Lemone/Burke/Bauldoff, Medical-Surgical Nursing 6Th Edition Test Bank

LeMone/Burke/Bauldoff, Medical-Surgical Nursing 6th Edition Test Bank
Chapter 4
Question 1
Type: MCSA
A patient tells the nurse that he must be having minor surgery since it will be done as an outpatient. How should
the nurse respond to this patient?
1. “Every surgical procedure is serious, and I will make sure you have information to have a successful recovery.”
2. “You are right.”
3. “If it were more serious, you would be admitted to the hospital.”
4. “Your insurance plan does not cover inpatient surgical procedures. That’s why your surgery is being done as an
outpatient.”
Correct Answer: 1
Rationale 1: The complexity of the surgery and recovery and the expected level of care needed on completion of
the surgery are the major differences between inpatient and outpatient surgical procedures. The outpatient surgical
patient and family must cope with the additional stress of needing to learn a great deal of information in a short
span of time. The nurse should explain that every surgical procedure is serious and that the patient will be given
information to have a successful recovery.
Rationale 2: The nurse should not agree with the patient about outpatient surgery being minor.
Rationale 3: The nurse does not know if the patient needs to be admitted to the hospital.
Rationale 4: The nurse does not have enough information about the patient’s insurance coverage to make the
statement about the patient having surgery as an outpatient.
Global Rationale: The complexity of the surgery and recovery and the expected level of care needed on
completion of the surgery are the major differences between inpatient and outpatient surgical procedures. The
outpatient surgical patient and family must cope with the additional stress of needing to learn a great deal of
information in a short span of time. The nurse should explain that every surgical procedure is serious and that the
patient will be given information to have a successful recovery. The nurse should not agree with the patient about
outpatient surgery being minor. The nurse does not know if the patient needs to be admitted to the hospital. The
nurse does not have enough information about the patient’s insurance coverage to make the statement about the
patient having surgery as an outpatient.
Cognitive Level: Applying

Client Need: Physiological Integrity
Client Need Sub: Reduction of Risk Potential
QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient centered care
LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank

Copyright 2015 by Pearson Education, Inc.
AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding
of human growth and development, pathophysiology, pharmacology, medical management and nursing
management across the health-illness continuum, across lifespan, and in all healthcare settings
NLN Competencies: Relationship Centered Care; Practice; Communicate information effectively; listen openly
and cooperatively
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 1. Compare the differences and similarities between outpatient and inpatient surgery.
MNL Learning Outcome:
Page Number: 50
Question 2
Type: MCSA
A patient scheduled for outpatient surgery asks the nurse why he will not be admitted to the hospital for the
surgery. What should the nurse explain as an advantage of having outpatient surgery?
1. reduced risk of healthcare-associated infections
2. ability to use home care for postoperative care in the home
3. reduced use of postoperative medications
4. inadequate staffing on the surgical care areas
Correct Answer: 1
Rationale 1: Advantages to outpatient surgery include a reduced risk of healthcare-associated infections.
Rationale 2: The patient may or may not have home care for postoperative care in the home.
Rationale 3: There is no evidence to suggest that patients who have outpatient surgery use fewer postoperative
medications.
Rationale 4: Saying that staffing on the surgical care areas is inadequate would be inappropriate.
Global Rationale: Advantages to outpatient surgery include a reduced risk of healthcare-associated infections.
The patient may or may not have home care for postoperative care in the home. There is no evidence to suggest
that patients who have outpatient surgery use fewer postoperative medications. Saying that staffing on the surgical
care areas is inadequate would be inappropriate.

NLN Competencies: Relationship Centered Care; Practice; Communicate information effectively; listen openly
and cooperatively
Page Number: 50
Question 3
Type: MCMA
The nurse is preparing to discharge a patient after having outpatient surgery. Which criteria should the nurse use
to determine whether the patient is eligible to be discharged?
Standard Text: Select all that apply.
1. stable vital signs
2. no nausea or dizziness
3. pain controlled
4. adequate urine output
5. patient’s expressed readiness to go home
Correct Answer: 1,2,3,4
Rationale 1: Following outpatient surgery, the patient will be discharged after meeting the institution’s criteria,
which typically include tolerance of fluids or food, stable vital signs, absence of nausea or dizziness, pain control,
adequate urine output, as well as patient being oriented and demonstrating understanding of postoperative
instructions.
instructions.
instructions.

instructions.
Rationale 5: The patient’s expressing readiness to go home is not a criterion that would make him or her eligible
for discharge after outpatient surgery.
Global Rationale Following outpatient surgery, the patient will be discharged after meeting the institution’s
criteria, which typically include tolerance of fluids or food, stable vital signs, absence of nausea or dizziness, pain
control, adequate urine output, as well as patient being oriented and demonstrating understanding of postoperative
instructions. The patient’s expressing readiness to go home is not a criterion that would make him or her eligible
for discharge after outpatient surgery.
Cognitive Level: Analyzing

AACN Essentials Competencies: IX.10. Facilitate patient-centered transitions of care, including discharge
planning and ensuring the caregiver’s knowledge of care requirements to promote safe care
NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health
assessments and interventions
Nursing/Integrated Concepts: Nursing Process: Assessment
Page Number: 51

Question 4
Type: MCSA
The nurse in the same-day surgical care area is preparing a patient for surgery. What should the nurse do to ensure
that this patient has a successful recovery from the surgery?
1. Provide teaching and additional resources to help the patient when at home.
2. Measure intake and output.
3. Assess vital signs.
4. Limit pain control measures since the patient will need to ambulate when leaving after the surgery.
Correct Answer: 1
Rationale 1: The major differences between inpatient and outpatient care lie in the degree of teaching and
emotional support that are necessary for outpatient surgical patients and their families. The degree of teaching that
is necessary for outpatient surgical patients and their families is greater than for postoperative patients who
recover as inpatients.
Rationale 2: The nurse may or may not need to measure the patient’s intake and output.

Rationale 3: The nurse will assess all surgical patients’ vital signs.
Rationale 4: The nurse should ensure the patient’s pain is controlled and not limit pain medication.
Global Rationale: The major differences between inpatient and outpatient care lie in the degree of teaching and
emotional support that are necessary for outpatient surgical patients and their families. The degree of teaching that
is necessary for outpatient surgical patients and their families is greater than for postoperative patients who
recover as inpatients. The nurse may or may not need to measure the patient’s intake and output. The nurse will
assess all surgical patients’ vital signs. The nurse should ensure the patient’s pain is controlled and not limit pain
medication.

AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage,
age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in
their care
NLN Competencies: Relationship Centered Care; Practice; learn cooperatively, facilitate the learning of others
Page Number: 51
Question 5
Type: MCSA
The nurse is providing care to a patient during the preoperative phase of surgery. Which of the following
interventions would be appropriate for the nurse to provide during this time?
1. assisting with bathing
2. patient safety
3. assessing level of consciousness
4. monitoring intake and output
Correct Answer: 1
Rationale 1: During the preoperative phase of surgical care, the nurse will assist the patient physically become
ready for the surgery. This may include assisting with bathing.
Rationale 2: Patient safety is an intervention for the nurse during the intraoperative phase of surgical care.
Rationale 3: Assessing level of consciousness is an intervention for the postoperative phase of surgical care.

Rationale 4: Monitoring intake and output is an intervention for the postoperative phase of surgical care.
Global Rationale: During the preoperative phase of surgical care, the nurse will assist the patient physically
become ready for the surgery. This may include assisting with bathing. Patient safety is an intervention for the
nurse during the intraoperative phase of surgical care. Assessing level of consciousness and monitoring intake and
output are interventions for the postoperative phase of surgical care.

QSEN Competencies: I.A.3. Provide patient-centered care with sensitivity and respect for the diversity of human
experience
Learning Outcome: 2. Identify the three phases of perioperative care.
Page Number: 69
Question 6
Type: MCSA
A patient was instructed on exercises to perform as part of preoperative teaching. While recovering from surgery,
the patient experiences a deep vein thrombosis (DVT). Which preoperative exercise should the nurse identify as
not having been effective for this patient?
1. leg exercises
2. deep breathing and coughing
3. use of incentive spirometry
4. splinting when coughing
Correct Answer: 1
Rationale 1: The preoperative patient is taught leg exercises in order to reduce the onset of the complication deep
vein thrombosis.
Rationale 2: Deep breathing and coughing are helpful to prevent complications of pneumonia and atelectasis.
Rationale 3: Use of incentive spirometry is helpful to prevent complications of pneumonia and atelectasis.

Rationale 4: Splinting when coughing is taught so that thoracic and abdominal incisions are maintained and
protected from an increase in intra-abdominal pressure that occurs when coughing.
Global Rationale: The preoperative patient is taught leg exercises in order to reduce the onset of the
complication deep vein thrombosis (DVT). In this case, the leg exercises were ineffective and did not prevent
DVT from occurring. Deep breathing and coughing and use of incentive spirometry are helpful to prevent
complications of pneumonia and atelectasis. Splinting when coughing is taught so that thoracic and abdominal
incisions are maintained and protected from an increase in intra-abdominal pressure that occurs when coughing.

experience
MNL Learning Outcome: 6.3.1. Explain the incidence, risk factors, and pathophysiology for arterial and venous
occlusive diseases.
Page Number: 67
Question 7
Type: MCSA
The nurse is assessing a patient who has returned to the care area after surgery. What should the nurse do to
ensure the patient receives appropriate care?
1. Check the physician’s orders to see if preoperative orders have been reordered.
2. Schedule the patient for vital signs assessments every four hours.
3. Orient the patient to person, place, and time.
4. Assess the patient’s mental status.
Correct Answer: 1
Rationale 1: The nurse needs to check the patient’s medical record to ensure that all orders written before surgery
have been reordered after surgery, since the patient’s condition has changed.
Rationale 2: Even though vital signs should be assessed according to hospital policy, the frequency of a
postoperative patient’s vital signs assessment will be more frequent than every four hours.

