Nokea
A nurse is providing teaching for a patient scheduled to have same-day surgery. Which teaching method would be most effective in preoperative teaching for ambulatory surgery?
- A. Lecture
- B. Discussion
- C. Audiovisuals
- D. Written instructions
Correct Answer: D
Rationale: Written instructions are most effective in providing information for same-day surgery.
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Which solution is reasonable and safe for this transition of care?
- A. Gabrielle's mom will be given time alone with Gabrielle in the preoperative room to provide comfort to Gabrielle
- B. Gabrielle's mom will accompany Gabrielle to the surgical suite and remain with Gabrielle until the inhaled anesthesia takes effect
- C. Gabrielle's mom will be at the preoperative bedside while the nurse initiates IV therapy and administers an IV sedative
- D. Gabrielle's mom will administer an oral sedative to Gabrielle under the supervision of the nurse
Correct Answer: B
Rationale: Allowing Gabrielle's mother to accompany her to the surgical suite until anesthesia takes effect is a safe and reasonable solution. It provides comfort and reduces anxiety during the transition, while ensuring clinical safety under controlled conditions.
A nurse on a surgical unit is aware that older adults develop reduced vital capacity as a result of normal physiologic changes. Based on these changes, which nursing intervention takes priority?
- A. Taking and recording vital signs every shift
- B. Turning, coughing, and deep breathing every 4 hours
- C. Encouraging increased intake of oral fluids
- D. Assessing bowel sounds daily
Correct Answer: B
Rationale: Reduced vital capacity in older adults decreases respiratory expansion, increasing the risk for pneumonia and atelectasis. Encouraging the patient to turn, cough, and deep breathe every 4 hours helps to prevent complications.
Which content and teaching modality best fit this particular situation?
- A. Have Gabrielle use the incentive spirometer while providing direction and encouragement
- B. Show Gabrielle the OR suite, taking time to point out the equipment and lights
- C. Have Gabrielle perform a series of arm and neck stretches
- D. Talk to Gabrielle and her mom about the likelihood of postoperative nausea and vomiting
Correct Answer: A
Rationale: Teaching Gabrielle to use the incentive spirometer with direction and encouragement is the most appropriate content and modality. It prepares her for postoperative respiratory exercises to prevent complications, is age-appropriate, and involves both her and her mother in the learning process.
A nurse in the PACU is preparing to receive a patient from surgery who sustained a ruptured spleen in a motor vehicle accident. Which of these system assessments will take priority?
- A. Neurologic system, ambulatory function
- B. Cardiovascular system, vital signs
- C. GI system, bowel function
- D. Integumentary, skin breakdown
Correct Answer: B
Rationale: The priority assessment focuses on the ruptured organ, blood loss, and monitoring for early signs of shock. Tachycardia, the first sign of shock, and decreasing blood pressure must be immediately reported to the health care provider. The neurologic system may be affected due to anesthesia, but ambulatory function is not the immediate priority. The nurse anticipates reduced or absent bowel sounds after surgery, but risk for blood loss is the priority. The nurse plans to promote wound healing and repositions the patient to prevent skin breakdown; however, hemorrhage and early detection of shock is the priority at this time.
When caring for a patient who returned from the operating room 8 hours ago, which finding requires follow-up assessment by the nurse?
- A. Patient reports discomfort at surgical site, scale of 5/10
- B. Patient voids small amounts every 20-30 minutes
- C. Patient is sleepy and awakens only to touch
- D. Patient reports thirst and dry mouth
Correct Answer: B
Rationale: This patient is displaying typical signs of urinary retention, voiding small frequent amounts. Discomfort is expected and can be managed with prescribed analgesics. Anesthesia or opioid analgesia promotes sedation from which this patient awakens to touch. Dry mouth and thirst can result from NPO status and possible anticholinergic medication intended to dry respiratory secretions during surgery.