Exam (elaborations)
UNIT 1- MED SURG - PERIOPERATIVE QUESTIONS AND ANSWERS FULLY SOLVED
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UNIT 1- MED SURG - PERIOPERATIVE
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UNIT 1- MED SURG - PERIOPERATIVEThe nurse is providing preoperative care for a client who will have an arthroscopy of the
left knee. As part of the Joint Commission National Patient Safety Goals (NPSG), what
will the nurse be required to do?
A - Ensure that the correct procedure is noted in the client's history.
B - Remind the surgeon that the client will have a left knee arthroscopy.
C - Verify with the client that a left knee arthroscopy will be performed.
D - Mark the left knee site with the client awake and the surgeon present. - answerD -
Mark the left knee site with the client awake and the surgeon present.
The nurse will be required to mark the left knee site with the client awake and the
surgeon present. The Joint Commission NSPG requires that the surgical site be marked
by an independent licensed professional and should, when possible, involve the client.
The surgeon is accountable and should be present.The EMR should identify the correct
procedure, but is not a specific JCAHO requirement. The nurse will verify the procedure
with the client when possible, but this is not a requirement. Communication with the
surgeon is ideal, but is not specifically required.
The nurse is educating a client who is about to undergo cardiac surgery with general
anesthesia. Which statement by the client indicates the need for further instruction?
A - "I will wake up with a tube in my throat."
B - "I will have a bandage on my chest."
C - "My family will not be able to see me right away."
D - "Pain medication will take away my pain." - answerD - "Pain medication will take
away my pain."
The client's statement that, "Pain medication will take away my pain," indicates the need
for further instruction. Pain medication will reduce pain, but will not take it away
completely.The client statement about waking up with a tube in the throat is accurate,
because the client will be intubated. Following heart surgery, a dressing is placed on the
chest. The client will not be able to see family immediately because he or she will go to
recovery first.
Which task would be best for the charge nurse to assign to the LPN/LVN working in the
surgery admitting area?
A - Provide preoperative teaching to a client who needs insertion of a tunneled central
venous catheter.
,B - Insert a retention catheter in a client who requires a flap graft of a sacral pressure
ulcer.
C - Obtain the medical history from a client who is scheduled for a total hip replacement.
D - Assess the client who is being admitted for an elective laparoscopic
cholecystectomy. - answerB - Insert a retention catheter in a client who requires a flap
graft of a sacral pressure ulcer.
Insertion of a catheter is the best task within the scope of skills approved for the
LPN/LVN.Preoperative teaching and physical assessment of a preoperative client are
under the scope of the RN. History information would be completed by the RN on the
unit.
At 8:00 a.m., the registered nurse is admitting a client scheduled for sinus surgery to the
outpatient surgery department. Which information given by the client is of most
immediate concern to the nurse?
A - An allergy to iodine and shellfish
B - Being nauseated after a previous surgery
C - Having a small glass of juice at 7:00 a.m.
D - Expressing anxiety about the surgery - answerC - Having a small glass of juice at
7:00 a.m.
Clients need to be NPO for a sufficient length of time before surgery to prevent
aspiration of fluid into the lungs. Intake of food or fluids may delay the start time of the
surgery, so the nurse must notify the surgeon and anesthesiologist for possible
rescheduling.The nurse would confirm that all allergies are charted, and that the client
has the correct allergy band identification. Many clients experience nausea after
surgery; the nurse would document this in the client's information as well. The nurse
would talk with the client and explore the anxiety; this is a normal feeling before surgery.
The nurse completes the preoperative checklist on a client scheduled for general
surgery. Which factor contributes the greatest risk for the planned procedure?
A - Age 59 years
B - General anesthesia complications experienced by the client's brother
C - Diet-controlled diabetes mellitus
D - Ten pounds (4.5 kg) over the client's ideal body weight - answerC - Diet-controlled
diabetes mellitus
The client's greatest risk factor is diabetes mellitus. Diabetes contributes an increased
risk for surgery or postsurgical complications.Older adults are at greater risk for surgical
procedures, but this client is not classified as an older adult. Family medical history and
problems with anesthetics may indicate possible reactions to anesthesia, but this is not
, the best answer. Obesity increases the risk for poor wound healing, but being 10
pounds (4.5 kg) overweight does not categorize this client as obese.
The nurse is instructing a client about the use of antiembolism stockings. Which
statement by the client indicates the need for further teaching?
A - "I will take off my stockings one to three times a day for 30 minutes."
B - "My stockings are too loose."
C - "It's better if they are too tight rather than too loose."
D - "These stockings help promote blood flow." - answerC - "It's better if they are too
tight rather than too loose."
Antiembolism stockings should fit properly to achieve the desired result. Stockings that
are too tight will impede blood flow.Frequent removal of the stockings is appropriate to
allow for hygiene and a break from their wear. Stockings that are too loose are
ineffective. Antiembolism stockings may be used during and after surgery to promote
venous return.
Colostomy surgery is categorized as what type of surgery?
A - Cosmetic
B - Curative
C - Diagnostic
D - Palliative - answerPalliative
Colostomy surgery is categorized as palliative. Palliative surgery is performed to relieve
symptoms of a disease process, but does not cure the disease.Cosmetic surgery is
performed primarily to alter or enhance personal appearance. Curative surgery is
performed to resolve a health problem by repairing or removing the cause. Diagnostic
surgery is performed to determine the origin and cause of a disorder or the cell type for
cancer.
A diabetic client who is scheduled for vascular surgery is admitted on the day of surgery
with several orders. Which order does the nurse accomplish first?
A - Use electric clippers to cut hair at the surgical site.
B - Start an infusion of lactated Ringer's solution at 75 mL/hr.
C - Administer one-half of the client's usual lispro insulin dose.
D - Draw blood for glucose, electrolyte, and complete blood count values. - answerDraw
blood for glucose, electrolyte, and complete blood count values.
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