Rationale 3: Orienting the patient to person, place, and time, is an activity of the PACU nurse.
Rationale 4: Assessing the patient’s mental status is an activity of the PACU nurse.
Global Rationale: The nurse needs to check the patient’s medical record to ensure that all orders written before
surgery have been reordered after surgery, since the patient’s condition has changed. Even though vital signs
should be assessed according to hospital policy, the frequency of a postoperative patient’s vital signs assessment
will be more frequent than every four hours. Orienting the patient to person, place, and time, and assessing the
patient’s mental status are activities of the PACU nurse.

experience
Page Number: 70

Question 8
Type: MCSA
After providing a patient with a preoperative sedative, the nurse notes that the surgical consent form has not been
signed by the patient. What should the nurse do?
1. Contact the surgeon.
2. Ask the patient to sign the consent form.
3. Send the patient for surgery with an unsigned consent form.
4. Phone the operating room suite to notify the nurse that the patient has not signed the consent form.
Correct Answer: 1
Rationale 1: The patient should be aware and alert before signing the consent form. The nurse should contact the
surgeon in the event the patient receives preoperative sedative medication and has not yet signed the consent for
surgery form. The surgeon who performs a procedure is responsible for obtaining the patient’s consent for care.
Rationale 2: The nurse should not ask the patient to sign the consent form if the patient is under the influence of a
sedative.

Rationale 3: The nurse should not send the patient for surgery with an unsigned consent form.
Rationale 4: The nurse should not phone the operating room suite to notify the nurse that the patient has not
signed the consent form.
Global Rationale: The patient should be aware and alert before signing the consent form. The nurse should
contact the surgeon in the event the patient receives preoperative sedative medication and has not yet signed the
consent for surgery form. The surgeon who performs a procedure is responsible for obtaining the patient’s consent
for care. The nurse should not ask the patient to sign the consent form if the patient is under the influence of a
sedative. The nurse should not send the patient for surgery with an unsigned consent form. The nurse should not
phone the operating room suite to notify the nurse that the patient has not signed the consent form.

Client Need: Safe and Effective Care Environment
Client Need Sub: Management of Care
QSEN Competencies: I.B.10. Engage patients or designated surrogates in active partnerships that promote
health, safety and well-being, and self-care management
AACN Essentials Competencies: II.7. Promote factors that create a culture of safety and caring
NLN Competencies: Quality and Safety; Knowledge; Factors that contribute to a systemwide safety culture; the
importance of reporting hazards and adverse events; the "just culture" approach to system improvement
Page Number: 51
Question 9
Type: MCSA
A patient being prepared for surgery has been diagnosed with dehydration. Which laboratory values support the
diagnosis for this patient?
1. hemoglobin and hematocrit
2. glucose
3. white blood cell count
4. platelet count
Correct Answer: 1
Rationale 1: An increase in hemoglobin and hematocrit levels would indicate dehydration.
Rationale 2: An alteration in glucose level could indicate impaired glucose metabolism or inadequate glucose
level.

Rationale 3: An alteration in white blood cell count could indicate an infection or immune deficiencies.
Rationale 4: An alteration in platelet count could indicate a malignancy or clotting deficiency disorder.
Global Rationale: An increase in hemoglobin and hematocrit levels would indicate dehydration. An alteration in
glucose level could indicate impaired glucose metabolism or inadequate glucose level. An alteration in white
blood cell count could indicate an infection or immune deficiencies. An alteration in platelet count could indicate
a malignancy or clotting deficiency disorder.

AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for
managing the acute and chronic care of patients and promoting health across the lifespan
NLN Competencies: Context and Environment; Knowledge; Read and interpret data
Learning Outcome: 3. Interpret the significance of data used in the perioperative period to determine the
patient’s health status and risk profile.
MNL Learning Outcome: 1.1.2. Differentiate the manifestations of fluid imbalances.
Page Number: 57

Question 10
Type: MCSA
A patient diagnosed with emphysema is being prepared for surgery. What laboratory value should the nurse
review to obtain information about the patient’s respiratory status?
1. carbon dioxide
2. white blood cell count
3. serum creatinine
4. blood urea nitrogen
Correct Answer: 1
Rationale 1: The carbon dioxide level will be elevated in a patient with emphysema. This is the laboratory value
that would provide information about the patient’s respiratory status.
Rationale 2: The white blood cell count would provide information regarding an infection or immune deficiency.
Rationale 3: The serum creatinine level provides information about the patient’s renal status.
Rationale 4: The blood urea nitrogen level also provides information about the patient’s renal status.
Global Rationale: The carbon dioxide level will be elevated in a patient with emphysema. This is the laboratory
value that would provide information about the patient’s respiratory status. White blood cell count would provide
information regarding an infection or immune deficiency. The serum creatinine and blood urea nitrogen levels
provide information about the patient’s renal status.

AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the
acute and chronic care of patients and promoting health across the lifespan
Learning Outcome: 3. Interpret the significance of data used in the perioperative period to determine the patient’s health
status and risk profile.
MNL Learning Outcome: 5.9.2. Differentiate the manifestations and diagnostic tests of chronic obstructive pulmonary
disease.
Page Number: 57

Question 11
Type: MCSA
An older adult patient being prepared for surgery is scheduled for an electrocardiogram. What should the nurse
explain to the patient regarding the purpose of this test?
1. It is routine for all patients having general anesthesia.
2. It is used to diagnose preexisting cardiac disease.
3. It is one way to validate laboratory values
4. It is a predictor of surgical procedure success.
Correct Answer: 1
Rationale 1: An electrocardiogram (ECG) is ordered routinely for patients undergoing general anesthesia when
they are over 40 years of age or have cardiovascular disease.
Rationale 2: The electrocardiogram might detect preexisting cardiac disease but will not diagnose disease.
Rationale 3: The electrocardiogram will not validate laboratory values.
Rationale 4: The electrocardiogram is not used to predict the success of surgical procedures.
Global Rationale: An electrocardiogram (ECG) is ordered routinely for patients undergoing general anesthesia
when they are over 40 years of age or have cardiovascular disease. The electrocardiogram might detect
preexisting cardiac disease but will not diagnose disease. The electrocardiogram will not validate laboratory
values and is not used to predict the success of surgical procedures.
MNL Learning Outcome: 6.9.4. Compare the steps when analyzing a client’s cardiac rhythm.
Page Number: 57
Question 12
Type: MCSA
An older patient, being prepared for surgery, has a low glomerular filtration rate. Which aspect of the patient’s
care should the nurse realize this finding will impact?
1. medication dosages
2. postoperative activity level
3. intraoperative bleeding
4. oxygenation status
Correct Answer: 1
Rationale 1: Older adults are susceptible to renal insufficiency, which puts them at risk for accumulation of
metabolic by-products and medications dependent on renal clearance. Medication dosages will need to be
adjusted for the older patient with a low glomerular filtration rate.
Rationale 2: The glomerular filtration rate will not impact the patient’s postoperative activity level.
Rationale 3: The glomerular filtration rate will not impact the amount of intraoperative bleeding.
Rationale 4: The glomerular filtration rate will not impact the patient’s oxygenation status.
Global Rationale: Older adults are susceptible to renal insufficiency, which puts them at risk for accumulation of
metabolic by-products and medications dependent on renal clearance. Medication dosages will need to be
adjusted for the older patient with a low glomerular filtration rate. The glomerular filtration rate will not impact
the patient’s postoperative activity level, amount of intraoperative blooding, or oxygenation status.

AACN Essentials Competencies: IX.19. Manage the interaction of multiple functional problems affecting
patients across the lifespan, including common geriatric syndromes
NLN Competencies: Context and Environment; Knowledge; Read and interpret data;
Nursing/Integrated Concepts: Nursing Process: Planning
MNL Learning Outcome: 12.3.3. Examine the diagnosis and treatment of kidney disorders.
Page Number: 57-58
Question 13
Type: MCSA
A patient is scheduled for total hip replacement surgery. What medication should the nurse provide to the patient
prior to the surgical procedure?
1. antibiotic
2. antacid
3. antiemetic
4. anticholinergic
Correct Answer: 1
Rationale 1: Antibiotics are given preoperatively to orthopedic patients to prevent postoperative infections.
Rationale 2: Antacids increase the gastric pH and reduce the volume of gastric fluid.
Rationale 3: Antiemetics enhance gastric emptying.
Rationale 4: Anticholinergics reduce oral and respiratory secretions to decrease the risk of aspiration and
vomiting.
Global Rationale: Antibiotics are given preoperatively to orthopedic patients to prevent postoperative infections.
Antacids increase the gastric pH and reduce the volume of gastric fluid. Antiemetics enhance gastric emptying.
Anticholinergics reduce oral and respiratory secretions to decrease the risk of aspiration and vomiting.

Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care
AACN Essentials Competencies: IX. 8. Implement evidence-based nursing interventions as appropriate for
NLN Competencies: Quality and Safety; Knowledge; Current best practices
Learning Outcome: 4. Explain nursing implications for medications prescribed for the surgical patient.
MNL Learning Outcome: 8.3.3. Examine the diagnosis and treatment of degenerative disorders.
Page Number: 58
Question 14
Type: MCSA
A patient received lorazepam (Ativan) as preoperative medication. What should the nurse assess when caring for
this patient?
1. respiratory depression
2. nausea and vomiting
3. confusion
4. rash
Correct Answer: 1
Rationale 1: For the patient who received lorazepam (Ativan), the nurse should monitor for respiratory
depression, hypotension, lack of coordination, and drowsiness.
Rationale 2: Nausea and vomiting is not associated with the use of lorazepam (Ativan).
Rationale 3: Confusion is not associated with the use of lorazepam (Ativan).
Rationale 4: Rash is not associated with the use of lorazepam (Ativan).
Global Rationale: For the patient who received lorazepam (Ativan), the nurse should monitor for respiratory
depression, hypotension, lack of coordination, and drowsiness. Nausea and vomiting, confusion, and rash are not
associated with the use of lorazepam (Ativan).

MNL Learning Outcome: 5.14.4. Utilize the nursing process in care of client.
Page Number: 58


Question 15
Type: MCSA
A patient with a history of sleep apnea is experiencing difficulty maintaining an airway during conscious sedation.
What should the nurse do to assist this patient?
1. Prepare to administer a reversal agent.
2. Begin artificial ventilations.
3. Measure oxygen saturation.
4. Apply prescribed oxygen via face mask.
Correct Answer: 1
Rationale 1: Patients with a history of sleep apnea may have difficulty with conscious sedation. The nurse should
prepare to administer a reversal agent to the patient.
Rationale 2: The patient may or may not need artificial ventilations at this time.
Rationale 3: The nurse should have been measuring the patient’s oxygen saturation throughout the procedure.
Rationale 4: The patient is having difficulty maintaining an airway so applying oxygen via face mask may not be
appropriate.
Global Rationale: Patients with a history of sleep apnea may have difficulty with conscious sedation. The nurse
should prepare to administer a reversal agent to the patient. The patient may or may not need artificial ventilations
at this time. The nurse should have been measuring the patient’s oxygen saturation throughout the procedure. The
patient is having difficulty maintaining an airway so applying oxygen via face mask may not be appropriate.

Page Number: 60
Question 16
Type: MCSA

The nurse is caring for a patient recovering from surgery conducted in the previous 24 hours. What should the
nurse do to assist this patient with pain control?
1. Administer prescribed analgesics around the clock.
2. Administer prescribed analgesics when the patient requests something for pain.
3. Assist the patient to a more comfortable position to reduce the amount of pain.
4. Offer the patient a back rub to reduce the amount of pain.
Correct Answer: 1
Rationale 1: Established, persistent, severe pain is more difficult to treat than pain that is at its onset.
Postoperative analgesics should be administered at regular intervals around the clock to maintain a therapeutic
blood level.
Rationale 2: Administering analgesics as needed (prn) lowers this therapeutic level; delays in medication
administration further increase pain intensity. “As needed” administration of analgesics is not recommended in
the first 36 to 48 hours postoperatively.
Rationale 3: The nurse could help the patient into a more comfortable position to reduce the amount of pain;
however, the nurse should provide the patient with the prescribed analgesics around the clock.
Rationale 4: The nurse could offer the patient a back rub to reduce the amount of pain; however, the nurse should
provide the patient with the prescribed analgesics around the clock.
Global Rationale: Established, persistent, severe pain is more difficult to treat than pain that is at its onset.
Postoperative analgesics should be administered at regular intervals around the clock to maintain a therapeutic
blood level. Administering analgesics as needed (prn) lowers this therapeutic level; delays in medication
administration further increase pain intensity. “As needed” administration of analgesics is not recommended in
the first 36 to 48 hours postoperatively. The nurse could help the patient into a more comfortable position and
offer the patient a back rub to reduce the amount of pain, however, the nurse should provide the patient with the
prescribed analgesics around the clock.

Page Number: 60


Question 17
Type: MCSA
An older patient is recovering from a surgical procedure. What should the nurse do to ensure the patient is
comfortable?
1. Provide warm blankets.
2. Limit movement to once every eight hours.
3. Explain all activities using a loud voice.
4. Limit fluids.
Correct Answer: 1
Rationale 1: The older patient may need extra blankets for warmth. This is what the nurse should do to ensure for
the patient’s comfort.
Rationale 2: The patient should be carefully turned and repositioned frequently to prevent the onset of pressure
ulcers.
Rationale 3: The nurse should speak in a low tone and not loudly.
Rationale 4: The older patient needs an adequate fluid intake and may not need to have fluids limited.
Global Rationale: The older patient may need extra blankets for warmth. This is what the nurse should do to
ensure for the patient’s comfort. The patient should be carefully turned and repositioned frequently to prevent the
onset of pressure ulcers. The nurse should speak in a low tone and not loudly. The older patient needs an adequate
fluid intake and may not need to have fluids limited.

Client Need Sub: Basic Care and Comfort
Learning Outcome: 5. Identify variations in perioperative care for patients across the life span and with differing
needs based on culture.
Page Number: 56
Question 18

Type: MCSA
When caring for an older patient having surgery, the nurse avoids shaving the patient. Which body system is the
nurse supporting by using this intervention?
1. integumentary
2. sensory-perceptual
3. respiratory
4. cardiovascular
Correct Answer: 1
Rationale 1: Avoiding shaving the older patient is one intervention to support the patient’s integumentary status.
Rationale 2: Speaking in low tones and using adequate room lighting would support the patient’s sensory-
perceptual status.
Rationale 3: Teaching deep breathing and coughing and monitoring lung sounds would support the patient’s
respiratory status.
Rationale 4: Monitoring peripheral pulses and edema would support the patient’s cardiovascular status.
Global Rationale: Avoiding shaving the older patient is one intervention to support the patient’s integumentary
status. Speaking in low tones and using adequate room lighting would support the patient’s sensory-perceptual
status. Teaching deep breathing and coughing and monitoring lung sounds would support the patient’s respiratory
status. Monitoring peripheral pulses and edema would support the patient’s cardiovascular status.

MNL Learning Outcome: 4.1.1. Explain the pathophysiology of inflammatory and infectious skin disorders.
Page Number: 74
Question 19
Type: MCSA

An older patient, recovering from surgery, is prescribed a soft diet. The nurse realizes that this diet supports which
age-related change?
1. decline in gastric motility
2. reduced intestinal absorption
3. lactose intolerance
4. gall bladder insufficiency
Correct Answer: 1
Rationale 1: A soft diet helps with this change in the older adult.
Rationale 2: Reduced intestinal absorption is not a gastrointestinal age-related change.
Rationale 3: Lactose intolerance can occur at many ages.
Rationale 4: Gall bladder insufficiency is not a gastrointestinal age-related change.
Global Rationale: A soft diet helps with this change in the older adult. Reduced intestinal absorption is not a
gastrointestinal age-related change. Lactose intolerance can occur at many ages. Gall bladder insufficiency is not
a gastrointestinal age-related change.

MNL Learning Outcome: 11.8.1. Explain the incidence and pathophysiology for disorders of intestinal motility.
Page Number: 74
Question 20
Type: MCSA
The nurse is planning care to support the cognitive-psychosocial status for an older patient having surgery. Which
intervention would be appropriate for this patient?
1. Provide time for teaching and learning.
2. Set limits with the patient.

3. Tell the patient that his physician will make all care decisions.
4. Remind the patient that the call bell is for emergencies only.
Correct Answer: 1
Rationale 1: To support the older patient’s cognitive-psychosocial status, the nurse should provide ample time for
teaching and learning.
Rationale 2: The nurse should not treat the older patient as a child by setting limits.
Rationale 3: The nurse should not treat the older patient as a child by stating that all care decisions will be made
by the physician.
Rationale 4: The nurse should not treat the older patient as a child by reminding that the call bell is for
emergencies only.
Global Rationale: To support the older patient’s cognitive-psychosocial status, the nurse should provide ample
time for teaching and learning. The nurse should not treat the older patient as a child by setting limits, by stating
that all care decisions will be made by the physician, or by reminding that the call bell is for emergencies only.

Client Need: Psychosocial Integrity
Client Need Sub:
their care
NLN Competencies: Relationship Centered Care; Practice; learn cooperatively, facilitate the learning of others
Page Number: 74
Question 21
Type: MCSA
A patient recovering from surgery reports a pain level of 6 on a 0–10 pain scale but refuses additional pain
medication since he does not want to “become addicted.” The nurse’s response should focus on which concept?
1. Physical dependence on pain medication is uncommon during the short-term postoperative use.
2. This patient already might have an addiction problem.
3. This patient might benefit from a placebo dose.

