NUR310 Chapter 18: Perioperative NCLEX Questions With Accurate answers. Rated A+.

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Five minutes after receiving a preoperative sedative medication by IV injection, a patient asks to get up to go to the bathroom to urinate. What is the most appropriate action for the nurse to take? ... 1. Offer the patient to use the urinal/bedpan after explaining the need to maintain safety. 2. Assist the patient to the bathroom and stay next to the door to assist patient back to bed when done. 3. Allow the patient to go to the bathroom since the onset of the medication will be more than 5 minutes. 4. Ask the patient to hold the urine for a short period since a urinary catheter will be placed in the operating room. - ✔✔1. Offer the patient to use the urinal/bedpan after explaining the need to maintain safety. a. The prime issue after administration of either sedative or opioid analgesic medications is safety. Because the medications affect the central nervous system, the patient is at risk for falls and should not be allowed out of bed, even with assistance. The other options would not be safe for the patient. What is the primary reason for accurately recording the patient's current medications during a preoperative assessment? 1. Some medications may alter the patient's perceptions about surgery. 2. Many anesthetics alter renal and hepatic function, causing toxicity of other drugs. 3. Some medications may interact with anesthetics, altering the potency and effect of the drugs. 4. Routine medications are withheld the day of surgery, requiring dosage and schedule adjustments after surgery. - ✔✔2. Some medications may interact with anesthetics, altering the potency and effect of the drugs a. Drug interactions may occur between prescribed medications and anesthetic agents used during surgery. For this reason, it is important to take a careful medication history and check that they have been communicated to the anesthesia care provider. Routine medications may or may not be prescribed for use the day of surgery. While performing preoperative teaching, the patient asks when she needs to stop drinking water before the surgery. Based on the most recent practice guidelines established by the American Society of Anesthesiologists, the nurse tells the patient that 1. she must be NPO after breakfast. 2. she needs to be NPO after midnight. 3. she can drink clear liquids up to 2 hours before surgery. 4. she can drink clear liquids up until she is moved to the OR. - ✔✔3. she can drink clear liquids up to 2 hours before surgery. a. Practice guidelines for preoperative fasting state the minimum fasting period for clear liquids is 2 hours. Evidence-based practice no longer supports the long-standing practice of requiring patients to be NPO after midnight. The nurse is admitting a patient to the same-day surgery unit. The patient tells the nurse that he was so nervous he had to take kava last evening to help him sleep. Which nursing action would be most appropriate? 1. Tell the patient that using kava to help sleep is often helpful. 2. Inform the anesthesiologist of the patient's recent use of kava. 3. Tell the patient that the kava should continue to help him relax before surgery. 4. Inform the patient about the dangers of taking herbal medicines without consulting his health care provider. - ✔✔4. Inform the anesthesiologist of the patient's recent use of kava a. Kava may prolong the effects of certain anesthetics. Thus the anesthesiologist needs to be informed of recent ingestion of this herbal supplement. Patients should not take anything before surgery without the health care provider's knowledge. Which preoperative patient has the greatest risk of bleeding as a result of his or her medication? 1. A woman who takes metoprolol (Lopressor) for the treatment of hypertension 2. A man whose type 1 diabetes is controlled with insulin injections four times daily 3. A man who is taking clopidogrel (Plavix) after the placement of a coronary artery stent 4. A man who recently started taking finasteride (Proscar) for the treatment of benign prostatic hyperplasia - ✔✔5. A man who is taking clopidogrel (Plavix) after the placement of a coronary artery stent a. Any drug that inhibits platelet aggregation, such as clopidogrel (Plavix), represents a bleeding risk. Insulin, metoprolol (Lopressor), and finasteride (Proscar) are less likely to contribute to a risk for bleeding. A 70-year-old woman has been admitted prior to having surgery for a bilateral mastectomy and breast reconstruction. What should the nurse include in the patient's preoperative teaching (select all that apply)? 1. Information about various options for reconstructive surgery 2. Information about the risks and benefits of her particular surgery 3. Information about risk factors for breast cancer and the role of screening 4. Information about where in the hospital she will be taken postoperatively 5. Information about performing postoperative deep-breathing and coughing exercises - ✔✔6. Information about where in the hospital she will be taken postoperatively; Information about performing postoperative deep-breathing and coughing exercises a. During preoperative teaching, it is important to introduce the role of deep-breathing and coughing exercises and to inform the patient about the different locations involved in her hospital stay. The specific risks and benefits of her surgery and reconstruction options should be addressed by her surgeon. Teaching about breast cancer screening would be inappropriate, and likely insensitive, at this point in her disease trajectory. The patient is having a mole removed that has changed appearance. What does the nurse teach the patient about the rationale for this surgical procedure? 1. It is to prevent malignancy. 2. It is to alleviate symptoms. 3. It is to cure the malignancy. 4. It is to provide cosmetic improvement. - ✔✔7. It is to prevent malignancy [Show More]

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