Nokea
The nurse is preparing a patient for surgery. Which of the following information about medication use is most important for the nurse to communicate to the health care provider?
- A. The patient uses acetaminophen occasionally for aches and pains.
- B. The patient takes garlic capsules daily but did not take any on the surgical day.
- C. The patient has a history of cocaine use but quit using the drug over 10 years ago.
- D. The patient took a sedative medication the previous night to assist in falling asleep.
Correct Answer: B
Rationale: Persistent use of garlic may predispose to intraoperative and postoperative bleeding. The use of a sedative the previous night, occasional acetaminophen use, and a distant history of cocaine use will not usually affect the surgical outcome.
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The nurse is admitting a female patient for an outpatient surgery procedure. Which of the following information is most important to report to the anaesthesiologist before surgery?
- A. The patient's lack of knowledge about postoperative pain control measures
- B. The patient's statement that her last menstrual period was 8 weeks previously
- C. The patient's history of a postoperative infection following a prior cholecystectomy
- D. The patient's concern that she will be unable to care for her children postoperatively
Correct Answer: B
Rationale: This statement suggests that the patient may be pregnant, and pregnancy testing is needed before administration of anaesthetic agents. Although the other data also may be communicated with the surgeon and anaesthesiologist, they will affect postoperative care and do not indicate a need for further assessment before surgery.
The nurse is analyzing a patient's preoperative blood studies. Which of the following blood studies should the nurse review to assess for anemia and infection in a patient with no known health problems?
- A. Red blood cell count
- B. White blood cell count
- C. Serum potassium
- D. Hematocrit
- E. Prothrombin (INR) time
Correct Answer: A,B,D
Rationale: Preoperative blood studies for assessing anemia, immune status, and infection include RBC, Hgb, Hct, platelets, WBC, and WBC differential. Prothrombin (INR) time would be used to assess bleeding tendencies. Serum potassium would not be assessed as part of anemia or infection but would be assessed in a patient who is taking a diuretic.
According to the ASA Physical Status Classification System, which of the following assessments is consistent with a rating of ASA III?
- A. Persistent asthma, controlled with an inhaler and corticosteroids
- B. Poorly controlled asthma and is wheezing
- C. Is in status asthmaticus and on a ventilator
- D. Has no significant health problems
Correct Answer: A
Rationale: A patient assessed as a rating of III on the ASA Physical Status Classification System has a history of persistent asthma controlled with β-adrenergic agonist inhaler and inhaled corticosteroids and is not wheezing. Poorly controlled asthma and wheezing is a rating of IV. No significant health problems, past or present, is a rating of I. A patient in status asthmaticus, intubated and on a ventilator, receiving corticosteroids intravenously, is rated as a V.
Which of the following topics is most important for the nurse to discuss preoperatively with a patient who is scheduled for a colon resection?
- A. Care for the surgical incision
- B. Medications used during surgery
- C. Deep-breathing and coughing techniques
- D. Oral antibiotic therapy after discharge home
Correct Answer: C
Rationale: Preoperative teaching, demonstration, and redemonstration of deep breathing and coughing are needed on patients having abdominal surgery to prevent postoperative atelectasis. Incisional care and the importance of completing antibiotics are better discussed after surgery, when the patient will be more likely to retain this information. The patient does not usually need information about medications that are used intraoperatively.
The nurse is preparing to administer atropine to a patient before surgery. Which of the following symptoms should the nurse teach the patient to expect?
- A. Dizziness
- B. Weakness
- C. Dry mouth
- D. Forgetfulness
Correct Answer: C
Rationale: Anticholinergic medications decrease oral and respiratory secretions, so the patient is taught that a dry mouth is an expected adverse effect. Weakness, forgetfulness, and dizziness are adverse effects associated with other preoperative medications such as opioids and benzodiazepines.