4. The physician should be notified to discuss pain management.
Correct Answer: 1
Rationale 1: Patients might fear “addiction” or physical dependence on pain medications, especially opioids,
postoperatively. The duration of use is typically short-term, and this concern should be discussed, but is not
anticipated to occur.
Rationale 2: The patient who already has an addiction problem most likely would be requesting more medication,
not refusing it.
Rationale 3: The patient is verbalizing pain, so administration of a placebo is unethical, against patient rights for
pain management, and should not be administered.
Rationale 4: It is within the scope of the nurse to review and make decisions with the patient regarding safe use
of pain medications that have been ordered by the physician. The physician does not need to be called at this time
unless the nurse’s interventions with the patient are unsuccessful.
Global Rationale: Patients might fear “addiction” or physical dependence on pain medications, especially
opioids, postoperatively. The duration of use is typically short-term, and this concern should be discussed, but is
not anticipated to occur. The patient who already has an addiction problem most likely would be requesting more
medication, not refusing it. The patient is verbalizing pain, so administration of a placebo is unethical, against
patient rights for pain management, and should not be administered. It is within the scope of the nurse to review
and make decisions with the patient regarding safe use of pain medications that have been ordered by the
physician. The physician does not need to be called at this time unless the nurse’s interventions with the patient
are unsuccessful.

QSEN Competencies: I.A.3. Demonstrate comprehensive understanding of the concepts of pain and suffering,
including physiologic models of pain and comfort
Learning Outcome: 6. Describe principles of pain management specific to acute postoperative pain control.
Page Number: 61

Question 22
Type: MCSA
An older patient is receiving an NSAID for postoperative pain. What should the nurse assess in this patient?
1. urine output
2. blood pressure
3. respiratory rate
4. heart rate
Correct Answer: 1
Rationale 1: NSAIDs can be given safely to older patients, but they should be observed closely for side effects,
particularly gastric and renal toxicity. The nurse should monitor the patient’s urine output to determine renal
function.
Rationale 2: NSAIDs do not usually affect blood pressure.
Rationale 3: NSAIDs do not usually affect respiratory rate.
Rationale 4: NSAIDs do not usually affect heart rate.
Global Rationale: NSAIDs can be given safely to older patients, but they should be observed closely for side
effects, particularly gastric and renal toxicity. The nurse should monitor the patient’s urine output to determine
renal function. NSAIDs do not usually affect blood pressure, respiratory rate, or heart rate.

MNL Learning Outcome: 12.3.1. Explain the incidence, causes, risk factors, and pathophysiology of kidney
disorders.
Page Number: 61

Question 23
Type: MCSA
An older surgical patient is having an epidural catheter inserted for pain control. What does the nurse realize is an
advantage of using this method of pain medication for this patient?
1. improved bowel activity
2. faster wound healing

3. earlier ambulation
4. improved appetite
Correct Answer: 1
Rationale 1: This type of intraspinal anesthesia provides safe and effective pain relief for patients of all ages with
less risk of adverse effects than general anesthesia.
Rationale 2: Patient-controlled epidural analgesia does not cause faster wound healing in the older patient.
Rationale 3: Patient-controlled epidural analgesia does not cause earlier ambulation in the older patient.
Rationale 4: Patient-controlled epidural analgesia does not cause improved appetite in the older patient.
Global Rationale: This type of intraspinal anesthesia provides safe and effective pain relief for patients of all
ages with less risk of adverse effects than general anesthesia. Patient-controlled epidural analgesia does not cause
faster wound healing, earlier ambulation, or improved appetite in the older patient.

Page Number: 60

Question 24
Type: MCSA
A patient says that his condition must be getting worse since he was receiving 10 mg morphine sulfate through the
IV for pain but now is prescribed Demerol 50 mg by mouth at home. How should the nurse respond to this
patient?
1. “Oral doses need to be higher than those given through an IV. It does not mean your condition is worse.”
2. “The doctor is making sure that you do not have any pain once you go home.”
3. “I will get the doctor so he can explain what is going on with your condition.”
4. “All patients have more pain when they go home so the doctor is making sure you have enough medication.”
Correct Answer: 1
Rationale 1: Oral doses of analgesics are not equal to parenteral doses. The oral dose of an opioid such as
morphine, codeine, or hydromorphone may be two to five times higher than the parenteral dose to achieve
equivalent pain relief. This is what the nurse should explain to the patient.
Rationale 2: The physician is not making sure the patient has no pain at home.
Rationale 3: The nurse does not need to get the physician to explain the patient’s condition.
Rationale 4: Not all patients have more pain when they are discharged after surgery.
Global Rationale: Oral doses of analgesics are not equal to parenteral doses. The oral dose of an opioid such as
morphine, codeine, or hydromorphone may be two to five times higher than the parenteral dose to achieve
equivalent pain relief. This is what the nurse should explain to the patient. The physician is not making sure the
patient has no pain at home. The nurse does not need to get the physician to explain the patient’s condition. Not
all patients have more pain when they are discharged after surgery.

Page Number: 61

Question 25
Type: MCSA
A patient is being transferred from the operating room to the recovery room. In which phase of the surgical
process will the nurse in the recovery room provide care?
1. postoperative
2. preoperative
3. intraoperative
4. restorative
Correct Answer: 1

Rationale 1: The postoperative phase begins when the patient is admitted to the recovery room and ends with the
patient’s recovery from the surgical intervention.
Rationale 2: The preoperative phase is prior to surgery.
Rationale 3: The intraoperative phase occurs during the surgery.
Rationale 4: Restorative is not a phase of the surgical experience.
Global Rationale: The postoperative phase begins when the patient is admitted to the recovery room and ends
with the patient’s recovery from the surgical intervention. The preoperative phase is prior to surgery. The
intraoperative phase occurs during the surgery. Restorative is not a phase of the surgical experience.

Page Number: 61
Question 26
Type: MCSA
A patient is signing a surgical consent. Afterwards, the nurse also signs the form. What is the meaning of the
nurse’s signature?
1. It means the patient was alert and aware of what was being signed.
2. It means the patient understood the procedure as described by the nurse.
3. It means the surgeon was too busy to wait for the patient to sign the form.
4. It means there is a likelihood of a successful outcome.
Correct Answer: 1
Rationale 1: The nurse also signs the form to indicate that the correct person is signing the form and that the
patient was alert and aware of what was being signed.

Rationale 2: Providing a description of the surgical procedure is not the responsibility of the nurse. Obtaining the
consent form is a nursing function.
Rationale 3: The physician’s schedule is not a factor.
Rationale 4: Success of the outcome is not dependent upon the completion of the consent form.
Global Rationale: The nurse also signs the form to indicate that the correct person is signing the form and that
the patient was alert and aware of what was being signed. Providing a description of the surgical procedure is not
the responsibility of the nurse. It is the responsibility of the physician. Obtaining the consent form is a nursing
function. The physician’s schedule is not a factor. Success of the outcome is not dependent upon the completion
of the consent form.

QSEN Competencies: V.C.3. Value own role in preventing errors
NLN Competencies: Context and Environment; Knowledge; principles of informed consent, confidentiality,
patient self-determination
Page Number: 51

Question 27
Type: MCSA
An older patient is being prepared for orthopedic surgery. For what potential risk should the nurse plan care?
1. decreased tolerance of general anesthesia
2. prolonged effects of anesthesia because of herbal supplements
3. wound dehiscence
4. decreased cognitive acuity
Correct Answer: 1
Rationale 1: Older adults have age-related changes that affect physiologic, cognitive, and psychosocial responses
to the stress of surgery in addition to decreased tolerance of general anesthesia and postoperative medications and
delayed wound healing.
Rationale 2: No information is provided to indicate the use of herbal supplements.

Rationale 3: Despite delayed wound healing, there is no information to support the increased risk for wound
dehiscence.
Rationale 4: Cognition remains stable in older adults, but information processing slows.
Global Rationale: Older adults have age-related changes that affect physiologic, cognitive, and psychosocial
responses to the stress of surgery in addition to decreased tolerance of general anesthesia and postoperative
medications and delayed wound healing. No information is provided to indicate the use of herbal supplements.
Despite delayed wound healing, there is no information to support the increased risk for wound dehiscence.
Cognition remains stable in older adults, but information processing slows.

Page Number: 74
Question 28
Type: MCSA
An older patient is completing preoperative diagnostic testing. The nurse notes that the patient’s carbon dioxide
level is elevated. What should the nurse be monitoring for this patient?
1. Respiratory status and arterial blood gases
2. Serum potassium level
3. Serum sodium level
4. Intake and output
Correct Answer: 1
Rationale 1: A patient with an altered carbon dioxide level could have a history of emphysema, chronic
bronchitis, asthma, pneumonia, or respiratory acidosis, or it could be caused by vomiting or nasogastric
suctioning. The best nursing intervention for this patient would be to monitor the patient’s respiratory status and
arterial blood gases.

Rationale 2: A review of the potassium level is not the most beneficial to this patient at this time.
Rationale 3: A review of the sodium level is not the most beneficial to this patient at this time.
Rationale 4: A review of the intake and output is not the most beneficial to this patient at this time.
Global Rationale: A patient with an altered carbon dioxide level could have a history of emphysema, chronic
bronchitis, asthma, pneumonia, or respiratory acidosis, or it could be caused by vomiting or nasogastric
suctioning. The best nursing intervention for this patient would be to monitor the patient’s respiratory status and
arterial blood gases. A review of the potassium, sodium levels, and intake and output are not the most beneficial
to this patient at this time.

