises
d. Palpating the suprapubic region for distention
1. Which of the following have been identified as evidence-based guidelines to reduce surgical site infections (SSIs)? (Select all that apply.)
a. Prepping the surgical site with a razor followed by an antiseptic scrub
b. Giving antibiotics immediately after the procedure
c. Maintaining blood glucose levels
d. Maintaining normal body temperatures
e. Maintaining proper positioning
2. Therapies and regimens designed to prevent venous thromboembolism (VTE) include which of the following? (Select all that apply.)
a. Pneumatic compression stockings
b. Venous foot pump
c. Low-molecular-weight heparin
3. Being overweight or obese increases the risk for many diseases and health conditions, including which of the following? (Select all that apply.)
b. Coronary heart disease
c. Sleep apnea
d. Respiratory problems