Chapter 2: Care of the Surgical Patient MULTIPLE CHOICE 1. The patient who had a nephrectomy yesterday has not used the patient-controlled analgesia (PCA) delivery system but admits to being in pain but fearful of addiction. What is the nurse’s best response? a. “Modern analgesic drugs do not cause addiction.” b. “Pain relief is worth a short period of addiction.” c. “Addiction rarely occurs in the brief time postsurgical analgesia is required.” d. “Addiction could be a real concern.” ANS: C Addiction rarely occurs in the short time that it is required after surgery. Postsurgical analgesia, because of its brief application, does not usually produce a physical or a psychological dependence. DIF: Cognitive Level: Application REF: Page 34 OBJ: 13 TOP: Fear of addiction KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity 2. A 73-year-old patient with diabetes was admitted for below-the-knee amputation of his right leg. Removal of his right leg is an example of which type of surgery? a. Palliative b. Diagnostic c. Reconstructive d. Ablative ANS: D Ablative is a type of surgery where an amputation, excision of any part of the body, or removal of a growth and harmful substance is performed. DIF: Cognitive Level: Comprehension REF: Page 16, Table 2-1 OBJ: 2 TOP: Types of surgeries KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity 3. In which situation might surgery be delayed? a. The patient has taken Dilantin today. b. An illegible signature is on the consent form.. c. The patient is still taking anticoagulants. d. The admission office is unable to confirm insurance coverage. ANS: C All medications should be cancelled before surgery, except for drugs such as phenytoin (Dilantin). Anticoagulant therapy increases the threat of hemorrhage and may be a cause for delay. DIF: Cognitive Level: Knowledge REF: Page 34, Page 36 Table 2-6 OBJ: 7 TOP: Anticoagulant therapy KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
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