MNL Learning Outcome: 0.1.2. Correlate the information related to specific serum laboratory studies to client
care.
Page Number: 57
Question 29
Type: MCSA
An older postoperative patient is given an antiemetic for nausea. Which manifestation indicates to the nurse that
this patient is experiencing a possible reaction to the medication?
1. involuntary muscle movements
2. confusion
3. dry mouth
4. breakthrough vomiting
Correct Answer: 1
Rationale 1: Antiemetics, such as Metoclopramide (Reglan) and Droperidol (Inapsine), can have tranquilizing
effects as well as cause an extrapyramidal reaction. The patient would demonstrate involuntary movements,
muscle tone changes, and abnormal posturing.

Rationale 2: Elderly patients may also experience drowsiness, which reduces orientation, after being given
antiemetics.
Rationale 3: A dry mouth may be experienced as a result of having been or currently being unable to have oral
intake.
Rationale 4: Breakthrough vomiting is not an indication of an adverse reaction.
Global Rationale: Antiemetics, such as metoclopramide (Reglan) and droperidol (Inapsine), can have
tranquilizing effects as well as cause an extrapyramidal reaction. The patient would demonstrate involuntary
movements, muscle tone changes, and abnormal posturing. Elderly patients may also experience drowsiness,
which reduces orientation, after being given antiemetics. A dry mouth may be experienced as a result of having
been or currently being unable to have oral intake. Breakthrough vomiting is not an indication of an adverse
reaction.

Nursing/Integrated Concepts: Nursing Process: Evaluation
Page Number: 58

Question 30
Type: MCSA
The nurse is assisting a postoperative patient in using an incentive spirometer. Which postoperative complications
is this nurse attempting to avoid?
1. atelectasis
2. deep vein thrombosis
3. hemorrhage
4. pulmonary embolism
Correct Answer: 1
Rationale 1: Promoting lung expansion and systemic oxygenation of tissues is a goal in preventing atelectasis.
Nursing care includes assisting with incentive spirometry.

Rationale 2: Deep vein thrombosis is not related to incentive spirometer use.
Rationale 3: Hemorrhage is not related to incentive spirometer use.
Rationale 4: Pulmonary embolism is not related to incentive spirometer use.
Global Rationale: Promoting lung expansion and systemic oxygenation of tissues is a goal in preventing
atelectasis. Nursing care includes assisting with incentive spirometry. Deep vein thrombosis, hemorrhage, and
pulmonary embolism are not related to incentive spirometer use.

QSEN Competencies: V.C.3.Value own role in preventing errors
NLN Competencies: Quality and Safety; Knowledge; Factors that contribute to a systemwide safety culture; the
importance of reporting hazards and adverse events; the "just culture" approach to system improvement
MNL Learning Outcome: 5.3.1. Explain the risk factors and pathophysiology of infectious lung diseases.
Page Number: 73
Question 31
Type: MCSA
A patient’s postoperative wound has sanguineous drainage with a thick, reddish appearance. The nurse realizes
this patient’s wound is in which phase of healing?
1. Inflammatory
2. Proliferative
3. Stationary
4. Remodeling
Correct Answer: 1
Rationale 1: The inflammatory phase begins with the surgical incision. Sanguineous drainage contains both
serum and red blood cells and has a thick, reddish appearance.
Rationale 2: The proliferative phase begins within 2 to 3 days after surgery.
Rationale 3: Stationary is not a phase of wound healing.

Rationale 4: In the remodeling phase, scar tissue is remodeled by a process of collagen synthesis and breakdown
to increase its strength. This phase begins about 3 weeks after surgery and can continue for 6 or more months.
Global Rationale: The inflammatory phase begins with the surgical incision. Sanguineous drainage contains both
serum and red blood cells and has a thick, reddish appearance. The proliferative phase begins within 2 to 3 days
after surgery. Stationary is not a phase of wound healing. In the remodeling phase, scar tissue is remodeled by a
process of collagen synthesis and breakdown to increase its strength. This phase begins about 3 weeks after
surgery and can continue for 6 or more months.

QSEN Competencies: I. A.1. Integrate understanding of multiple dimensions of patient centered care
NLN Competencies: Teamwork; Practice; Function competently within one's own scope of practice as leader or
member of the health care team
Nursing/Integrated Concepts: Nursing Process: Evaluation
Page Number: 71

Question 32
Type: MCSA
A patient who is recovering from abdominal surgery has a Penrose drain. What should the nurse include in the
care of this patient?
1. Make sure there is a safety pin on the end of the drain.
2. Empty the drain every 30 minutes.
3. Clean the wound with normal saline every two hours.
4. Remove the drain four hours postoperatively.
Correct Answer: 1
Rationale 1: Penrose drains need a safety pin at the exposed end to prevent the drain from slipping down into the
wound.
Rationale 2: Unless full or assessing for a potential problem, there is no need to empty the drain until the end of
the shift.
Rationale 3: There is no need to clean the wound with saline.
Rationale 4: Removal of the drain requires a physician’s order.

Global Rationale: Penrose drains need a safety pin at the exposed end to prevent the drain from slipping down
into the wound. Unless full or assessing for a potential problem, there is no need to empty the drain until the end
of the shift. There is no need to clean the wound with saline. Removal of the drain requires a physician’s order.

NLN Competencies: Context and Environment; Practice: conduct population-based transcultural health
Page Number: 71

Question 33
Type: MCSA
During the assessment of a postoperative patient’s bowel sounds, the nurse auscultates absent sounds over all four
abdominal quadrants. The nurse realizes this finding could indicate what health problem?
1. paralytic ileus
2. normal bowel function
3. the onset of flatus
4. the onset of stool
Correct Answer: 1
Rationale 1: A distended abdomen with absent bowel sounds may indicate paralytic ileus.
Rationale 2: Normal bowel sounds are low in pitch.
Rationale 3: The onset or presence of flatus is accompanied by bowel sounds.
Rationale 4: The onset of stool is accompanied by bowel sounds.
Global Rationale: A distended abdomen with absent bowel sounds may indicate paralytic ileus. Normal bowel
sounds are low in pitch. The onset or presence of flatus and stool is accompanied bowel sounds.

MNL Learning Outcome: 11.3.2. Differentiate the manifestations of stomach and duodenum disorders.
Page Number: 74

Question 34
Type: MCSA
A patient is scheduled for extraction of a cataract. How should the nurse classify this patient’s surgical procedure?
1. minor elective
2. minor diagnostic
3. major constructive
4. major elective
Correct Answer: 1
Rationale 1: Surgical procedures are classified according to purpose, risk factor, and urgency. Cataract extraction
would be considered a minor elective surgery. Minor procedures carry minimal risk and minimal physical assault.
Rationale 2: A minor diagnostic surgery is used to determine or confirm a condition.
Rationale 3: Major constructive procedures require extensive physical assault and/or serious risk. Constructive
procedures are used to build tissue/organs which are absent.
Rationale 4: Major elective procedures are suggested to the patient by the physician but there is little risk if they
are not performed.
Global Rationale: Surgical procedures are classified according to purpose, risk factor, and urgency. Cataract
extraction would be considered a minor elective surgery. Minor procedures carry minimal risk and minimal
physical assault. A minor diagnostic surgery is used to determine or confirm a condition. Major constructive
procedures require extensive physical assault and/or serious risk. Constructive procedures are used to build
tissue/organs which are absent. Major elective procedures are suggested to the patient by the physician but there is
little risk if they are not performed.

MNL Learning Outcome: 9.1.3. Examine the diagnosis and treatment of age-related eye disorders.
Page Number: 50

Question 35
Type: MCSA
A patient who is being admitted for surgery asks the nurse why information is being collected about the patient’s
use of herbal and natural supplements. How should the nurse respond to this patient?
1. “Herbal supplements may interact with anesthetic agents.”
2. “Herbal remedies may cause pain relievers to be ineffective.”
3. “The physician is in charge of medications.”
4. “There is no need to take these preparations.”
Correct Answer: 1
Rationale 1: The use of herbal supplements must be documented prior to surgery. It is possible for these elements
to interact with anesthetic agents.
Rationale 2: Herbal remedies have not been shown to render analgesics ineffective.
Rationale 3: Stating that the physician is in charge of medications does not adequately respond to the patient’s
inquiry.
Rationale 4: Stating that there is no need to take these prescriptions does not adequately respond to the patient’s
inquiry.
Global Rationale: The use of herbal supplements must be documented prior to surgery. It is possible for these
elements to interact with anesthetic agents. Herbal remedies have not been shown to render analgesics ineffective.
Stating that the physician is in charge of medications and that there is no need to take these prescriptions does not
adequately respond to the patient’s inquiry.


