Caring for a client who is postoperative following abdominal surgery

ATI Targeted Assessment: Med-Surgical: Perioperative Care 1. A nurse is providing discharge teaching for a client who is postoperative following a rhinoplasty using general anesthesia. Which of the following instructions should the nurse include? 2. A nurse is planning care for a client who is postoperative and has a closed-wound drainage system in place. Which of the following interventions should the nurse plan to include? 3. A nurse is receiving evening shift report on four clients who returned from the PACU that morning. The nurse should assess which of the following clients first? ) 4. A nurse is caring for a client who has a surgical wound with a Penrose drain in place. Which of the following interventions should the nurse plan to perform? 5. A nurse is caring for a client who has bradycardia following a surgical procedure using spinal anesthesia. The nurse should plan to administer which of the following medications to the client? 6. A client had an open transverse colectomy 5 days ago. The nurse enters the client's room and recognizes that the wound has eviscerated. After covering the wound with a sterile, saline-soaked dressing, which of the following actions should the nurse take? 7. A nurse is reviewing the medication administration record for a client who is scheduled for surgery the next day. The nurse should identify that which of the following medications places the client at risk for complications during surgery and should be reported to the provider? 8. A nurse is reviewing the medical record of a client who is scheduled for an elective surgery. Which of the following medications should the nurse expect the provider to discontinue prior to surgery to minimize the risk of complications? 9. A surgical nurse enters a surgical suite to ensure surgical asepsis is maintained. Which of the following findings requires intervention by the nurse? 10. A nurse is providing discharge instructions for a client who is postoperative following abdominal surgery. Which of the following client statements indicates an understanding of the teaching? 11. A nurse is caring for a client who is preoperative and is asking multiple question about risk of the procedure. Which of the following actions should the nurse take? 12. A nurse is assessing a client who is 2 days postoperative following a total prostatectomy. The nurse notes that the client's right calf is red, edematous, and warm to the touch. Which of the following actions should the nurse take? 13. A nurse is assessing a client's recovery from spinal anesthesia. Which of the following sensations should the nurse expect to return to the client first? 14. A nurse is caring for a client who is 12 hours postoperative from a gastrectomy and has an NG tube set to continuous low suction. Which of the following findings requires intervention by the nurse? 15. A nurse is providing teaching for a client who is scheduled to undergo moderate sedation for a bronchoscopy. The nurse should verify that the client understands the procedure when the client states which of the following? 16. A nurse is monitoring a client who received succinylcholine during a surgical procedure. Which of the following actions should the nurse take if the client develops manifestations of malignant hyperthermia? 17. A nurse is assessing a client who is preoperative. The nurse should identify that which of the following factors reported by the client increases the risk for a postoperative wound infection? 18. A nurse is providing teaching for a client who is in the immediate postoperative period and has a PCA pump. Which of the following statements should the nurse include in the teaching? 19. A nurse is reviewing the medical record of a client who is to undergo general anesthesia for surgery. The nurse should report which of the following findings to the provider? 20. A circulating nurse is monitoring the temperature in a surgical suite. The nurse should identify that cool temperatures reduce a client's risk for which of the following potential complications of surgery? 21. A nurse is caring for a client who is postoperative following abdominal surgery. Which of the following nursing interventions should the nurse perform to prevent respiratory complications? Advise the client to splint the surgical incision when coughing and deep breathing. 22. A nurse in the PACU is assessing a client who is postoperative. Which of the following findings should the nurse report to the provider? Presence of inspiratory stridor (This indicates tracheal edema and requires intervention) 23. A nurse is providing preoperative teaching to a client who is scheduled to have a mastectomy with reconstructive surgery. Which of the following statements by the client indicates an understanding of the teaching? "I will be able to shower after the doctor removes the drain." 