Question 1 of 10
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Which activity would the nurse teach a patient before surgery to reduce serious risks associated with surgery? Select all that apply. One, some, or all responses may be correct.
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- Leg exercisesTeaching the patient leg exercises is a high priority during the preoperative period. These activities reduce the serious risks associated with surgery, such as deep venous thrombosis.
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- Deep breathingTeaching the patient deep breathing is a high priority during the preoperative period.
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- Splinted coughingTeaching the patient splinted coughing is a high priority during the preoperative period.
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- Use of stool softenersConstipation is a common risk associated with surgery, but it is not considered serious.
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- Incentive spirometry useTeaching the patient use of an incentive spirometer is a high priority during the preoperative period. This activity reduces serious risks associated with surgery, such as pneumonia.
Question 2 of 10
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Which statement is accurate regarding informed consent?
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- Explaining the procedure and its risks may be done by the charge nurse of the unit.The health care provider who is performing the procedure is the person who explains the procedure and its associated risks.
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- A notary public must witness the patient’s signature and then cosign the document so that it becomes legal.A nurse may witness the signature of the patient; a notary public is not required to do so.
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- The consent form becomes part of the patient’s medical record; however, it is not considered a legal document.The consent form is part of the medical record, and it is also a legal document.
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- Written consent is intended to protect the patient from unwanted procedures, and it also protects the health care facility.It is true that written consent is intended to protect the patient from unwanted procedures, and it also protects the health care facility and caregivers.
Question 3 of 10
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Which education regarding medication would the nurse include when providing preoperative teaching for a patient?
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- After surgery, all preoperative medications are resumed for the patient.Surgery cancels all medications prescribed before surgery except for conditions of long-standing duration, such as Dilantin for seizure control. The surgeon would represcribe medication as necessary after surgery.
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- Patients who receive an opioid analgesic usually require more anesthetic during surgery.The patient who has received an opioid analgesic usually requires a smaller amount of anesthetic during surgery.
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- The preoperative phase is the optimal time to introduce the concept of patient-controlled analgesia (PCA) to the patient.An introduction to PCA preoperatively is advantageous because the patient is better able to comprehend the concept and operation of the equipment.
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- After receiving preoperative medication, the patient is generally encouraged to ambulate on the nursing unit to encourage deep breathing.After receiving preoperative medication, the patient must remain in bed. The nurse institutes safety procedures, such as keeping the bed in a low position, keeping the side rails up, and monitoring the patient every 15 minutes until the patient leaves for surgery.
Question 4 of 10
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Which issue is considered a potential serious intraoperative complication of surgery? Select all that apply. One, some, or all responses may be correct.
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- InfectionInfection is a potential intraoperative complication of surgery.
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- SedationSedation is a desired outcome.
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- ConstipationConstipation is not considered a serious complication.
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- Malignant hyperthermiaMalignant hyperthermia is a potential intraoperative complication of surgery.
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- Injury related to positioningInjury related to positioning is a potential intraoperative complication of surgery.
Question 5 of 10
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In which way would a 20-year history of smoking affect a patient’s surgical risk?
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- These patients are usually overweight.Smokers are not necessarily overweight.
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- Smokers often have a poor nutritional status.Smokers do not necessarily have poor nutritional status.
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- The patient is more likely to develop pneumonia after surgery.Smoking for 20 years would significantly affect the patient’s respiratory system postoperatively, increasing the risk for respiratory conditions such as pneumonia after surgery.
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- A history of smoking often causes the patient to have a poor pain tolerance.Pain tolerance depends on the individual and is not affected by smoking cigarettes.
Question 6 of 10
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After the patient is taken to the surgical suite, the surgical team requests the licensed practical nurse/licensed vocational nurse (LPN/LVN) from the acute care area bring the patient’s hearing aids to communicate with the patient. To which zone of the surgical area would the nurse bring the hearing aids?
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- Surgical holding zoneThe surgical holding area or zone is where the patient is kept just before going into the surgical suite. The nurse would not deliver the hearing aids to this area.
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- Unrestricted zoneThe unrestricted zone includes the control desk area where street clothes may be permitted. This zone is appropriate for the LPN/LVN to enter for not wearing clean surgical scrubs and a cap.
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- Restricted zoneThe restricted zone is the area around the surgical table and instruments. The personnel in this area are wearing sterile attire. The LPN/LVN would not be permitted in this area.
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- Semi-restricted zoneThe semi-restricted zone includes hallways and corridors in the surgical department. Surgical personnel who are not in sterile attire will work in these areas. For example, the circulating nurse and anesthesia personnel. Clean scrub clothes and caps are worn in this area.