AACN Essentials Competencies: IX.17. Develop a beginning understanding of complementary and alternative modalities
and their role in health care
NLN Competencies: Context and Environment; Practice: conduct population-based transcultural health assessments and
interventions
Page Number: 53

Question 36
Type: MCMA
After complaining of discomfort from a surgical procedure, the patient voices fear of addiction with taking
analgesics as prescribed. What information should be provided to the patient regarding these concerns?
1. “Addiction to opioid analgesics is rare when used for short-term postoperative pain management.”
2. “Psychological tolerance is not commonly experienced by patients who take narcotic analgesics during the
postoperative experience.”
3. “Pain tolerance and the need for opioid analgesics are individualized.”
4. “Patients should be screened for addiction potential prior to being given narcotics.”
5. “I’ll turn the TV on to help distract you from your pain.”
Correct Answer: 1, 2, 3
Rationale 1: The use of opioid analgesics during the postoperative period is rarely associated with physical
dependency concerns.
Rationale 2: The use of opioid analgesics during the postoperative period is rarely associated with psychological
dependency concerns.
Rationale 3: The pain management needs of patients will vary and should be managed individually.
Rationale 4: Screening is not routinely recommended for surgical patients.
Rationale 5: This does not address the patient’s need for pain control or the patient’s concern over addiction from
postoperative opioid analgesics.
Global Rationale: The use of opioid analgesics during the postoperative period is rarely associated with physical
or psychological dependency concerns. The pain management needs of patients will vary and should be managed
individually. Screening is not routinely recommended for surgical patients. Offering to turn on the TV to distract
the patient does not address the patient’s need for pain control or the patient’s concern over addiction from
postoperative opioid analgesics.

Page Number: 61

Question 37
Type: MCSA
The patient who is preparing for surgery asks the nurse to keep his glasses and hearing aid in place until he is
under anesthesia. Which nursing response demonstrates accurate therapeutic communication?
1. “I will contact the surgery department to discuss your requests.”
2. “You cannot keep those in.”
3. “The policies in the surgery unit will not allow it.”
4. “Certainly, you can keep them for that time.”
Correct Answer: 1
Rationale 1: Although communication will be enhanced if the patient can keep glasses and hearing aids for as
long as possible, the nurse will need to check with the surgical department first before granting the patient’s wish.
Rationale 2: As a patient advocate, the nurse is responsible for making an inquiry.
Rationale 3: The nurse does not have the authority to make decisions on behalf of the surgical department.
Rationale 4: The nurse should not give information that may be inaccurate.
Global Rationale: Although communication will be enhanced if the patient can keep glasses and hearing aids for
as long as possible, the nurse will need to check with the surgical department first before granting the patient’s
wish. As a patient advocate, the nurse is responsible for making an inquiry. The nurse does not have the authority
to make decisions on behalf of the surgical department and should not give information that may be inaccurate.

Client Need: Psychosocial Integrity
Client Need Sub:
QSEN Competencies: I.A.9. Discuss principles of effective communication
AACN Essentials Competencies: II.2. Demonstrate leadership and communication skills to effectively
implement patient safety and quality improvement initiatives within the context of the interprofessional team
NLN Competencies: Quality and Safety; Practice; Communicate effectively with different individuals (team
members, other care providers, patients, families, etc.) so as to minimize risks associated with handoffs among
providers and across transitions in care
Page Number: 69
Question 38
Type: MCHS
The nurse is assigned as the surgical scrub nurse for outpatient cases. Place an “X” on the picture that depicts how
the nurse will dress for these cases.

Correct Answer:
Rationale: The surgical scrub nurse handles sutures, instruments, and other equipment immediately adjacent to
the sterile field and therefore wears the sterile attire pictured on the right. The picture on the left depicts surgical
attire that is worn by those not participating at the operating table.
Global Rationale:

Client Need: Safe and Effective Care and Environment
Client Need Sub: Safety and Infection Control
Page Number: 63

Question 39
Type: MCHS
The patient is scheduled for a perineal surgery. Place an “X” on the position in which the nurse would place this
patient for surgery.

Correct Answer:
Rationale: This position is called the lithotomy position and it is used for gynecologic, perineal, or rectal
surgeries. The first position is the prone position, which is used for spinal surgeries and removal of hemorrhoids.
The center position is the lateral chest position, which is used for some thoracic surgeries, as well as hip
replacements.
Global Rationale:

Page Number: 65

Question 40
Type: MCSA
The nurse takes the form identified below to a patient’s room in preparation for an emergency surgical procedure.
The patient states, “Doc said he would tell me all about the surgery when he gets here. Do you know what they
are going to do?” What is the nurse’s best response?

1. “Let’s wait on signing this until your physician has talked to you.”

2. “Let me go get a medical surgical textbook so I can use the pictures to explain the procedure.”
3. “I am not certain; let me call the nursing supervisor to explain it to you.”
4. “Go ahead and sign this so we will have that part done when the physician gets here.”
Correct Answer: 1
Rationale 1: The form pictured is an informed consent document. It should not be signed until the procedure has
been explained to the patient, and the explanation is the responsibility of the physician.
Rationale 2: This nurse should not explain the procedure.
Rationale 3: This nurse should not ask another nurse to do so.
Rationale 4: The signing of this document must wait until the patient is educated about the procedure so that true
“informed” consent can be given.
Global Rationale: The form pictured is an informed consent document. It should not be signed until the
procedure has been explained to the patient, and the explanation is the responsibility of the physician. This nurse
should not explain the procedure or ask another nurse to do so. The signing of this document must wait until the
patient is educated about the procedure so that true “informed” consent can be given.

Page Number: 51

Question 41
Type: MCSA
While completing item number 4 in the preoperative preparation section of the form provided below, the nurse
notes that the patient depends on a hearing aid. What action should the nurse take?

1. Leave the device in the patient’s ear and notify the OR nurse of its presence.

2. Remove the device and place it in a denture cup in the patient’s room.
3. Remove the device and give it to the patient’s family member.
4. Place a piece of tape across the patient’s ear and the device.
Correct Answer: 1
Rationale 1: The patient must be able to hear and understand instruction that will be part of the universal protocol
to reduce surgical errors, so the nurse should leave the device in the patient’s ear and notify the OR nurse of its
presence.
Rationale 2: Removing the device and placing it in a denture cup in the room will make it unavailable to the
patient in the OR.
Rationale 3: Giving the device to the family will make it unavailable to the patient in the OR.
Rationale 4: Taping the device into the ear might damage it or cause injury to the patient’s ear.
Global Rationale: The patient must be able to hear and understand instruction that will be part of the universal
protocol to reduce surgical errors, so the nurse should leave the device in the patient’s ear and notify the OR nurse
of its presence. Removing the device and placing it in a denture cup in the room or giving it to the family will
make it unavailable to the patient in the OR. Taping the device into the ear might damage it or cause injury to the
patient’s ear.
Cognitive Level: Application

QSEN Competencies: I.B.15. Communicate care provided and needed at each transition in care
Page Number: 69
Question 42
Type: MCMA
The nurse is changing the abdominal surgical dressing of an older patient who has developed pneumonia and a
cough. Upon removing the dressing, the nurse notes the situation as pictured below. What should be the nurse’s
intervention?

1. Place saline moistened sterile dressing over the incision.
2. Notify the patient’s surgeon of the occurrence.
3. Don sterile gloves and insert the loop of bowel back into the abdomen.
4. Document the presence of a dehiscence in the medical record.
5. Replace the dressing and ask the oncoming shift to advise the physician about the situation when rounds are
made.
Correct Answer: 1, 2
Rationale 1: The tissue must be kept moist, so application of a sterile dressing that is moistened with sterile saline
is appropriate.
Rationale 2: The surgeon should be made aware of the situation immediately, as a return to the OR will probably
be necessary.
Rationale 3: The nurse should not attempt to put the loop of bowel back into the abdomen, as this might cause
additional trauma.
Rationale 4: Documentation is not a priority in this emergency situation.
Rationale 5: The surgeon should be made aware of the situation immediately, as a return to the OR will probably
be necessary, so having the next shift notify the surgeon is wrong.

Global Rationale: This situation depicts an evisceration, which is an emergency situation, not a dehiscence.
Older patients may be at greater risk for this postoperative complication because of thinning of the skin and
subcutaneous tissues. The tissue must be kept moist, so application of a sterile dressing that is moistened with
sterile saline is appropriate. The surgeon should be made aware of the situation immediately, as a return to the OR
will probably be necessary, so having the next shift notify the surgeon is wrong. The nurse should not attempt to
put the loop of bowel back into the abdomen as this might cause additional trauma. Documentation is not a
priority in this emergency situation.

MNL Learning Outcome: 4.1.3. Examine the diagnosis and treatment of inflammatory and infectious skin
disorders.
Page Number: 72

Question 43
Type: MCSA
The patient who had an emergency abdominal surgery looks at his incision on the first postoperative day and says,
“I sure hope this doesn’t leave much of a scar. Is there some type of medicine or ointment I can put on it?” What
should the nurse consider prior to responding to that comment?
1. This incision will heal by primary intention and will probably leave only a hairline scar.
2. This incision will fill in with granulation tissue and leave a moderately big scar despite any medication applied.
3. This incision was done in an emergent fashion but continuous application of steroid creams will prevent
scarring.

4. This incision will have to be reclosed later and will leave a large scar unless a topical antibiotic is used
continuously.
Correct Answer: 1
Rationale 1: This picture shows a clean, straight incision that was closed early, so it will probably leave a hairline
scar. This is called healing by primary intention.
Rationale 2: Healing by secondary intention is when the incision is left open and granulation begins. This leaves
a large scar.
Rationale 3: The fact that this was an emergency surgery should have nothing to do with the scarring potential if
the incision is clean and closed immediately.
Rationale 4: Healing by secondary intention occurs when the incision is left open and granulation begins. This
leaves a large scar.
Global Rationale: This picture shows a clean, straight incision that was closed early, so it will probably leave a
hairline scar. This is called healing by primary intention. Healing by secondary intention is when the incision is
left open and granulation begins. This leaves a large scar. The fact that this was an emergency surgery should
have nothing to do with the scarring potential if the incision is clean and closed immediately. Healing by
secondary intention is when the incision is left open and granulation begins.

disorders.
Page Number: 70

Question 44
Type: MCMA
The nurse is changing the surgical dressing on an older patient’s abdomen and sees the item pictured in the
diagram below. How should the nurse care for this device?