24. A nurse is caring for a client who is 2 days postoperative following a cholecystectomy. The client has been vomiting for the past 24 hr and reports a pain level of 8 on a scale from 0 to 10. The nurse notes a hard, distended abdomen and absent bowel sounds. After conferring with the provider, which of the following actions should the nurse take first? Insert an NG tube 25. A nurse is providing preoperative teaching to a client who is scheduled for a gastrectomy in 1 week. The client is anxious about the upcoming surgery. Which of the following actions should the nurse take? Provide concise, factual information 26. A nurse is assessing a client who is 2 hr postoperative following an appendectomy. Which of the following findings should the nurse report to the provider? Urine output of 20mL/hr. (The nurse should notify the provider if the urine output is less than 30 ml/hr, meaning the client could be hypovolemic and have decreased perfusion to the kidneys) 27. A nurse is caring for a client who is receiving moderate (conscious) sedation with midazolam. The client's respiratory rate decreases from 16/min to 6/min, and the oxygen saturation decreases from 92% to 85%. Which of the following medications should the nurse administer? Flumazenil. (The client’s RR and o2 levels indication respiratory sedation caused by a benzodiazepine. The nurse should administer Flumazenil, a benzo agonist, to reverse the sedative effects of the medication) 28. A nurse is creating a plan of care for a client who is preoperative for a total hip arthroplasty, practices Judaism, and adheres to a kosher diet. Which of the following interventions is the nurse's priority? Determine if the client's faith conflicts with the treatment plan. (The nurses priority is to assess first. By finding out the clients religion, the nurse can inform the surgeon and prevent any issues during or after the surgery) 29. A client is transferred from the surgical suite to the PACU following oral surgery. While monitoring the client's vital signs, the nurse finds that the client's tongue has become swollen and is obstructing the airway. Which of the following actions should the nurse take first? Use the head-tilt, chin-lift method to open the airway. 30. A nurse is providing preoperative teaching for a client who is about to have a below- the-knee amputation. Which of the following instructions should the nurse include? "Your surgeon might prescribe an antibiotic before surgery."

Table of Contents

• ATI Practice Test - Learning System Fundamentals 2A client's provider has ordered that a sputum specimen be collected for culture and sensitivity. The nurse plans to collect his specimenA. after the client has taken an expectorant.B. in the evening, after forcing fluids all day.C. after antibiotics have been started.D. in the morning, on arising.
• D. in the morning, on arising.
• ATI Practice Test - Learning System Fundamentals 2A nurse is informed during change-of-shift report that a client who is postoperative has not voided for 8 hr. The appropriate initial nursing action is to A. assist the client to the bathroom.B. place a bedpan under the client and pour warm water over the perineum.C. palpate and percuss the client's bladder.D. catherize the client.
• C. palpate and percuss the client's bladder.Rationale:Remember the various stages of the nursing process (data collection, intervention, evaluation). Rely on the nursing process to determine what to do. Data collection comes first followed by planning, intervention, and evaluation.
• ATI Practice Test - Learning System Fundamentals 2When assisting an older adult client with dysphagia at mealtime, the nurse shouldA. encourage the client to drink plenty of fluids.B. offer the client tart and sour foods.C. have the client tilt head back when swallowing.D. turn on the television at mealtimes.
• B. offer the client tart and sour foods.Rationale:Tart and sour foods stimulate saliva production, which helps with chewing and swallowing.
• ATI Practice Test - Learning System Fundamentals 2A client admitted for evaluation and control of hypertension. Several hours after the client's admission, the nurse discovers teh client supine on the floor, unresponsive to verbal or painful stimuli. The nurse's first action at this time should be toA. establish an airwayB. collect neurological data from the client.C. administer oxygen.D. elevate the client's head to 45º.
• ATI Practice Test - Learning System Fundamentals 2A client has just been transferred from the postanesthesia care unit following abdominal surgery. To prevent atelectasis, which measure does the nurse plan to include in the client's care?A. Administer 40% oxygen via humidified face mask.B. Have the client use the incentive spirometer q1 to 2 hr while awake.C. Restrict fluids while the intravenous line remains in place.D. Maintain patency of the nasogastric tube until bowel sounds return.
