chapter 17 - Chapter 17 Surgical Care MULTIPLE CHOICE 1 A...

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Chapter 17: Surgical Care MULTIPLE CHOICE 1. A postoperative patient is complaining of incisional pain. An order has been given for morphine every 4 to 6 hours PRN. The first assessment by the nurse should be to: 1. assess for the presence of bowel sounds. 2. assess pupillary reaction. 3. ask the patient’s family if she is having pain. 4. see when the patient last received pain medication. ANS: 4 Verifying the time of the last dose decreases the risk of a dose of medication being given too soon. PTS: 1 DIF: Cognitive Level: Analysis REF: 264 OBJ: 9 TOP: Acute Pain KEY: Nursing Process Step: Evaluation MSC: NCLEX: Safe, Effective Care Environment 2. The nurse is admitting a patient who is scheduled for a hysterectomy. Malignant hyperther- mia is a potential postoperative complication. In gathering information on the patient’s med- ical history, the nurse should ask: 1. “Do you think you might have a fever?” 2. “Do you currently have an infection?” 3. “Has anyone in your family ever had problems with general anesthesia?” 4. “Have you ever had any type of malignancy?” ANS: 3 Malignant hyperthermia is a life-threatening complication that occurs in response to certain drugs. Susceptibility to this response is inherited. PTS: 1 DIF: Cognitive Level: Analysis REF: 260 OBJ: 7 TOP: General Anesthesia KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity 3. A patient who had a hysterectomy yesterday has been NPO. The physician has now ordered the patient’s diet to be clear liquids. Before administering the diet, the nurse should check for: 1. feelings of hunger. 2. bowel sounds. 3. positive Homans’ sign. 4. gag reflex. ANS: 2 Absence of bowel sounds would contraindicate a diet. PTS: 1 DIF: Cognitive Level: Application REF: 263 OBJ: 9 TOP: Postoperative Nursing Implementations KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
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4. The technique the nurse should use to change a postoperative dressing is: 1. enteric isolation. 2. aseptic technique. 3. clean technique. 4. respiratory isolation. ANS: 2 Aseptic technique is important to reduce the risk of infection. PTS: 1 DIF: Cognitive Level: Comprehension REF: 272 OBJ: 9 TOP: Postoperative Risk for Infection KEY: Nursing Process Step: Planning MSC: NCLEX: Safe, Effective Care Environment 5. The nurse is caring for the postoperative patient who has had spinal anesthesia. The nurse would place highest priority on reporting which of these assessments? 1. Complaints of a headache 2. Pulse rate of 78 beats per minute 3. Voided 300 mL 4. Blood pressure of 126/78 ANS: 1 One complication of spinal anesthesia is postspinal headache. It is caused by the leaking of cerebrospinal fluid at the puncture site. PTS: 1 DIF: Cognitive Level: Analysis REF: 259 OBJ: 7 TOP: Regional Anesthesia KEY: Nursing Process Step: Evaluation MSC: NCLEX: Physiological Integrity 6. The nurse is caring for a postoperative patient. To best prevent deep vein thrombosis (DVT) in this patient, the nurse plans to diligently ensure that the patient: 1. splints the incision.
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