!DOCTYPE html> 10-1. While preparing a patient who will be undergoing infiltration of local anesthesia, the nurse instructs the patient to report all of the following EXCEPT: a. Metallic taste in the mouth b. Tingling of the lips c. Ringing in the ears d. Sweet taste in the mouth 10-2. To help reduce the incidence of surgical site infections, the perianesthesia nurse can teach the preoperative patient simple principles to support lowering the risk. These include how to observe wounds, how to change dressings, how to clean wounds, and: a. To report excessive bleeding b. Knowledge of postoperative medications c. The importance of hand washing d. The need for adequate carbohydrate intake 10-3. Preoperative education for the patient contemplating bariatric surgery includes information about preparation and the surgical procedure itself. The education includes postoperative instructions related to: a. Diet, lifestyle changes, and potential complications b. Increasing dietary intake of carbohydrates to provide energy for healing c. Decreasing postoperative activity to minimize the risk of thrombophlebitis d. Prolonged fasting and bowel rest to promote wound healing 10-4. The advantages of using simulation for the clinical training of health care providers include all of the following EXCEPT: a. Mistakes do not harm patients b. Personnel can work with actual equipment c. Simulation scenarios can be simplified d. Role playing can help develop critical thinking 10-5. According to the American Society of Anesthesiologists’ (ASA’s) fasting guidelines, a healthy adult patient undergoing an elective procedure may be instructed to continue to consume clear liquids until: a. 2 hours preoperatively b. 4 hours preoperatively c. 6 hours preoperatively d. 8 hours preoperatively 10-6. A hospital is located in an area with a large population of immigrants. As a result of the wide diversity of patients cared for in the day surgery unit, the staff demonstrate competencies in: a. An additional language besides English b. Multigenerational thinking c. Cultural sensitivity d. Gender differences 10-7. According to the American Society of Anesthesiologists’ (ASA’s) fasting guidelines, a healthy 8-month-old patient undergoing an elective procedure may be instructed to continue to consume formula until: a. 2 hours preoperatively b. 4 hours preoperatively c. 6 hours preoperatively d. 8 hours preoperatively 10-8. When interviewing a patient for preanesthesia and nursing assessments, it is helpful to remember that generational differences affect an individual’s ability to learn and participate in care. The perianesthesia nurse knows that the patient who is born between 1980 and 2000 is known as: a. Generation W b. Generation Y c. Generation X d. Generation Z 10-9. Preoperatively patients may be instructed to hold the following medications on the day of surgery as determined by the surgeon or anesthesia provider: a. Beta blockers b. Anticonvulsants c. Oral hypoglycemic medications d. Chronic pain medications 10-10. The incidence of postoperative nausea and vomiting (PONV) is higher in the ophthalmic surgical patient than in other surgical procedures. The patient has asked for complementary therapy recommendations. The perianesthesia nurse is aware that the following therapy is very popular: a. Ginger b. St. John’s wort c. Licorice d. Ginseng 10-11. A family member notices a nurse’s name tag and the credentials “CAPA” on the tag. The perianesthesia nurse explains to the family that certification in perianesthesia nursing: a. Is a validation of specialty knowledge b. Is a validation of a specialty job description c. Is a validation of the clinical ladder d. Is a requirement of a magnet institution 10-12. Preoperative instructions should include information regarding the need to stop herbal supplements that can increase bleeding. These include the following EXCEPT: a. Feverfew b. Garlic c. Goldenseal d. Ginseng 10-13. Patient education is more effective when the content and methods are: a. Individualized for the patient and family b. Generic and scripted c. Standardized d. Incorporating medical and technical terminology 10-14. The goals of patient education are all of the following EXCEPT: a. Decreased anxiety b. Increased patient’s sense of self-worth c. Reduced facility liability d. Increased patient satisfaction scores 10-15. According to the American Society of Anesthesiologists’ (ASA’s), patients should be instructed to stop taking herbal medications: a. At least 3 days preoperatively b. Only on the day of surgery c. At least 7 days preoperatively d. At least 14 days preoperatively 10-16. Marvin is a 44-year-old patient who is scheduled for a surgical repair of a badly fractured patella sustained from a fall. He admits to a recent history of opioid-related drug abuse but states he has been “sober” for a few months. His urine drug screen from six days ago was negative. During the preparation for surgery he discloses his intention to “man up” and refuse any opioids for fear of relapse. The nurse in this situation tries to reassure the patient that: a. There is no research indicating that opioids for analgesia worsen the disease of addiction b. Opioids will be withheld to support detoxification and rehabilitation from drug abuse c. Providing opioids during acute pain will lead to decreased cravings for drugs of abuse d. Toleration of significant pain will strengthen a patient’s conviction to refrain from opioids 10-17. When teaching a patient to deep-breathe and cough after surgery, the nurse has the patient: a. Take a rapid deep breath and cough once as he or she lets the breath out quickly b. Take a rapid deep breath and cough multiple times as he or she lets the breath out at decreasing lung volumes c. Take slow deep breaths and cough once as he or she lets the breath out slowly d. Take slow deep breaths and cough multiple times as he or she lets the breath out quickly 10-18. Parents of a 7-year-old male patient who fell off the monkey bars at the playground and broke his left arm are anxious about his postoperative care. The patient will have a temporary cast after surgery (bright green, per patient’s request). When providing discharge instructions the perianesthesia nurse includes all of the following EXCEPT: a. Elevate the limb on pillows b. Once dry, apply dry heat to the cast to stimulate circulation c. Once dry, apply ice to the area of the fracture d. Avoid putting any objects between the cast and skin 10-19. A 42-year-old healthy male patient has undergone endoscopic sinus surgery, and