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During preoperative teaching about pain management, the patient asks the nurse to explain how a PCA pump works. What will the nurse teach the patient about PCA?
- A. It allows the patient to be completely free of pain during the postoperative period.
- B. It allows the patient to take unlimited amounts of medication as needed.
- C. It allows the patient to choose the type of medication given postoperatively.
- D. It permits the patient to self-administer limited doses of pain medication.
Correct Answer: D
Rationale: The nurse educates the patient that the PCA pump allows patients to self-administer doses of pain-relieving medication within health care provider-prescribed times and dose limits. It is not realistic to promise absence of pain or unlimited access to medication nor allow the patient to select the pain medication prescribed.
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A scrub nurse is assisting a surgeon with a kidney transplant. What are the patient responsibilities of the scrub nurse? Select all that apply.
- A. Maintaining sterile technique
- B. Draping and handling instruments and supplies
- C. Identifying and assessing the patient on admission
- D. Integrating case management
- E. Preparing the skin at the surgical site
- F. Providing exposure of the operative area
Correct Answer: A,B
Rationale: The scrub nurse is a member of the sterile team who maintains sterile technique while draping and handling instruments and supplies. Two duties of the circulating nurse are to identify and assess the patient on admission to the OR and prepare the skin at the surgical site. The perioperative registered nurse actively assists the surgeon by providing exposure of the operative area. The advanced practice registered nurse coordinated nurse and integrates care activities, collaborates with physicians and nurses in all phases of perioperative and postanesthesia care, and integrates care management, critical paths, and research into care of the surgical patient.
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 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.
A nurse is caring for a patient who is obese and has had abdominal surgery. The nurse prioritizes a plan to prevent what postoperative complication?
- A. Anesthetic interactions
- B. Impaired wound healing
- C. Weight gain
- D. Flatulence
Correct Answer: B
Rationale: Adipose (fatty) tissue has poor blood supply, which places the obese patient at risk for delayed wound healing, wound infection, and disruption in the integrity of the wound. Medication interactions are not the primary concern and are managed by the nurse anesthetist or anesthesiologist. Postoperative bleeding and flatulence (gas) after anesthesia are concerns for all patients, not just those with obesity.
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.