Preoperative
What should the nurse do if a patient scheduled for surgery is taking aspirin 325 mg daily?
B. Discontinue aspirin 48 hours before surgery
What type of surgery is indicated for a patient with a severe bleeding injury?
Emergent
An older adult patient is scheduled for surgery. Considering the patient's reduced physiological reserve, which preoperative assessment is most critical to prevent perioperative complications?
When is informed consent not required before a surgical procedure?
Five minutes after receiving the ordered preoperative midazolam (Versed) by IV injection, the
patient asks to get up to go to the bathroom to urinate. Which action by the nurse is most
appropriate?
a. Assist the patient to the bathroom and stay with the patient to prevent falls.
b. Offer a urinal or bedpan and position the patient in bed to promote voiding.
c. Allow the patient up to the bathroom because medication onset is 10 minutes.
d. Ask the patient to wait because catheterization is performed just before the
surgery
ANS: B
The patient will be at risk for a fall after receiving the sedative, so the best nursing action is to
have the patient use a bedpan or urinal. Having the patient get up either with assistance or
independently increases the risk for a fall. The patient will be uncomfortable and risk
involuntary incontinence if the bladder is full during transport to the operating room
Which of the following is NOT a requirement for obtaining valid informed consent for a non-emergent surgical procedure?
Which surgery classification is appropriate for a patient with acute gallbladder infection requiring surgery within 24-30 hours?
Urgent
Which of the following is a common but often undiagnosed complication in older adults following major surgery?
Delirium is a common postoperative complication in older adults that is often undiagnosed. It can significantly impact recovery and overall outcomes
At what reading level should consent materials be written to meet health literacy requirements?
The nurse plans to provide preoperative teaching to an alert older man who has hearing and
vision deficits. His wife usually answers most questions that are directed to the patient. Which
action should the nurse take when doing the teaching?
a. Use printed materials for instruction so that the patient will have more time to review the material.
b. Direct the teaching toward the wife because she is the obvious support and
caregiver for the patient.
c. Provide additional time for the patient to understand preoperative instructions and
carry out procedures.
d. Ask the patient’s wife to wait in the hall in order to focus preoperative teaching
with the patient himself
ANS: C
The nurse should allow more time when doing preoperative teaching and preparation for older
patients with sensory deficits. Because the patient has visual deficits, he will not be able to use
written material for learning. The teaching should be directed toward both the patient and the
wife because both will need to understand preoperative procedures and teaching
What is a significant concern for diabetic patients who are NPO (nothing by mouth) before surgery?
A. Potential hypoglycemia during surgery
In an emergency surgery situation, what is a critical step if the patient is unconscious?
B. Obtain informed consent from a family member
What is the primary reason why obese patients tend to experience shallow respirations when supine, and what postoperative complication does this increase the risk for?
Decreased diaphragmatic movement; risk of hypoventilation
What is the role of the nurse regarding the informed consent process?
A patient who has diabetes and uses insulin to control blood glucose has been NPO since
midnight before having a knee replacement surgery. Which action 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. Give the patient 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
ANS: B
Preoperative insulin administration is individualized to the patient, and the current blood
glucose will provide the most reliable information about insulin needs. It is not possible to
predict whether the patient will require no insulin, a lower dose, or a higher dose without
blood glucose monitoring.
Why is assessing a patient's nutritional and fluid status important before surgery?
A patient is diagnosed with acute kidney stones causing severe pain and obstruction. What classification of surgery is indicated, and within what timeframe should it be performed?
B. Urgent, within 24-30 hours.
For a patient with hearing impairments, what is an essential consideration for effective communication during the perioperative period?
Which herbal supplement can prolong the effects of anesthesia and affect blood pressure during surgery?
Which information in the preoperative patient’s medication history is most important to
communicate to the health care provider?
a. The patient uses acetaminophen (Tylenol) 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.
ANS: B
Chronic 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
When caring for a preoperative patient on the day of surgery, which actions included in the
plan of care can the nurse delegate to unlicensed assistive personnel (UAP)? (Select all that
apply.)
a. Teach incentive spirometer use. d. Remove nail polish and apply pulse
oximeter.
b. Explain preoperative routine care. e. Transport the patient by stretcher to
the operating room.
c. Obtain and document baseline vital signs.
ANS: C, D, E
Obtaining vital signs, removing nail polish, pulse oximeter placement, and transport of the
patient are routine skills that are appropriate to delegate. Teaching patients about the
preoperative routine and incentive spirometer use require critical thinking and should be done
by the registered nurse.
A patient needs surgery to remove cataracts. Which category does this fall into, and why is timely surgery recommended?
C. Required, to improve quality of life within a few weeks or months.
Obesity increases the risk and severity of complications associated with surgery. Which of the following complications is most directly linked to the presence of fatty tissues in obese patients?
A nurse is preparing a patient for surgery. The patient has already signed the informed consent form. However, the patient expresses that they did not fully understand the risks and benefits of the procedure. What is the nurse’s best course of action?
The outpatient surgery nurse reviews the complete blood cell (CBC) count results for a patient
who is scheduled for surgery in a few days. The results are white blood cell (WBC) count 10.2
´ 103/µL; hemoglobin 15 g/dL; hematocrit 45%; platelets 150 ´ 103/µL. Which action should
the nurse take?
a. Call the surgeon and anesthesiologist immediately.
b. Ask the patient about any symptoms of a recent infection.
c. Discuss the possibility of blood transfusion with the patient.
d. Send the patient to the holding area when the operating room calls
ANS: D
The CBC count results are normal. With normal results, the patient can go to the holding area
when the operating room is ready for the patient. There is no need to notify the surgeon or
anesthesiologist, discuss blood transfusion, or ask about recent infection.