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Therapeutics: Course Point (CH. 29)

The nurse is preparing a client for surgery and asks if the client has an advance directive. The client asks “What is an advance directive?” What is the nurse’s best response to this?
An advance directive will communicate your wishes for healthcare postoperatively in case you are unable to do so
A client is undergoing surgery for an appendectomy. This would be considered what type of surgery?
Emergency surgery
Which measure would the nurse implement for prevention of deep vein thrombosis (DVT) in a postoperative client?
place graduated compression compression stockings on the client
A client has been taking aspirin since his heart attack in 1997. The client is at risk for:
hemorrhage
The nurse is providing education for a postoperative client regarding pain management. Which teaching point should the nurse include?
You will receive pain medication by injection as long as you are n.p.o.
A female client age 54 years has been scheduled for a bunionectomy (removal of bone tissue from the base of the great toe) which will be conducted on an ambulatory basis. Which characteristic applies to this type of surgery?
the client will be admitted the day of surgery and return home the same day
A 2-year-old toddler just underwent a tonsillectomy and adenoidectomy surgery. The postanesthesia care unit (PACU) nurse is checking on him. What is the best course of action regarding the developmental care of this child?
allow the parents into the PACU before the child wakes
The procedural physician has initiated performance of a time-out in the operating room before surgery. The student nurse asks the operating room nurse why this is important. What is the operating room nurse’s best response?
The time-out checks to be sure that we have the right client and procedure.
Which statement, if made by an adolescent preparing for abdominal surgery, would indicate to the nurse that the client requires additional instruction?
I can have a hamburger and French fries as soon as I wake up
A client is undergoing conscious sedation for an endoscopy. When the client becomes overly sedated, which medication does the nurse anticipate will be required?
naloxene
The nurse recognizes that palliative surgery is performed for what purpose?
to lessen the intensity of an illness
Which of these clients in the postanesthesia care unit (PACU) requires the most immediate attention by the nurse?
a client who is pale and diaphoretic with a heart rate of 115 beats/minute
A client had an open cholecystectomy (gall bladder removal) 36 hours earlier, and the nurse’s assessment this morning confirms that the client has not yet had a bowel movement since prior to surgery. How should the nurse best respond to this assessment finding?
Monitor the client closely and promote fluid intake.
A nurse is dressing the wound of a client who is admitted to the outpatient surgical unit. What is a major advantage of outpatient surgery?
It interferes less with the client’s daily routine.
A client is scheduled for surgery within the hour. Which assessment data requires immediate nursing intervention?
consumed a diet soda thirty minutes ago
Which nursing action should the PACU nurse take to prevent postoperative complications in clients?
Assist the client to do leg exercises to increase venous return.
A nurse is employed in an operative setting. Which of these roles is within the registered nurse (RN) scope of practice?
-counting sponges before and after surgery
-monitoring the client’s VS
-positioning the client on the operating table
A client comes to the postoperative area and complains of chest pain and palpitations. Which assessment information does the nurse need to obtain?
heart rate and blood pressure
Which client most likely requires special preoperative assessment and treatment as a result of the existing medication regimen?
a woman who takes daily anticoagulants to treat atrial fibrillation
(risk of hemorrhage)
The nurse is preparing a client for a colonoscopy. The nurse is familiar with the colonoscopy procedures at the hospital and is aware that which type of anesthesia is commonly used for this procedure?
conscious sedation
Ames is an 87-year-old man who underwent a hip replacement today. He is telling the nurse that his parents, who are deceased, are coming to visit him today. He continues to tell the nurse that he needs to cut the lawn and run errands. The last time the nurse entered the room, Ames was trying to climb over the bed rail. Which term best describes Ames’ condition?
delirium
(acute confusion that is reversible)
The nurse is talking with a client who wishes to have a tattoo removed. Which client statement indicates that the client understands how the procedure will be accomplished?
The provider will perform this laser surgery in an ambulatory care setting
A client who came in through the emergency department with a severely fractured leg will be transported to surgery within the hour. When the client asks how long hospitalization will occur after surgery, what is the appropriate nursing response?
Because you are having inpatient surgery, you will be at least 1 day after surgery
Which surgical client does the nurse in the preoperative setting anticipate having the greatest potential for surgical complications?
76-year-old client with a history of renal failure and chronic bronchitis
The nurse is caring for a client who had an outpatient procedure. Which assessment finding indicates to the nurse that the client may be ready for discharge to home?
blood pressure 118/70 mm Hg, respirations 18 breaths per minute
Which nursing action will best promote pain management for a client in the postoperative phase?
performing relaxation techniques
A nurse is assessing a client who is experiencing pulmonary embolus. What would be the priority nursing intervention for this client?
place the client in semi-Fowler’s position
A nurse is assigned to be the circulating nurse during a surgical procedure. The nurse would be responsible for which activity?
Anticipating the needs of other members of the surgical team
The nurse is assessing an obese client scheduled for heart surgery. Which surgical risk related to obesity should the nurse monitor?
delayed wound healing and wound infection
A nurse is reinforcing wound edges and applying a blinder to the separated incisions of a client after a surgery. Which postoperative complication has the client developed?
dehiscence
The nurse is taking a history on Kumar, who informs her that he has an allergy to adhesive tape. When the nurse asks Kumar to describe his reaction to the tape, he describes it as “blotchy and reddened.” What type of allergic reaction is this?
type IV
A nurse is caring for an infant who is postoperative following cardiac surgery. What is the most common postoperative complication found in this age group?
respiratory complications
Which of the following factors is most important in the nurse’s decision on assessment data, outcomes, and the monitoring needs of a client in preparing for surgery?
type of surgery
A 17-year-old client who is married wishes to have a breast reduction. She has insurance through her job as a cashier. Which information will the nurse provide to the client?
You can sign the consent form on this line.

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