1. Plan to replace the precut gauze as part of the dressing change.
2. Cleanse around the tube with the cleanser ordered or according to protocol.
3. Use the safety pin to secure the outermost bandage to the dressing.
4. Remove the tube, culture the wound, and cleanse it with saline gauze
5. Remove the safety pin
Rationale 1: The nurse cares for this device by cleansing around it per hospital protocol and replacing the precut
gauze dressing as necessary.
Rationale 2: The nurse cares for this device by cleansing around it per hospital protocol and replacing the precut
gauze dressing as necessary.
Rationale 3: The pin should not be used to secure the dressing as that would make it very easy to inadvertently
pull the drain out when the dressings are removed to be changed.
Rationale 4: The drain is there to passively remove drainage from the wound bed, and it should not be removed
until there is a physician order to do so. A culture is necessary only if there are assessment findings that indicate
possible infection.
Rationale 5: The safety pin is in place to keep the drain from slipping back into the patient, so it should not be
removed.
Global Rationale: This is a Penrose drain. The nurse cares for this device by cleansing around it per hospital
protocol and replacing the precut gauze dressing as necessary. The pin should not be used to secure the dressing
as that would make it very easy to inadvertently pull the drain out when the dressings are removed to be changed.
The drain is there to passively remove drainage from the wound bed and it should not be removed until there is a
physician order to do so. A culture is necessary only if there are assessment findings that indicate possible
infection. The safety pin is in place to keep the drain from slipping back into the patient, so it should not be
removed.

disorders.
Page Number: 71

Question 45
Type: MCMA
A patient is scheduled to have a hernia repair done today on an outpatient basis. The patient’s sibling angrily says,
“When I had this done 20 years ago, they kept me in the hospital nearly a week. Why can’t my brother stay here
where someone can take care of him?” What are appropriate responses by the nurse?
1. “He will be at less risk of getting an infection at home.”
2. “He will probably be more comfortable in his own bed at home.”
3. “It is cheaper for the insurance company if he goes home today.”
4. “The government won’t let him stay.”
5. “If you ask the physician, the hospital will probably let him stay.”

Rationale 1: The best answers to this angry sibling focus on what is best for the patient, so replying about
reduction of infection risk and comfort are the best choice.
Rationale 2: The best answers to this angry sibling focus on what is best for the patient, so replying about
reduction of infection risk and comfort are the best choice.
Rationale 3: While it is probably cheaper for the insurance company for the patient to go home and there are
governmental regulations about hospital admission and Medicare, this is not the best time to bring those concepts
into the conversation.
Rationale 4: While it is probably cheaper for the insurance company for the patient to go home and there are
governmental regulations about hospital admission and Medicare, this is not the best time to bring those concepts
into the conversation.
Rationale 5: It is also not advisable to infer that the hospital has a decision to make in whether this patient stays
or goes home.
Global Rationale: The best answers to this angry sibling focus on what is best for the patient, so replying about
reduction of infection risk and comfort are the best choice. While it is probably cheaper for the insurance
company for the patient to go home and there are governmental regulations about hospital admission and
Medicare, this is not the best time to bring those concepts into the conversation. It is also not advisable to infer
that the hospital has a decision to make in whether this patient stays or goes home.

MNL Learning Outcome: 12.13.3. Examine the diagnosis and treatment of abdominal structural and obstructive
disorders.
Page Number: 50
Question 46
Type: MCSA
The nurse is reviewing the patient’s current medications as a part of preparation for an elective surgery. What
information should the nurse reinforce with the patient?
1. “Continue to take your regular prescribed dose of warfarin (Coumadin).”
2. “You may take your regular herbal supplements up until the day before surgery.”
3. “Discontinue your antihypertensive medications two days prior to surgery.”
4. “Stop taking your daily aspirin at least three days prior to surgery.”
Correct Answer: 4
Rationale 1: Anticoagulant medications, including warfarin (Coumadin), should be discontinued prior to surgery
to prevent excessive blood loss during surgery.
Rationale 2: Herbs or nutritional supplements that impair clotting should be discontinued 2 weeks prior to
surgery.
Rationale 3: Antihypertensive medications will be analyzed by the healthcare provider on an individual basis.
Rationale 4: Anticoagulant medications should be discontinued prior to surgery to prevent excessive blood loss
during surgery. These include aspirin.
Global Rationale: Anticoagulant medications, including warfarin (Coumadin) and aspirin, should be
discontinued prior to surgery to prevent excessive blood loss during surgery. Herbs or nutritional supplements that
impair clotting should be discontinued 2 weeks prior to surgery. Antihypertensive medications will be analyzed
by the healthcare provider on an individual basis.

Page Number: 56
Question 47
Type: SEQ
The nurse suspects that a patient recovering from surgery in the postanesthesia recovery unit (PACU) is
developing malignant hyperthermia. Place these interventions in the order in which they should be performed.
Standard Text: Click and drag the options below to move them up or down.
Choice 1. Administer oxygen with a nonrebreather mask.
Choice 2. Check IV access.

Choice 3. Notify the anesthesia provider.
Choice 4. Administer Dantrolene.
Correct Answer: 1,2,3,4
Rationale 1: As soon as the nurse suspects malignant hyperthermia is occurring, oxygen should be administered
by nonrebreather mask. Oxygen is necessary to support tissues that rapidly become hypermetabolic.
Rationale 2: The nurse should then be certain IV access is still patent and should notify the anesthesia provider.
The IV access step is done first as it is quick and if not patent, can be restarted while the anesthesia provider
responds.
Rationale 3: The nurse should then be certain IV access is still patent and should notify the anesthesia provider.
The IV access step is done first as it is quick and if not patent, can be restarted while the anesthesia provider
responds.
Rationale 4: Dantrolene is given IV, so a patent IV is essential.
Global Rationale: As soon as the nurse suspects malignant hyperthermia is occurring, oxygen should be
administered by nonrebreather mask. Oxygen is necessary to support tissues that rapidly become hypermetabolic.
The nurse should then be certain IV access is still patent and should notify the anesthesia provider. The IV access
step is done first as it is quick and if not patent, can be restarted while the anesthesia provider responds.
Dantrolene is given IV, so a patent IV is essential.

Learning Outcome: 4. Explain nursing implications for medications prescribed for the surgical patient..
Page Number: 59

Question 48
Type: SEQ
The nurse is preparing to teach an older patient scheduled for surgery on performing diaphragmatic breathing.
Place the steps of this breathing technique in the order in which the nurse should teach the patient.
Standard Text: Click and drag the options below to move them up or down.

Choice 1. Sit up straight in bed.
Choice 2. Place your hands lightly on your abdomen.
Choice 3. Breathe in deeply through your nose.
Choice 4. Hold your breath for five seconds.
Choice 5. Completely exhale through pursed lips.
Correct Answer: 1,2,3,4,5
Rationale 1: The patient should be placed in high or semi-Fowler’s position.
Rationale 2: The patient should be asked to place hands lightly on the abdomen.
Rationale 3: The patient should be asked to take a deep breath in through the nose.
Rationale 4: The patient should be asked to hold the breath to the count of five.
Rationale 5: The patient should be asked to exhale completed through pursed lips.
Global Rationale: The patient should be placed in high or semi-Fowler’s position, asked to place hands lightly on
the abdomen, asked to take a deep breath in through the nose, asked to hold the breath to the count of five, asked
to exhale completed through pursed lips, then encouraged to repeat the exercise five times consecutively.

Page Number: 67
Question 49
Type: MCMA
Which patient information is essential for the nurse to provide the physician who is preparing to administer
conscious sedation to a patient?

1. The patient has a history of snoring.
2. The patient drank a cup of coffee two hours ago.
3. The patient wants to be asleep for the procedure.
4. The patient’s father was hypertensive.
5. The patient has a history of gout.
Rationale 1: While all of this information leads to a greater understanding of the patient, that the patient snores is
essential information at this time.
Rationale 2: While all of this information leads to a greater understanding of the patient, that the patient is not
NPO is essential information at this time.
Rationale 3: That the patient wishes to be asleep for the procedure is not essential information.
Rationale 4: That the patient’s father was hypertensive is not essential information at this time.
Rationale 5: That the patient has a history of gout is not essential information at this time.
Global Rationale: While all of this information leads to a greater understanding of the patient, the essential
information is that the patient snores and that the patient is not NPO. The other information is not relevant at this
time.

Page Number: 60

Question 50
Type: MCSA
A patient being prepared for surgery has a history of chronic obstructive pulmonary disease. Which diagnostic test
should the nurse expect to be completed prior to this patient’s surgical procedure?
1. Pulmonary function tests
2. CT scan of the brain
3. Lumbar puncture
4. Abdominal MRI
Correct Answer: 1
Rationale 1: Pulmonary function studies often are performed with patients who have chronic obstructive
pulmonary disease to determine the extent of respiratory dysfunction.
Rationale 2: There is no reason for a CT scan of the brain to be completed.
Rationale 3: There is no reason for a lumbar puncture to be completed.
Rationale 4: There is no reason for an abdominal MRI to be completed.
Global Rationale: Pulmonary function studies often are performed with patients who have chronic obstructive
pulmonary disease to determine the extent of respiratory dysfunction. There is no reason for the patient to have a
CT scan of the brain, lumbar puncture, or MRI of the abdomen.

