Nokea
A student nurse is caring for clients on the postoperative unit. The student asks the registered nurse why malnutrition can lead to poor surgical outcomes. What responses by the nurse are best?
- A. Malnourished clients will have fragile skin
- B. Malnourished clients always have other problems
- C. Many drugs are bound to protein in the body
- D. Poorer wound healing
- E. Weakness and fatigue are common in malnutrition
Correct Answer: A,C,D,E
Rationale: Malnutrition can lead to poorer surgical outcomes for several reasons, including fragile skin that might break down, altered pharmacokinetics due to protein binding, poorer wound healing, and weakness or fatigue that can interfere with recovery. Malnutrition is not always associated with other comorbidities.
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A preoperative nurse is reviewing morning laboratory values on four clients waiting for surgery. Which result warrants immediate communication with the surgical team?
- A. Creatinine 2 mg/dL
- B. Potassium 3.8 mEq/L
- C. Hemoglobin 12 g/dL
- D. Platelet count 150,000/mm³
Correct Answer: A
Rationale: A creatinine level of 2 mg/dL is elevated, indicating potential renal impairment, which can affect anesthesia and surgical outcomes. This warrants immediate communication with the surgical team. The other values are within normal ranges and do not require urgent reporting.
A client in the preoperative holding room has received sedation and now needs to urinate. What action by the nurse is best?
- A. Allow the client to walk to the bathroom
- B. Assist the client to the bathroom
- C. Give the client a bedpan or urinal to use
- D. Insert a urinary catheter now instead of waiting
Correct Answer: C
Rationale: Although possibly uncomfortable or embarrassing for the client, the client should not be allowed out of bed after sedation due to safety concerns. Providing a bedpan or urinal is the safest option. The client may or may not need a urinary catheter, depending on the surgical procedure.
The Surgical Care Improvement Project (SCIP) includes which core measures?
- A. Preventing infection
- B. Preventing serious cardiac events
- C. Preventing thrombembolic events
- D. Improving surgical technique
- E. Enhancing postoperative recovery
Correct Answer: B,C,E
Rationale: The SCIP project includes core measures to prevent infection, serious cardiac events, and thrombembolic events such as deep vein thrombosis.
A nurse is giving a preoperative client a dose of ranitidine (Zantac). The client asks why the nurse is giving this drug when the client has no history of ulcers. What response by the nurse is best?
- A. It helps prevent ulcers from the stress of the surgery
- B. It reduces stomach acid to prevent aspiration
- C. Since you don't have ulcers, I will have to ask
- D. The physician prescribed this medication for you
Correct Answer: B
Rationale: Ranitidine (Zantac) is given preoperatively to reduce gastric acid production, which lowers the risk of aspiration during surgery. This is the most accurate explanation. Preventing ulcers is not the primary purpose in this context, and the other options do not provide a clear rationale.
A nursing instructor is teaching students about different surgical procedures and their classifications. Which procedures are correctly classified?
- A. Hemicolectomy: diagnostic
- B. Liver biopsy: diagnostic
- C. Spinal cord decompression: palliative
- D. Total shoulder replacement: restorative
- E. Mastectomy: restorative
Correct Answer: B,E
Rationale: A diagnostic procedure is used to determine cell type of cancer and to determine the cause of a problem, such as a liver biopsy. A restorative procedure aims to improve functional ability, such as a total shoulder replacement. A curative procedure either removes or repairs the causative problem, such as a mastectomy or hemicolectomy, which are not diagnostic or palliative.