in preparing for discharge, the nurse instructs the patient to: a. Notify the surgeon if having to change the mustache dressing more than once per hour b. Attempt to keep swallowing secretions c. Blow the nose gently with extreme caution d. Apply a heating pad to the frontal sinus area 10-20. Within 20 minutes of admission to the PACU after a uvulopalatopharyngoplasty, a previously responsive but drowsy patient is observed to have decreasing SpO2 and shallow respiratory effort. Prompt intervention includes which of the following? a. Draw up naloxone because the patient is overnarcotized b. Prepare for probable intubation with a size 8 endotracheal tube c. Stimulate the patient and prepare to apply continuous positive airway pressure d. Wake the patient to teach use of the incentive spirometer 10-21. It is a very busy day in the Phase II PACU area of a same-day surgery center. Staffing is adequate, but due to high patient complexity, the unlicensed assistive personnel (UAP) are supporting the RN staff. The RN can delegate all of the following activities to trained UAP EXCEPT: a. Provide a review of discharge instructions to the patient and family b. Collect a urine sample for laboratory studies c. Obtain and document vital signs d. Check a postoperative finger-stick blood glucose 10-22. The primary purpose of teaching a postoperative elective outpatient to “stay on top of their pain” is to: a. Prevent recurrence of the original source of pain b. Enhance the ability to meet functional goals c. Avoid having to call the surgeon for additional prescriptions d. Enhance the ability of the body to rest and heal 10-23. A 74-year-old female patient, anxious for a vacation cruise, has scheduled an elective blepharoplasty. Postoperative instructions for the patient will include the application of intermittent ice compresses, resuming a regular diet, and minimal bending or heavy lifting. The patient should also be instructed to avoid which of the following for the first 24 hours? a. Analgesics, as they will not be necessary b. Applying antibiotic ointment to the incisions c. Cold liquids with meals d. Hot liquids with meals 10-24. The best way to evaluate patient and family understanding of instructions given is: a. Ask if they understand the information b. Ask them to teach the information back to you c. Provide the patient and family with a written quiz based on the information given d. Have them sign an attestation form 10-25. An otherwise healthy 52-year-old male patient has just had a laparoscopic-assisted removal of a cancerous bowel lesion. Discharge teaching includes timely reporting of unresolved fevers, unrelieved pain, and nausea and vomiting. The nurse is aware that this information is MOST crucial to optimize patient outcomes and early identification of problems related to: a. Vascular injuries b. Neurologic injuries c. Bladder injuries d. Bowel injuries 10-26. Patient teaching regarding the proper method of instillation of eye drops includes all of the following EXCEPT: a. Wash hands before using the drops b. Rub the eyes gently to disperse the medication c. Tilt the head back with eyes open d. Pull down the tissue below the lower lid 10-27. Discharge instructions for most surgeries should include encouragement to contact a provider or go to the nearest emergency room for any of the following EXCEPT: a. Uncontrolled pain b. Heavier than expected bleeding c. Presence of a low grade fever d. Shortness of breath 10-28. Based on theories of growth and development, school-aged children: a. Experience separation anxiety b. Fear body mutilation c. Learn through play d. Have short attention spans 10-29. A 25-year-old female patient is being admitted for ear surgery. Knowing the procedure predisposes the patient to nausea and vertigo, the nurse instructs the patient in all of the following EXCEPT: a. Move slowly and avoid sudden, jerky movements b. Take slow, deep breaths through the mouth c. Sneeze with the mouth closed d. Prevent water in the ears 10-30. The BEST time to provide discharge instructions is: a. Just before discharge to enhance retention of information b. Just before going to the operating room to distract from the preop anxiety c. During the preoperative nursing assessment for early review d. During the postoperative follow-up visit with the surgeon 10-31. Following a total knee replacement, the patient arrives in the Phase I PACU with a wound drainage device in place. When teaching the family about the wound drainage, which of the following statements is true? a. Gravity devices are often used to prevent excess pressure to the wound b. Wound drainage blood loss should not exceed 500 mL in 8 hours c. Closed suction devices increase the risk of a hematoma d. Blood loss over the first hour can be 250-300 mL 10-32. A 75-year-old female patient is brought to the surgery center by her daughter for an outpatient biopsy of the left breast. The patient is a poor historian and was diagnosed with early dementia approximately 3 years ago. She still has recognition of her daughter and can easily follow commands. Her current deficit is short-term memory. The preoperative nurse includes the daughter in any postoperative teaching. With regard to pain assessment in the cognitively impaired, all of the following tips are useful EXCEPT: a. Attempt to obtain the patient’s self-report b. If the procedure is assumed to be painful, assume the person has pain c. Limit the number of questions about pain to avoid suggestion d. Look for nonverbal signs of pain like crying, restlessness, and increased agitation 10-33. The HIGHEST order of participation in perianesthesia patient teaching is a function of: a. Ethical practice b. Performance improvement c. Regulatory requirements d. Preemptive problem solving 10-34. Patients undergoing peripheral nerve blocks should be instructed on all of the following EXCEPT: a. The expected length of the blockade b. Support of the extremity while moving due to impaired muscle control c. Avoidance of smoking and handling hot liquids until the block has resolved d. Application of continuous ice to prevent thermal injury 10-35. Which of the following descriptions does NOT generally apply to the learning style of an adult? a. Self-directed b. Relies on experience c. Problem centered d. Tactile oriented 10-36. To help prevent surgical site infection, the patient should be instructed to avoid: a. Showering or bathing with an antibacterial soap before the procedure
Patient and Family Education
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