• B. Have the client use the incentive spirometer q1 to 2 hr while awake.
• ATI Practice Test - Learning System Fundamentals 2A client is admitted to the hospital for evaluation of inadequate circulation to the lower extremities. The provider prescribes a tub bath at the client's request. While assisting the client with the bath, the nurse would put the client at risk with which of the following actions?A. Filling the tub about one third fullB. Asking if the water is the right temperature when the client steps into the tubC. Closing the door to the tub room and telling the client to use the call light for assistance when needed.D. Checking the skin for signs of breakdown either before or after the client bathes.
• B. Asking if the water is the right temperature when the client steps into the tub
• ATI Practice Test - Learning System Fundamentals 2A nurse is caring for a client who is 3 days postoperative following a cholecystectomy. The nurse suspects wound infection because the drainage on the dressing is yellow and thick. The nurse identifies this type of drainage asA. purulent.B. serous.C. serosanguineous.D. sanguineous.
• ATI Practice Test - Learning System Fundamentals 2A client who reports shortness of breath requests the nurse's help in changing position. In addition to repositioning the client, the nurse should give highest priorityA. giving the client a back rub to help her relax.B. notifying the charge nurse that the client is short of breath.C. putting the client on 15-min checks.D. observing the rate, depth, and character of the client's respirations.
• D. observing the rate, depth, and character of the client's respirations.
• ATI Practice Test - Learning System Fundamentals 2A nurse is caring for a client who is 2 postoperative following had abdominal surgery. The nurse is concerned about which of the following findings?A. Shallow respirations 20/minB. A urinary drainage bag with 100 mL of straw-colored urineC. A blood pressure reading of 98/66D. A wound dressing with thick, light green drainage
• D. A wound dressing with thick, light green drainage
• ATI Practice Test - Learning System Fundamentals 2A nurse is planning to collect a liquid stool specimen from a client for ova and parasites. Inaccurate test results may result if the nurseA. refrigerates the collects specimen.B. transfers the specimen to a sterile container.C. instructs the client to defecate into a bedpan.D. sends only the bloody and mucoid portions of the stool.
• A. refrigerates the collects specimen.
• ATI Practice Test - Learning System Fundamentals 2A client is in the bathroom. The nurse hears a loud thud, and after opening the bathroom door, sees the client lying on the floor. The nurse's first reaction should be toA. call for help.B. determine unresponsiveness.C. see if the client is breathing.D. open the client's airway.
• B. determine unresponsiveness.
• ATI Practice Test - Learning System Fundamentals 2A client admitted to a long-term care facility requires total care. In providing mouth care for the client, the appropriate nursing action is toA. place the client on his back with a pillow under his head.B. use a thumb and index finger to keep the client's mouth open.C. clean the client's teeth with a stiff toothbrush.D. turn the client on his side before starting mouth care.
• D. turn the client on his side before starting mouth care.
• ATI Practice Test - Learning System Fundamentals 2A provider prescribes a cleansing enema for a client having bowel surgery. Which of the following nursing interventions is appropriate during this procedure?A. Place the solution bag 3 feet above the client.B. Wear sterile gloves to insert the tubing.C. Lubricate the anus prior to insertion.D. Position the client on his left lateral side.
• D. Position the client on his left lateral side.
• ATI Practice Test - Learning System Fundamentals 2A nurse caring for preoperative client administers atropine as prescribed toA. decrease oral and respiratory secretions.B. reduce the risk of deep vein thrombosis postoperatively.C. increase gastric pH and promote gastric emptying.D. induce sedation and relieve anxiety.
• A. decrease oral and respiratory secretions.
