Perioperative Care NCLEX Questions -

Perioperative Care NCLEX Questions - Med Surg Final Already Passed

A patient is to have a left inguinal hernia repair at the outpatient surgical clinic. Preoperatively, it is most important for the nurse to determine whether the

• patient has had any experience with outpatient surgery

in the past.

• patient's medical plan covers outpatient surgery.

• patient plans to stay overnight at the surgical center.

• patient has someone available for transportation and care at home. ✔✔D

The nurse is assessing a 36-year-old woman who has been admitted for knee surgery. Which information obtained during the preoperative assessment should be reported to the surgeon before surgery?

• The patient's lack of knowledge about postoperative pain control measures

• The patient's statement that her last menstrual period was 8 weeks previously

• The patient's history of a postoperative infection following a prior cholecystectomy

• The patient's concern that she will be unable to care for her children postoperatively ✔✔B

During the preoperative assessment of a patient scheduled for a colon resection, the patient tells the nurse about using St. John's wort to prevent depression. The nurse should alert the staff in the postanesthesia recovery area that the patient may

• have more postoperative bleeding than expected

• take longer to recover from the anesthesia

• have hypertensive episodes

• experience increased pain ✔✔B

The nurse asks a hospitalized patient to sign the operative permit as directed in the health care provider's preoperative orders. The patient tells the nurse, "I do not really understand what is involved in the surgery." The nurse should

• postpone the consent form signing and notify the holding room staff that the health care provider

needs to discuss the surgery with the patient.

• explain what the planned surgical procedure entails before having the patient sign the consent

form.

• have the patient sign the form and ask the health care provider to visit the patient before surgery

to further explain the procedure.

• Have the patient sign the from and then Notify the health care provider that the informed consent

process is not complete. ✔✔A

During the preoperative interview with the nurse, a patient scheduled for an elective hysterectomy to treat benign tumors of the uterus tells the nurse that she just does not know whether she can go through with the surgery because she knows she will die in surgery as her mother did. The most appropriate response by the nurse is

• "Tell me more about what happened to your mother."

• "You will receive medications to reduce your anxiety."

• "Surgical techniques have improved a lot in recent years."

• "Many people have fears and anxieties about surgery." ✔✔A

The patient's statement may indicate an unusually high anxiety level or a family history of problems such as malignant hyperthermia, which will require precautions during surgery. The other statements are accurate, but the nurse's initial response should be further assessment.

Which information about medication use in a preoperative patient is most important to communicate to the health care provider?

• The patient takes garlic capsules daily but did not take any on the surgical day.

• The patient took a sedative medication the previous night to assist in falling asleep.

• The patient uses acetaminophen (Tylenol) as needed for occasional aches and pains.

• The patient has a history of cocaine use but quit using the drug over 10 years ago. ✔✔A

Chronic use of garlic may predispose to intraoperative and postoperative bleeding. The use of a sedative the previous night, occasional acetaminophen use, and a distant history of cocaine use will not impact on the surgical outcome.

Ten minutes after receiving the ordered preoperative opioid by intravenous (IV) injection, the patient asks to get up to go to the bathroom to urinate. The most appropriate action by the nurse is to

• offer a urinal or bedpan and position the patient in bed to promote voiding.

• assist the patient to the bathroom and stay with the patient to prevent falls.

• ask the patient to wait because catheterization is performed at the beginning of the surgical

procedure.

• allow the patient up to the bathroom because the onset of the medication takes more than 10

minutes. ✔✔A

The patient will be at risk for a fall after receiving the opioid, so the best nursing action is to have the patient use a bedpan or urinal. Having the patient get up either with assistance or independently increases the risk for a fall. The patient will be uncomfortable and risk involuntary incontinence if the bladder is full during transport to the operating room.

A patient becomes restless and agitated in the in the postanesthesia care unit (PACU) as he begins

to regain consciousness. The first action the nurse should take is:

• administer the ordered postoperative pain medication.

• turn the patient to a lateral position.

• check the patient's oxygen saturation with a pulse oximeter.

• orient the patient and tell him that the surgery is over. ✔✔C

While in the PACU, the patient's blood pressure drops from an admission pressure of 126/82 to 106/78 with a pulse change of 70 to 94. The nurse administers oxygen and then

• increases the rate of the IV fluids.

• performs neurovascular checks on the lower extremities.