BIOLOGY 102. Medical-Surgical Nursing Critical Thinking in Client Care, 4th Edition CHAPTER 4

Medical-Surgical Nursing Critical Thinking in Client Care, 4th Edition Priscilla LeMon

CHAPTER 4

CHAPTER 4

1. When preparing a client for surgery, the nurse observes that the client has been crying. When the nurse asks the client to sign the surgery consent form, the client states “I guess I should just go ahead and sign it, even though I’m not really sure about doing this.” The best response by the nurse would be:

a. “Most people are usually nervous before surgery.”

b. “The surgeon is waiting, so you should decide.”

c. “What concerns are you having?”

d. “Should we just cancel your surgery?”

2. Upon review of the medical history prior to surgery, the nurse notes that a client has a history of alcoholism. The nurse makes a point to bring this to the surgeon’s attention when informed consent is being provided. The rationale for this action would be:

a. The client could be at risk for depression postoperatively.

b. The client will be at greater risk for respiratory complications postoperatively.

c. The client could be dehydrated.

d. The client might require more general anesthesia.

3. The nurse is providing preoperative teaching to a client with diabetes. The client states “I know I won’t need as much insulin after surgery, since I haven’t had anything to eat or drink since midnight.” Which response by the nurse would be most appropriate?

a. “You are right, the insulin need will be less postoperatively.”

b. “Your insulin need will be adjusted and most likely will increase due to the stress of surgery on your body.”

c. “We will give you your usual dose of insulin just prior to surgery.”

d. “You will be given insulin during surgery to avoid complications postoperatively.”

4. A client has a history of malignant hyperthermia. A bowel resection with colostomy placement surgery is scheduled. The nurse anticipates which type of anesthesia will be used with this client?

a. Regional anesthesia

b. Inhaled anesthesia

c. Conscious sedation

d. Total intravenous anesthesia

5. A client reports a pain level of 6 on a 0–10 pain scale. The nurse offers to review the orders for additional pain medication. The client states “I really don’t want to take any more pain medication, because I am afraid I will become addicted.” The nurse’s response should focus on which concept?

a. Physical dependence on pain medication is uncommon during the short-term postoperative use.

b. This client already might have an addiction problem.

c. This client might benefit from a placebo dose.

d. The physician should be notified to discuss pain management.

6. The nurse has many teaching responsibilities preoperatively. From the following list, select all topics that would be within the nurse’s scope to provide instructions about preoperatively:

a. Diaphragmatic breathing

b. Positioning/turning in bed

c. Coughing exercises

d. Potential risks of the surgery

7. Assessment findings that would alert the nurse that a client might be at greater risk for deep vein thrombosis include: (Select all that apply.)

a. Client is 35 years old.

b. Client has varicose veins.

c. Client is obese.

d. Client is on an anticoagulant medication.

8. Following a coughing episode, a client who is 12 hours postoperative from abdominal surgery notifies the nurse of “a feeling of pressure in the surgical wound.” The nurse observes that the surgical wound is open. The initial response by the nurse should be:

a. Check the client’s vital signs, then notify the physician.

b. Cover the wound with a sterile dressing moistened with normal saline, then notify the physician.

c. Notify the physician.

d. Place the client in the Trendelenburg position.