Nokea
A nurse teaches a patient the rationale for performing leg exercises after surgery. How does the nurse best explain the purpose of the exercises to the patient?
- A. Improves respiratory function
- B. Maintains functional abilities
- C. Provides diversional activities
- D. Increases venous return
Correct Answer: D
Rationale: Leg exercises promote venous return and decrease complications related to venous stasis causing DVT and help prevent muscle weakness. These exercises also decrease risk for thrombophlebitis and emboli.
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Based on the objective and subjective assessment of this patient, which priority problem should the nurse identify to guide the perioperative plan of care?
- A. Bleeding risk
- B. Activity intolerance
- C. Acute anxiety
- D. Thermal injury risk
Correct Answer: C
Rationale: Gabrielle's calm but cooperative behavior, coupled with her reluctance to let go of her mother, indicates acute anxiety as the priority problem. Addressing anxiety is critical to ensure a smooth perioperative experience, as it can impact cooperation and emotional readiness for surgery.
A nurse is preparing a patient for same-day surgery. Which of these patient-related findings must the nurse report immediately?
- A. Asking how long after the surgery they can leave the hospital
- B. Received an oral anticoagulant last night
- C. Surgeon has not yet filled out the consent form
- D. Blood pressure is 142/86
Correct Answer: B
Rationale: Patients receiving anticoagulants are at risk for bleeding or hemorrhage during invasive and surgical procedures. Wanting to know an anticipated discharge date is expected, the surgeon can fill out the consent form prior to sedation, and a slight increase in blood pressure is possible related to anxiety before surgery.
An adult patient awaiting surgery says to the nurse, 'I am so frightened-what if I don't wake up?' What is the nurse's best response?
- A. Are you worried about the anesthesia?
- B. Tell me what concerns you most.
- C. Your surgeon is great; she operated on my aunt!
- D. Many people are anxious before surgery.
Correct Answer: B
Rationale: An open-ended question that allows the patient to express concerns, fears, and feelings is therapeutic and most appropriate. The other options suggest 'yes/no' answers or suggest issues that may not be present. This type of communication does not allow the patient to clarify their thoughts.
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.
A nurse is planning caring for a patient who had thoracic surgery. Which nursing interventions are most appropriate for patients undergoing this type of surgery?
- A. Observing for incisional wound healing
- B. Monitoring vital signs, especially pulse and blood pressure
- C. Instructing the patient on the proper use of the incentive spirometer
- D. Applying antiembolism stockings
Correct Answer: A,B,C
Rationale: A thoracic incision, near or overlying the lungs, makes it difficult or painful for patients to take deep breaths and cough. The nurse uses analgesics, repositioning, coughing and deep breathing, and an incentive spirometer to promote respiratory expansion and airway clearance to decrease the risk for respiratory complications. Monitoring vital signs is also critical to detect complications early.