Deck 15: Priorities for the Preoperative Patient

Question 1

The nurse is completing the health history that is conducted during the preoperative period. What is the priority assessment?
1)Caretaker after discharge
2)Oral intake over the last day
3)Bowel elimination pattern
4)Previous response to anesthesia

Answer 1

4

Question 2

The nurse correlates an increased risk of infection because of immunosuppression to which patient condition?
1)Anxiety
2)Delirium
3)Pain
4)Depression

Answer 2

1

Question 3

The nurse is reviewing the medical records for patients who are scheduled for surgery the next day. Which patient may not provide consent to receive blood products?
1)A Hispanic Catholic patient
2)An African-American Baptist patient
3)A Caucasian Jehovah's Witness patient
4)A Native American patient with no religious affiliation

Answer 3

3

Question 4

Which action is the priority when providing care to a patient in the preoperative period?
1)Admitting the patient to the facility
2)Educating the patient on the surgical process
3)Ensuring the patient's preoperative checklist is complete
4)Answering all questions for the patient about surgery

Question 5

During the time-out for a surgical procedure, who is responsible for marking the surgical site?
1)Circulating nurse
2)Surgical technician
3)Patient's primary nurse
4)Surgeon

Question 6

The nurse is conducting a medication assessment for a preoperative patient. Which action by the nurse is appropriate for the patient who is prescribed metoprolol?
1)Obtaining a baseline electrocardiogram
2)Monitoring blood pressure
3)Assessing for hyperglycemia
4)Tapering the drug 2 days before surgery

Question 7

The nurse is conducting a medication assessment for a preoperative patient. Which action by the nurse is appropriate for the patient who is prescribed insulin?
1)Obtaining a baseline electrocardiogram
2)Monitoring blood pressure
3)Holding the drug during the perioperative period
4)Assessing blood glucose levels closely during the perioperative period

Question 8

In providing preoperative teaching to a patient with a smoking history, which information does the nurse include in the teaching plan to encourage the patient not to smoke before surgery?
1)"Smoking increases your risk of bleeding after surgery."
2)"Smoking increases your risk of respiratory depression during surgery."
3)"Smoking increases your risk of nausea and vomiting after surgery."
4)"Smoking increases your risk of aspiration after surgery."

Question 9

The nurse is completing the preoperative checklist on the night shift in preparation for the patient's surgery, scheduled for 0800. Which tasks could the nurse complete at this time?
1)Documenting the time of last voiding
2)Checking the medical record for the history, physical, and signed informed consent
3)Administering preoperative medication
4)Removing the prosthesis

Question 10

What information does the nurse teach the patient regarding NPO status before a surgical procedure?
1)Nothing solid by mouth for 12 to 14 hours before surgery
2)Nothing solid by mouth for 10 to 12 hours before surgery
3)Nothing solid by mouth for 8 to 10 hours before surgery
4)Nothing solid by mouth for 6 to 8 hours before surgery

Question 11

Which gauge catheter does the nurse use when initiating intravenous (IV) access for a preoperative patient?
1)18
2)20
3)22
4)24

Question 12

The nurse is conducting a medication assessment for a preoperative patient. Which action by the nurse is appropriate for the patient who is prescribed dexamethasone?
1)Obtaining a baseline electrocardiogram
2)Monitoring blood pressure
3)Assessing for hyperglycemia
4)Tapering the drug 2 days before surgery

Question 13

Which identifier should the nurse use during the initial time-out to determine the right patient?
1)Date of birth
2)Maiden name
3)Medical record number
4)Employer

Question 14

The nurse administers the preoperative medication to the patient 1 hour before elective surgery and then discovers the preoperative consent is not signed. Which action by the nurse is the most appropriate?
1)Have the patient sign the consent quickly, before the medication begins taking effect.
2)Have a family member or medical power of attorney sign the consent.
3)Send the patient to the holding area without a signed consent.
4)Notify the healthcare provider that surgery will need to be canceled.