Question 7 of 10
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When the licensed practical nurse/licensed vocational nurse (LPN/LVN) who is working as an assistant to the surgeon arrives to the surgical area, who would the nurse seek to assist with sterile gowning?
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- The circulating nurseThe circulating nurse is a nonsterile team member. The major functions of the circulating nurse do not include to assist with sterile gowning because of nonsterile attire.
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- Anesthesia care providerThe anesthesia care provider’s role is to manage the patient’s anesthetic and monitor the patient. The anesthesia provider works in the nonsterile field and would not be responsible for assisting personnel into sterile attire.
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- The scrub nurseThe scrub nurse works in the sterile field and has a major responsibility to assist other team members into sterile attire.
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- SurgeonThe surgeon does work in the sterile field; however, the surgeon’s role is to provide the surgical procedure to the patient, not to assist other personnel into sterile attire.
Question 8 of 10
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The patient who is scheduled to get an implanted vascular access device asks the licensed practical nurse/licensed vocational nurse (LPN/LVN) whether the provider will “knock them out” for the procedure. Which response by the nurse would be appropriate?
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- “The health care provider will use general anesthesia for the procedure.”The procedure is a minor procedure that does not require sedation or deep-muscle relaxation of general anesthesia.
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- “The health care provider will use a local anesthetic for the procedure.”The placement of an implanted vascular access device is a minor surgical procedure. Local anesthesia will numb the area for a short period of time and can provide pain control for several hours after the procedure.
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- “The health care provider will use conscious sedation for the procedure.”The placement of an implanted port does not require the use of conscious sedation, which leaves the patient unaware of the surroundings and events but allows for independent breathing.
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- “The health care provider will use cryothermia for the procedure.”The use of cryothermia is not indicated for the placement of an implanted vascular device. Cryothermia is used when the patient cannot tolerate general anesthesia.
Question 9 of 10
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Which finding, if noted on evaluation of the surgical patient’s nursing goals, suggests that the licensed practical nurse/licensed vocational nurse (LPN/LVN) would consider ways to improve the presurgical process?
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- The patient remained NPO beginning at midnight before the procedure as prescribed.General goals for patient care include that the patient remains NPO before the procedure as prescribed by the health care provider. When the patient goal is met, no improvement in the process is indicated.
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- The patient’s informed consent was completed after the patient arrived at the operating room.The informed consent should be completed and verified before entering the operating room. Part of the responsibility of the nurse in the immediate preoperative period is to ensure that the informed consent has been obtained, particularly before any preoperative medication is given that could cloud the patient’s thinking or judgment. If the informed consent is not obtained until the patient arrives to the operating room, this indicates a need for improvement.
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- Preoperative medications were administered according to the surgeon’s prescription.When the patient’s preoperative medications are given according to the surgeon’s prescription, the goal of administering medications on time is achieved and does not indicate a need for improvement.
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- The patient indicates understanding of the procedure in the surgical holding area.The patient indicating understanding of the procedure while in the surgical holding area meets the goal of the patient being knowledgeable of their procedure. This does not indicate a need for improvement.
Question 10 of 10
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The licensed practical nurse/licensed vocational nurse (LPN/LVN) is preparing an older adult for surgery and is concerned that the patient may not be retaining patient education. Which action would the nurse take to enhance education for the patient? Select all that apply. One, some, or all responses may be correct.
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- Administer preoperative antianxiety medication as prescribed.The nurse would not administer the preoperative antianxiety medication before teaching because the medication could cause sedation and more difficulty with patient education. The preoperative antianxiety medication would be administered after the preoperative checklist is complete.
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- Ensure that the patient is wearing glasses to read material.When the patient needs glasses, the nurse would ensure the patient is wearing them to ensure adequate vision for learning.
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- Request that a family member be with the patient during teaching.Having a family member present may assist to reduce anxiety that could impact the patient’s ability to learn. The family member can also assist if the patient is forgetful or needs information reinforced at a later time.
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- Reinforce key points of the patient teaching periodically.Reinforcing key teaching points periodically assists memory and retention of content.
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- Send written teaching instructions home with the patient after surgery.Sending written instructions home with the patient after the surgery serves to reinforce the content taught and gives the patient a source to refer to if needed.
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- Request the surgeon visit with the patient and provide education.The surgeon’s responsibility is to ensure the patient has provided informed consent. The nurse’s responsibility is to ensure the patient receives the patient education needed for the procedure. The surgeon would not be asked to reinforce patient teaching; the nurse would retain this responsibility.