Nokea
The nurse is preparing a patient for surgery prior to her hysterectomy without oophorectomy. The nurse is witnessing the patients signature on a consent form. Which comment by the patient would best indicate informed consent?
- A. I know Ill be fine because the physician said he has done this procedure hundreds of times
- B. I know Ill have pain after the surgery but theyll do their best to keep it to a minimum
- C. The physician is going to remove my uterus and told me about the risk of bleeding
- D. Because the physician isnt taking my ovaries, Ill still be able to have children
Correct Answer: C
Rationale: The surgeon must inform the patient of the benefits, alternatives, possible risks, complications, disfigurement, disability, and removal of body parts as well as what to expect in the early and late postoperative periods. The nurse clarifies the information provided, and, if the patient requests additional information, the nurse notifies the physician. In the correct response, the patient is able to tell the nurse what will occur during the procedure and the associated risks. This indicates the patient has a sufficient understanding of the procedure to provide informed consent. Clarification of information given may be necessary, but no additional information should be given. The other listed statements do not reflect an understanding of the surgery to be performed.
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An OR nurse will be participating in the intraoperative phase of a patients kidney transplant. What action will the nurse prioritize in this aspect of nursing care?
- A. Monitoring the patients physiologic status
- B. Providing emotional support to family
- C. Maintaining the patients cognitive status
- D. Maintaining a clean environment
Correct Answer: A
Rationale: During the intraoperative phase, the nurse is responsible for physiologic monitoring. The intraoperative nurse cannot support the family at this time and the nurse is not responsible for maintaining the patients cognitive status. The intraoperative nurse maintains an aseptic, not clean, environment.
The surgical nurse is preparing to send a patient from the presurgical area to the OR and is reviewing the patients informed consent form. What are the criteria for legally valid informed consent? Select all that apply.
- A. Consent must be freely given
- B. Consent must be notarized
- C. Consent must be signed on the day of surgery
- D. Consent must be obtained by a physician
- E. Signature must be witnessed by a professional staff member
Correct Answer: A,D,E
Rationale: Valid consent must be freely given, without coercion. Consent must be obtained by a physician and the patients signature must be witnessed by a professional staff member. It does not need to be signed on the same day as the surgery and it does not need to be notarized.
The nurse admitting a patient who is insulin dependent to the same-day surgical suite for carpal tunnel surgery. How should this patients diagnosis of type 1 diabetes affect the care that the nurse plans?
- A. The nurse should administer a bolus of dextrose IV solution preoperatively
- B. The nurse should keep the patient NPO for at least 8 hours preoperatively
- C. The nurse should initiate a subcutaneous infusion of long-acting insulin
- D. The nurse should assess the patients blood glucose levels vigilantly
Correct Answer: D
Rationale: The patient with diabetes who is undergoing surgery is at risk for hypoglycemia and hyperglycemia. Close glycemic monitoring is necessary. Dextrose infusion and prolonged NPO status are contraindicated. There is no specific need for an insulin infusion preoperatively.
The nurse is performing a preadmission assessment of a patient scheduled for a bilateral mastectomy. Of what purpose of the preadmission assessment should the nurse be aware?
- A. Verifies completion of preoperative diagnostic testing
- B. Discusses and reviews patients health insurance coverage
- C. Determines the patients suitability as a surgical candidate
- D. Informs the patient of need for postoperative transportation
Correct Answer: A
Rationale: Purposes of preadmission testing (PAT) include verifying completion of preoperative diagnostic testing. The nurses role in PAT does not normally involve financial considerations or addressing transportation. The physician determines the patients suitability for surgery.
The nurse is teaching her to perform deep breathing and coughing to use postoperatively. What action should the nurse teach the patient?
- A. The patient should take three deep breaths and cough hard three times, at least every 15 minutes for the immediately postoperative period
- B. The patient should take three deep breaths and exhale forcefully and then take a quick short breath and cough from deep in the lungs
- C. The patient should take a deep breath in through the mouth and exhale through the mouth, take a short breath, and cough from deep in the lungs
- D. The patient should rapidly inhale, hold for 30 seconds or as long as possible, and exhale slowly
Correct Answer: C
Rationale: The patient assumes a sitting position to enhance lung expansion. The nurse then demonstrates how to take a deep, slow breath and how to exhale slowly. After practicing deep breathing several times, the patient is instructed to breathe deeply, exhale through the mouth, take a short breath, and cough from deep in the lungs.