MS 17 Nclex - Prep for Med Surg Exam 1 PDF

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Prep for Med Surg Exam 1...

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Lewis: Medical-Surgical Nursing, 10th Edition Chapter 17 Rationales for Bridge to NCLEX® Examination questions

1. Correct answer: a Rationale: Many operative procedures are performed as ambulatory surgery (i.e., same-day or outpatient surgery). Obesity is not a contraindication to surgery in the outpatient setting. This patient is not classified as obese on the basis of the BMI. The case implied that a laparoscopic technique will be used that involves several small incisions and meets the requirement of a minimally invasive technique.

2. Correct answer: b Rationale: The nurse should ask additional screening questions to determine the patient’s risk for a latex allergy. Latex precaution protocols should be used for patients identified as having a positive latex allergy test result or a history of signs and symptoms related to latex exposure. Many health care facilities have created latex-free product carts that can be used for patients with latex allergies.

3. Correct answer: a Rationale: Ginkgo can increase bleeding during and after surgery. The surgeon should determine how long it should be discontinued before surgery.

4. Correct answer: a Rationale: An emancipated minor may sign his or her own permit. The nurse should be available to witness the signature, but no further action is required.

5. Correct answer: d Rationale: If a patient has fear of pain and discomfort after surgery, the nurse should reassure the patient that a pain management plan will be in place. The nurse should teach the patient to

ask for medications after surgery when pain is present and assure him or her that taking these medications will not contribute to an addiction. The nurse should instruct the patient on the use of some form of pain rating scale (e.g., 0 to 10, FACES) and to request pain medication before the pain becomes severe.

6. Correct answer: c Rationale: The nothing-by-mouth (NPO) protocol of each surgical facility should be followed. Restriction of fluids and food is designed to minimize the potential risk of pulmonary aspiration and to decrease the risk of postoperative nausea and vomiting. If a patient has not followed the NPO instructions, surgery may be delayed or cancelled. The nurse should notify the anesthesia care provider immediately.

7. Correct answer: b Rationale: Insulin is not usually omitted completely. The patient should obtain instructions from her HCP or surgeon about any dosage adjustments that she should make the day before and the morning of surgery (if applicable).

8. Correct answers: c, d Rationale: Many older adults have sensory deficits. Preoperative and operating rooms are cool; warm blankets should be provided as needed....