Question 15

Which is the priority action by the nurse when a patient discloses a medication allergy during the health history before a surgical procedure?
1)Asking the patient to describe the reaction that occurs
2)Documenting the information on the patient's medical record
3)Placing an alert bracelet on the patient before leaving the unit
4)Verifying the information with the patient's family members at the bedside

Question 16

The nurse is conducting a medication assessment for a preoperative patient. Which action by the nurse is appropriate for the patient who is prescribed phenobarbital?
1)Obtaining a baseline electrocardiogram
2)Monitoring blood pressure
3)Maintaining the drug during the perioperative period
4)Assessing blood glucose levels closely during the perioperative period

Question 17

The nurse is conducting a medication assessment for a preoperative patient. Which action by the nurse is appropriate for the patient who is prescribed warfarin?
1)Obtaining a baseline electrocardiogram
2)Monitoring blood pressure
3)Assessing for hyperglycemia
4)Tapering the drug 2 days before surgery

Question 18

The nurse provides care to a patient who is having surgery later in the day. Which intervention is appropriate for the patient who is currently prescribed amiodarone?
1)Monitoring for hyperglycemia
2)Evaluating baseline coagulation studies
3)Ensuring suction is available at all times
4)Determining if a baseline electrocardiogram was completed

Question 19

What is the priority nursing action when providing patient care during the preoperative phase of care?
1)Ensuring NPO status
2)Monitoring vital signs
3)Obtaining informed consent
4)Completing a preoperative checklist

Question 20

The nurse provides care to a patient who is having surgery later in the day. The patient has contractures to both hands but is legally competent. Which action does the nurse implement during the informed consent process?
1)Asking a family member to sign the patient's consent form
2)Obtaining consent for patient's procedure from the surgeon
3)Telling the patient to place an "x" on the signature line of the consent form
4)Documenting that no consent form is required based on the patient's procedure

Question 21

Which are actions the nurse implements during the informed consent process when providing patient care? Select all that apply.
1)Reviewing the consent form
2)Witnessing the patient's signature on the consent form
3)Teaching the patient why the procedure is being implemented
4)Educating the patient on adverse effects associated with the procedure
5)Validating patient understanding of the information presented for the procedure

Question 22

The nurse is admitting an older adult patient for surgery. Which specific assessments are most important to include when preparing this patient for surgery? Select all that apply.
1)Number of living siblings
2)Medications currently being taken
3)Cognitive status
4)Skin integrity
5)Hobbies and entertainment preferences

Question 23

The nurse correlates an increased risk of which complication related to a patient wearing jewelry in the operating suite?
1)Intravenous infiltration
2)Bleeding
3)Infection
4)Burns

Question 24

According to the World Health Organization, which members of the surgical team are required to be involved in the completion of the Surgical Safety Checklist before the skin incision is made? Select all that apply.
1)Anesthesiologist or anesthetist
2)Surgical technician
3)Nurse
4)Surgeon
5)Operating room nurse manager

Question 25

A patient is informed that a surgical procedure is to be scheduled in 2 weeks. Which teaching points does the nurse include to prepare the patient for the surgery? Select all that apply.
1)The number of surgeries scheduled that day
2)Deep breathing and coughing expectations
3)Location of the surgical incision
4)Presence of dressings or drains
5)Components of the pain scale

Question 26

The nurse must verify a patient's identity during the first time-out process. Which actions by the nurse are appropriate? Select all that apply.
1)Asking the patient to state his or her name
2)Asking the patient to state his or her date of birth
3)Asking the patient to state his or her Social Security number
4)Comparing the patient's picture on the ID band to the patient
5)Verifying the listed address in the medical record with the patient's spouse

Question 27

The nurse educator for surgical services is planning an educational session related to informed consent. Which of the following situations requires two signatures on the consent form? Select all that apply.
1)The patient can only mark with an "x."
2)The patient is deaf.
3)The patient is a minor.
4)The patient is incapable of signing.
5)The patient speaks another language.

Question 28

Which should the nurse ask the patient to verify during the initial time-out, the "pause for cause"? Select all that apply.
1)"What is the name of your surgeon?"
2)"Which procedure are you having done today?"
3)"Is the information on your identification band correct?"
4)"Which side of the body is your procedure going to be completed on?"
5)"Have you signed your informed consent for the scheduled procedure?"

Question 29

The nurse performs preoperative teaching for a patient requiring a surgical intervention. Which actions by the patient indicate appropriate understanding of the information provided? Select all that apply.
1)Demonstrating how to turn and get out of bed
2)Having no anxiety about the impending surgery
3)Demonstrating proper performance of leg exercises
4)Demonstrating proper coughing and deep breathing
5)Asking questions about and voicing understanding of information provided

Question 30

In working in perioperative services, the nurse understands that which of the following are the required components of the informed consent for the actual surgical procedure being planned? Select all that apply.
1)Name and reason for the surgery
2)Length of time of the surgery
3)Name of surgeon performing the surgery
4)Number of times the surgeon has performed the procedure
5)All alternative options to surgery