MNL Learning Outcome: 5.9.2. Differentiate the manifestations and diagnostic tests of chronic obstructive
pulmonary disease.
Page Number: 57
Question 51
Type: MCMA
A older patient recovering from total hip replacement surgery 8 hours ago has not been able to void
spontaneously. Which actions should the nurse take to assist this patient?
1. Increase fluids.
2. Turn onto the left side.
3. Palpate the bladder for distention.
4. Insert an indwelling urinary catheter.
5. Complete a bladder scan at the bedside.
Rationale 1: Promote fluid intake as allowed, monitoring intake and output.
Rationale 2: Turning onto the left side will not promote urinary elimination.
Rationale 3: Assess for bladder distention if the patient has not voided within 7 to 8 hours after surgery.
Rationale 4: Urinary catheterizations should be avoided to reduce the potential for urinary tract infections and
urethral trauma.
Rationale 5: Use a portable ultrasound scanner to determine the amount of urine in the bladder.
Global Rationale: The nurse should promote fluid intake as allowed, monitoring intake and output. Assess for
bladder distention if the patient has not voided within 7 to 8 hours after surgery. Use a portable ultrasound scanner
to determine the amount of urine in the bladder. Turning onto the left side will not promote urinary elimination.
Urinary catheterizations should be avoided to reduce the potential for urinary tract infections and urethral trauma.

MNL Learning Outcome: 12.1.3. Examine the diagnosis and treatment of urinary tract and bladder conditions.
Page Number: 74
Question 52
Type: MCMA
The intraoperative nurse is caring for a patient in the maintenance phase of anesthesia. Which actions should the
nurse prepare to provide to the patient at this time?
1. Prepare the skin.

2. Assess oxygen saturation level.
3. Participate in the surgical procedure.
4. Position the patient for the surgical procedure.
5. Measure blood pressure and heart rate.
Rationale 1: During the maintenance phase of anesthesia, the skin is prepared.
Rationale 2: The anesthesiologist monitors the patient’s blood pressure, heart rate, and oxygen saturation level at
this time.
Rationale 3: During the maintenance phase of anesthesia, the surgery is performed.
Rationale 4: During the maintenance phase of anesthesia, the patient is positioned.
Rationale 5: The anesthesiologist monitors the patient’s blood pressure, heart rate, and oxygen saturation level at
this time.
Global Rationale: During the maintenance phase of anesthesia, the patient is positioned, the skin is prepared, and
surgery is performed. The anesthesiologist monitors the patient’s blood pressure, heart rate, and oxygen saturation
level at this time.

Learning Outcome: 7. Differentiate the care needed for patients receiving varying levels of anesthesia care.
Page Number: 59
Question 53
Type: MCMA
A patient who has reacted poorly to general anesthesia in the past is scheduled for surgery to repair a rotator cuff
tear. For which types of anesthesia should the nurse prepare educational materials for this patient?
1. Spinal
2. Topical
3. Epidural
4. Nerve block
5. Local nerve infiltration

Rationale 1: Spinal anesthesia is effective for approximately 90 minutes. Surgeries of the lower abdomen,
perineum, and lower extremities are likely to use this type of regional anesthesia.
Rationale 2: Topical anesthesia would not be an option for this case.
Rationale 3: Epidural blocks are local anesthetic agents injected into the epidural space, outside the dura mater of
the spinal cord. It is indicated for surgeries of the shoulders.
Rationale 4: Nerve blocks are accomplished by injecting an anesthetic agent at the nerve trunk to produce a lack
of sensation over a specific larger area, such as an extremity.
Rationale 5: Local nerve infiltration is achieved by injecting an anesthetic agent around a local nerve to suppress
sensation over a limited area of the body. This technique may be used when a skin or muscle biopsy is obtained or
when a small wound is sutured.
Global Rationale: Epidural blocks are local anesthetic agents injected into the epidural space, outside the dura
mater of the spinal cord. It is indicated for surgeries of the shoulders. Nerve blocks are accomplished by injecting
an anesthetic agent at the nerve trunk to produce a lack of sensation over a specific larger area, such as an
extremity. Spinal anesthesia is effective for approximately 90 minutes. Surgeries of the lower abdomen, perineum,
and lower extremities are likely to use this type of regional anesthesia. Topical anesthesia would not be an option
for this case. Local nerve infiltration is achieved by injecting an anesthetic agent around a local nerve to suppress
sensation over a limited area of the body. This technique may be used when a skin or muscle biopsy is obtained or
when a small wound is sutured.

their care
NLN Competencies: Relationship Centered Care; Practice: learn cooperatively, facilitate the learning of others
MNL Learning Outcome: 8.1.3. Distinguish the diagnosis and treatment of traumatic musculoskeletal injuries.
Page Number: 60
Question 54
Type: MCMA
The nurse determines that a patient recovering from spinal anesthesia is experiencing complications from the
anesthesia. Which actions should the nurse expect to be provided to this patient?
1. Caffeine
2. Analgesics
3. Intravenous fluids
4. Epidural blood patch
5. Vasoactive medication
Correct Answer: 1, 2, 3, 4
Rationale 1: Leakage of cerebrospinal fluid (CSF) into the epidural space can cause reduced CSF pressure and
postoperative headaches. Treatment may include caffeine.
postoperative headaches. Treatment may include analgesics.
postoperative headaches. Treatment may include hydration.
postoperative headaches. Treatment may include an epidural blood patch.
Rationale 5: Vasoactive medications are used if hypotension occurs.
Global Rationale: Leakage of cerebrospinal fluid (CSF) into the epidural space can cause reduced CSF pressure
and postoperative headaches. Treatment may include hydration, caffeine, analgesics, or administration of an
epidural blood patch. Vasoactive medications are used if hypotension occurs.

MNL Learning Outcome: 7.2.3. Examine the diagnosis and treatment of headaches.
Page Number: 60
Question 55
Type: MCMA
While the nurse is assisting a patient recovering from epidural anesthesia to ambulate, the patient becomes dizzy
and has a blood pressure of 78/48 mmHg. What actions should the nurse take?
1. Notify the anesthesiologist.

2. Notify the pharmacy to obtain atropine.
3. Continuously monitor blood pressure.
4. Prepare to administer intravenous fluids.
5. Prepare to administer vasoactive medications.
Correct Answer: 1, 3, 4, 5
Rationale 1: Hypotension is common with epidural. Blood pressure should be monitored and, if critical
hypotension occurs, the anesthesia provider should be alerted and expected to increase intravenous fluids and
administer vasoactive medications.
Rationale 2: Atropine is not indicated in the treatment of this adverse effect of epidural anesthesia.
Global Rationale: Hypotension is common with epidural. Blood pressure should be monitored and, if critical
administer vasoactive medications. Atropine is not indicated in the treatment of this adverse effect of epidural
anesthesia.

MNL Learning Outcome: 6.1.3. Examine the treatment options for disorders of blood pressure regulation.
Page Number: 60


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LeMone/Burke/Bauldoff, Medical-Surgical Nursing 6th Edition Test Bank

2. “You are right.”

3. “If it were more serious, you would be admitted to the hospital.”

Cognitive Level: Applying

LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank

1. reduced risk of healthcare-associated infections

2. ability to use home care for postoperative care in the home

3. reduced use of postoperative medications

4. inadequate staffing on the surgical care areas

Rationale 1: Advantages to outpatient surgery include a reduced risk of healthcare-associated infections.

Cognitive Level: Applying

Standard Text: Select all that apply.

1. stable vital signs

4. adequate urine output

5. patient’s expressed readiness to go home

Correct Answer: 1,2,3,4

LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank

Cognitive Level: Analyzing

2. Measure intake and output.

3. Assess vital signs.

LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank

Cognitive Level: Applying

1. assisting with bathing

3. assessing level of consciousness

4. monitoring intake and output

LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank

Cognitive Level: Applying

2. deep breathing and coughing

3. use of incentive spirometry

4. splinting when coughing

LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank

Cognitive Level: Analyzing

3. Orient the patient to person, place, and time.

4. Assess the patient’s mental status.

LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank

Cognitive Level: Applying

1. Contact the surgeon.

2. Ask the patient to sign the consent form.

3. Send the patient for surgery with an unsigned consent form.

LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank

Cognitive Level: Applying

1. hemoglobin and hematocrit

3. white blood cell count

Rationale 1: An increase in hemoglobin and hematocrit levels would indicate dehydration.

LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank

Cognitive Level: Analyzing

2. white blood cell count

4. blood urea nitrogen

Cognitive Level: Analyzing

1. It is routine for all patients having general anesthesia.

2. It is used to diagnose preexisting cardiac disease.

3. It is one way to validate laboratory values

4. It is a predictor of surgical procedure success.

Rationale 3: The electrocardiogram will not validate laboratory values.

2. postoperative activity level

Cognitive Level: Analyzing

Rationale 3: Antiemetics enhance gastric emptying.

Cognitive Level: Applying

2. nausea and vomiting