• ATI Practice Test - Learning System Fundamentals 2When obtaining a urine specimen and culture and sensitivity from an indwelling catheter, the nurse should:A. cleanse the entry port prior to withdrawing urine.B. wear sterile gloves.C. collect the specimen from the urometer port.D. drain the bag and wait for a fresh urine sample to collect from the drainage bag.
• A. cleanse the entry port prior to withdrawing urine.
• ATI Practice Test - Learning System Fundamentals 2Following an accidental fall while playing volleyball, a client is sent home in a lower leg cast due to a hairline fracture of the tibia and must use crutches. When reinforcing teaching about the four-point gain, the nurse explains that the client shouldA. keep his elbows extended.B. be able to bear weight on both legs.C. support the majority of his weight in the axillae.D. hold the affected extremity up off the ground.
• B. be able to bear weight on both legs.
• ATI Practice Test - Learning System Fundamentals 2A client is recovering from an appendectomy for a ruptured appendix has a surgical wound healing by a secondary intention. When changing the client's dressing, which observation should the nurse report to the charge nurse?A. A halo of erythema on the surrounding skinB. Pink, shiny tissue with a granular appearanceC. Seriosanguineous drainageD. Tenderness when touched
• A. A halo of erythema on the surrounding skinRationale:This is an indication of infection.
• ATI Practice Test - Learning System Fundamentals 2A client newly diagnosed with diabetes mellitus is admitted to the hospital. When obtaining a urine specimen from the client, the nurse should avoidA. putting the empty urine specimen cup in the client's bathroom.B. placing the full specimen cup in a clean plastic bag on arrival at the laboratory pickup area.C. attaching a label with the client's identification to the specimen cup.D. explaining to the client the procedure for obtaining the urine specimen.
• B. placing the full specimen cup in a clean plastic bag on arrival at the laboratory pickup area.
• ATI Practice Test - Learning System Fundamentals 2A client who has pancreatic cancer will be using patient-controlled analgesia (PCA) with morphine sulfate (Roxanol) to manage chronic pain. Which of the following instructions should the nurse reinforce with the client and family?A. "Remember to press the button hen you begin to sense pain."B. "A nurse will check your blood pressure frequently to watch for an allergic reaction."C. "Your family should press the button for your if you're sleeping so that you don't miss a dose.D. "The PCA is programmed to deliver a small doses of morphine q30 min."
• A. "Remember to press the button hen you begin to sense pain."
• ATI Practice Test - Learning System Fundamentals 2A client has just had an indwelling urinary catheter inserted. If the nurse took all of the following actions, he used improper technique when heA. inserted the catheter an additional 1 to 2 inches after observing urine in the drainage tubing.B. placed the client in the dorsal recumbent position with knees bent and legs apart.C. cleansed the client's urinary meatus with soap and water prior to inserting the catheter.D. used sterile 0.9% sodium chloride to inflate the catheter's retention balloon.
• C. cleansed the client's urinary meatus with soap and water prior to inserting the catheter.
• ATI Practice Test - Learning System Fundamentals 2A nurse is caring for a client who is paralyzed on the right side following a cerebrovascular accident (CVA). When preparing to give a bed bath to the client, the nurseA. put the bed in low semi-Fowler's position.B. adjust the bed to the lowest position.C. raise the bed to the high horizontal position.D. unplug the bed.
• C. raise the bed to the high horizontal position.
• ATI Practice Test - Learning System Fundamentals 2A nurse is caring for a client who is 1-day postoperative following abdominal surgery. What is the first action the nurse should take after discovering that the client's wound has eviscerated?A. Have the client lie on his back with his knees flexed.B. Cover the incision with a moist sterile dressing.C. Ask the charge nurse to notify the client's surgeon.D. Measure the client's vital signs.
• B. Cover the incision with a moist sterile dressing.
• ATI Practice Test - Learning System Fundamentals 2A client receiving chemotherapy has developed stomatitis. An appropriate lunch selection for this client is A. cheese omelet, cherry gelatin, milkshake.B. hot dog on a soft roll, potato chips, orange juice.C. Haddock, french fries, tomato juice.D. Chicken Caesar salad, lemon-lime soda.
