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The nurse has provided preoperative instructions to a client scheduled for surgery at an ambulatory care center. Which statement, made by the client, would indicate that further instruction is needed?
- A. If I do not follow the instructions, my surgery could be cancelled.
- B. The nurse will explain the details of the surgery before I sign a consent.
- C. My medical records will be sent to the ambulatory care center prior to my surgery.
- D. The physician will update my family after the procedure and provide specific discharge instructions.
Correct Answer: B
Rationale: Further instruction would be needed to clarify that the physician, not the nurse, explains the details of the surgery and obtains voluntary consent for the procedure. It is correct that preoperative instructions must be followed prior to surgery for the safety of the client, medical records are present for review prior to surgery, and the physician speaks with the family following the procedure and provides instructions for discharge.
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The nurse is caring for a client postoperatively. What nursing interventions help prevent venous stasis and other circulatory complications in a client who has undergone surgery?
- A. Place pillows under the client's knees or calves.
- B. Encourage the client to move legs frequently and do leg exercises.
- C. Apply pressure on the client's lower extremities.
- D. Maintain the client in a side-lying position.
Correct Answer: B
Rationale: The nurse should encourage the client to move legs frequently and do leg exercises to prevent venous stasis and other circulatory complications. The nurse should not place pillows under the client's knees or calves unless prescribed and should avoid placing pressure on the client's lower extremities. Placing the client in a side-lying position will not help prevent venous stasis and other circulatory complications in a client who has undergone surgery.
A physically fit 86-year-old is scheduled for right knee replacement. Which factor places the client at increased risk for complications during or after surgery?
- A. Age
- B. Type of surgery
- C. Ability to metabolize medication
- D. Nutritional status
Correct Answer: A
Rationale: General risk factors are related to age, nutritional status; use of alcohol, tobacco, and other substances; and physical condition. In this scenario, the risk to the client is age; the type of surgery, client's ability to metabolize medication, and client's nutritional status are not risk factors for complication in the scenario described.
The nurse is caring for the client in the preoperative period and documenting rationale for a palliative surgical procedure. Which rationale is appropriate?
- A. The physician needs additional information to plan medical treatment.
- B. The client wishes to improve body structures and elects a procedure.
- C. The physician is repairing a deformity from birth or disease process.
- D. The client and physician are focusing on symptom relief not a cure.
Correct Answer: D
Rationale: The nurse realizes a palliative surgical procedure is focused on the relief of symptoms or enhancement of function without a cure. Diagnostic surgical procedures provide additional information for medical diagnosis and treatment. Cosmetic surgery procedures are elective, with the purpose of improving body appearance. Reconstructive surgery corrects a deformity.
Several of the clients at the clinic are preparing to have surgery within the next 2 weeks. They are completing preoperative paperwork today with their visit. What is a reason(s) that people might need to have surgery? Select all that apply.
- A. Cosmetic
- B. Diagnostic
- C. Palliative
- D. Normative
- E. Causative
Correct Answer: A,B,C
Rationale: Reasons people have surgery include cosmetic reasons, diagnostic procedures, palliative surgeries, exploratory surgeries, and curative surgeries. Normative and causative are not reasons for surgery.
The PACU nurse is about to administer pain medication to an older adult client who is recovering from surgery. What does this client's age put them at increased risk for? Select all that apply.
- A. Acute confusion
- B. Respiratory depression
- C. Disorientation
- D. Infection
- E. Greater requirement for pain medication
Correct Answer: A,B,C,D
Rationale: The older adult client requiring pain medication postoperatively is at greater risk for confusion, disorientation, respiratory depression, and infection. The older adult client does not have a greater requirement for pain medication, because even standard doses may cause complications that would not occur in younger clients.