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The nurse is providing preoperative teaching to a patient who is scheduled for surgery in 3 days. Which of the following information should the nurse include when addressing preoperative sensory information?
- A. Warming blankets are available as the operating room is often cold
- B. Lighting in the operating room is low that may cause the patient to have blurred vision.
- C. The operating room bed is narrow and a safety strap is used to secure the patient to the bed.
- D. Not to be alarmed by the quiet environment as there is no conversation in the operating room.
- E. Machines may be making 'ticking and pinging noises' that can be heard.
Correct Answer: A,C,E
Rationale: When providing preoperative teaching related to sensory information the nurse should include that warming blankets will be available as the operating room is often cold, a safety strap will be applied over the patients knees as the operating room bed is narrow, and the operating room machines make noises that the patient may hear when they are awake. Lighting in the OR is very bright, not dull although the patient may have blurred vision related to the preoperative medication it would not be related to the OR. Talking may be heard in the OR but is often distorted because of the masks and patients should be directed to ask any questions that they may have.
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The nurse is conducting a preoperative interview with a patient who is scheduled for an elective hysterectomy and the patient tells the nurse, 'I am afraid that I will die in surgery like my mother did!' Which of the following responses by the nurse is most appropriate?
- A. Tell me more about what happened to your mother.
- B. You will receive medications to reduce your anxiety.
- C. You should talk to the doctor again about the surgery.
- D. Surgical techniques have improved a lot in recent years.
Correct Answer: A
Rationale: The patient's statement may indicate an unusually high anxiety level or a family history of problems such as malignant hyperthermia, which will require precautions during surgery. The other statements also may address the patient's concerns, but further assessment is needed first.
On the day of surgery, the nurse is admitting a patient with a history of cigarette smoking. Which of the following actions is most important at this time?
- A. Auscultate for adventitious breath sounds.
- B. Ask whether the patient has smoked recently.
- C. Remind the patient about harmful effects of smoking.
- D. Calculate the cigarette smoking history in pack-years.
Correct Answer: A
Rationale: Abnormal breath sounds may indicate the presence of an acute respiratory infection or persistent lung disease that will affect the choice of anaesthesia or proceeding with the scheduled surgery. The other nursing actions also are appropriate but will not affect the immediate surgical procedure as much as the presence of abnormal breath sounds.
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.
A patient who is scheduled for surgery in a week tells the nurse doing the preoperative assessment about an allergy to bananas, kiwfruit, and latex products. Which of the following actions is most important for the nurse to take?
- A. Notify the dietitian about the food allergies.
- B. Alert the surgery centre about the latex allergy.
- C. Reassure the patient that all allergies are noted on the medical record.
- D. Ask whether the patient uses antihistamines to reduce allergic reactions.
Correct Answer: B
Rationale: When a patient is allergic to latex, special nonlatex materials are used during surgical procedures and the staff will need to know about the allergy in advance to obtain appropriate nonlatex materials and have them available on the surgical date. The other actions also may be appropriate, but prevention of allergic reaction (either contact dermatitis or anaphylaxis) during surgery is the most important action.
The nurse is caring for a patient with diabetes who is scheduled for a mastectomy at 1:00 PM today and it is now 8:30 AM. The patient uses insulin to control blood glucose and has been NPO since midnight. Which of the following actions should the nurse take?
- A. Withhold the usual scheduled insulin dose because the patient is NPO.
- B. Obtain a blood glucose measurement before any insulin administration.
- C. Administer the usual insulin dose because stress will increase the blood glucose.
- D. Administer a lower dose of insulin because there will be no oral intake before surgery.
Correct Answer: B
Rationale: Preoperative insulin administration is individualized to the patient, and the current blood glucose will provide the most reliable information about insulin needs. It Sp?³??