ATI Care of Preoperative Patients, Questions and Answers with Explanations, 100% Correct, Download to Score A

Test Bank

MULTIPLE CHOICE

1. A client voluntarily signed the operative consent form. What is the nurse’s next action?

a.            Teach the client about the surgery.

b.            Have family members witness the signature.

c.             Sign under the client’s name as a witness.

d.            Call for the physician to sign the form.

ANS: C

The nurse’s signature as a witness indicates that the consent form was signed by the client voluntarily. None of the other steps are necessary.

DIF: Cognitive Level: Application/Applying or higher REF: N/A

TOP: Client Needs Category: Safe and Effective Care Environment (Management of Care—Informed Consent)

MSC: Integrated Process: Communication and Documentation

2. The nurse is caring for an older adult client with a history of chronic lung disease who will be undergoing surgery the following day. When postoperative care is planned, which potential problem is the highest priority for this client?

a.            Maintaining oxygenation

b.            Tolerating activity

c.             Anxiety and fear

d.            Hypovolemia

ANS: A

Breathing problems take priority over the other problems listed. This would be compounded in a client with any chronic lung disorder.

DIF: Cognitive Level: Application/Applying or higher REF: N/A

TOP: Client Needs Category: Physiological Integrity (Reduction of Risk Potential—Potential for Complications From Surgical Procedures and Health Alterations)

MSC: Integrated Process: Nursing Process (Analysis)

3. The nurse is completing preoperative teaching for a client, and it becomes apparent that the client does not understand the surgery that will be performed. What is the priority action for the nurse?

a.            Obtain informed consent from the client.

b.            Continue teaching the client about the surgery.

c.             Revise the teaching plan for the client.

d.            Notify the surgeon and document the finding.

ANS: D

The surgeon should be notified right away so that the client can be instructed about the surgery to be performed. The client cannot give informed consent unless he or she understands the procedure.

DIF: Cognitive Level: Application/Applying or higher REF: N/A

TOP: Client Needs Category: Safe and Effective Care Environment (Management of Care—Informed Consent) MSC: Integrated Process: Teaching/Learning

4. During the preoperative assessment, the client tells the nurse that he smokes three packs of cigarettes daily. Which action by the nurse is best?

a.            Call the surgeon to cancel the surgery.

b.            Have baseline laboratory studies drawn.

c.             Perform a respiratory assessment.

d.            Give a nebulizer treatment.

ANS: C

Smoking increases the client’s risk for atelectasis and hypoxia. The nurse should assess the client for signs of respiratory disease. The physician will need to know this information but will not necessarily cancel the operation. Baseline laboratory studies need to be ordered by the physician. There is no indication for giving a nebulizer to this client.

DIF: Cognitive Level: Application/Applying or higher REF: N/A

TOP: Client Needs Category: Physiological Integrity (Reduction of Risk Potential—Potential for Complications From Surgical Procedures and Health Alterations)

MSC: Integrated Process: Nursing Process (Intervention)

5. When the nurse brings a client’s preoperative medications, the client responds, “I don’t need that. I had a good night’s sleep last night.” What is the nurse’s best response?

a.            “The doctor ordered this medication so you should take it.”

b.            “I will make a note that you refused to take the medication.”

c.             “I will ask your surgeon if you have to take the medication.”

d.            “Let me teach you about your medications for surgery.”

ANS: D

Preoperative medications can include sedatives but are often given to prevent laryngospasm and to help reduce pharyngeal and gastric secretions. The client must be fully aware of the rationale for all medications and the risks of not taking them.

DIF: Cognitive Level: Application/Applying or higher REF: N/A

TOP: Client Needs Category: Physiological Integrity (Pharmacological and Parenteral Therapies—Expected Actions/Outcomes)

MSC: Integrated Process: Communication and Documentation

6. A client receiving preoperative medication tells the nurse that she took all the following vitamins and herbs last night before going to bed. Which one does the nurse report to the surgical team as a priority?

a.            Valerian root

b.            St. John’s wort

c.             Garlic

d.            Chamomile

ANS: C

Garlic interferes with coagulation, increasing the client’s risk for bleeding during and after the surgical procedure. This would be a critical piece of information for the surgical team to know.

DIF: Cognitive Level: Application/Applying or higher REF: N/A

TOP: Client Needs Category: Physiological Integrity (Pharmacological and Parenteral Therapies—Adverse Effects/Contraindications/Side Effects/Interactions)

MSC: Integrated Process: Nursing Process (Intervention)

7. The nurse reviews a client’s laboratory results before surgery and notes a fasting blood glucose of 120 mg/dL, a prothrombin time (PT) of 25 seconds, and potassium (K+) of 3.8 mEq/L. Which action by the nurse is best?

a.            Ask the surgeon for additional laboratory studies.

b.            Administer a potassium supplement of 20 mEq.

c.             Increase the IV infusion of D5W to 100 mL/hr.

d.            Record laboratory results on the preoperative assessment.

ANS: A

The prothrombin time is elevated, which could lead to bleeding during or after surgery. The surgeon and the anesthesiologist should be notified of this laboratory test result right away, and additional coagulation studies will be needed. The potassium is within normal limits. The blood glucose level is elevated but not critically so. The surgeon should be notified of all laboratory work, and the client may need an IV solution without glucose. The results should be recorded, but the surgery will likely be cancelled owing to the coagulation problem, which is the priority concern with this client.

DIF: Cognitive Level: Application/Applying or higher REF: N/A

TOP: Client Needs Category: Physiological Integrity (Reduction of Risk Potential—Laboratory Values) MSC: Integrated Process: Nursing Process (Analysis)