• A. cheese omelet, cherry gelatin, milkshake.Rationale:Stomatitis is an inflammation of the mouth.
• ATI Practice Test - Learning System Fundamentals 2When reinforcing teaching about colostomy care, the nurse reminds the client to replace the bag.A. every other day.B. every 4 to 6 hr.C. daily.D. as often as needed.
• ATI Practice Test - Learning System Fundamentals 2A client's postoperative orders include administering a medication the nurse has never heard of. The drug reference available on the nursing unit does not list the medication. The nurse shouldA. call the charge nurse and ask her to question the order.B. give the medication as prescribed by the provider.C. call the facility's pharmacy and ask for a package insert.D. Ask a more senior staff nurse for more information.
• C. call the facility's pharmacy and ask for a package insert.
• ATI Practice Test - Learning System Fundamentals 2In planning care for a client with a surgical wound healing by secondary intention, the nurse can anticipate that the client willA. require skin grafting for the wound to heal.B. have the wound sutured closed at a later date.C. be at an increased susceptibility for infection.D. have well-approximated wound edges.
• C. be at an increased susceptibility for infection.
• ATI Practice Test - Learning System Fundamentals 2A client awake at 0100 says to the nurse, "The staff is making too much noise, and I haven't had a decent night's sleep since my wife died a year ago. Please get me a cup of hot tea to help me relax and quench my thirst." Which of the following should the nurse do?A. Get the cup of hot tea the client requested.B. Close the door to eliminate noise of the hallway.C. Offer to get a warm glass of milk for the client.D. Suggest that the client get more exercise during the day.
• C. Offer to get a warm glass of milk for the client.
• ATI Practice Test - Learning System Fundamentals 2A nurse overseeing an assistive personnel (AP) instructs the AP to include a draw sheet on the occupied bed she is making. THe nurse explains that the purpose of the draw sheet is toA. absorb urine, feces, and bodily secretions.B. promote warmth and comfort.C. give the bed a neat appearance.D. aid in positioning the client.
• D. aid in positioning the client.
• ATI Practice Test - Learning System Fundamentals 2An nurse is performing an eye irrigation for a client who has been exposed to smoke and ash. Which of the following nursing actions should receive the highest priority during the irrigation?A. Cleansing the eyelids prior to the irrigation.B. Having the client sit upright with her head tilted back.C. Wearing gloves during the procedure.D. Asking the client to look at thee ceiling during the irrigation.
• C. Wearing gloves during the procedure.
• ATI Practice Test - Learning System Fundamentals 2A nurse is observing a client who is postoperative following thoracic surgery. Which of the following manifestations should alert the nurse to the possibility of early hypovolemic shock?A. BradycardiaB. Warm, flushed skinC. HypertensionD. Tachycardia
• ATI Practice Test - Learning System Fundamentals 2A nurse is caring for a client who has just had a mastectomy and has a closed wound-suction device (Hemovac) in place. Which nursing action will ensure proper operation of the device?A. Emptying the device when it's fullB. Collapsing the device whenever it is 1/2 to 2/3 full of airC. Keeping the tubing above the level of the surgical incisionD. Irrigating the tubing with sterile 0.9% sodium chloride q8h
• B. Collapsing the device whenever it is 1/2 to 2/3 full of air
• ATI Practice Test - Learning System Fundamentals 2An assistive personnel reports that a client's intravenous (IV) infusion has infiltrated. Which of the following would be an unexpected finding when the nurse assesses the client's infusion line and insertion site?A. The infusion slows or stops while the tubing is not kinked.B. The area around the injection site feels warm when touched.C. Swelling, hardness, or pain located around the insertion site.D. blood fails to return in the tubing when the bottle lowered.
• B. The area around the injection site feels warm when touched.
• ATI Practice Test - Learning System Fundamentals 2When reinforcing teaching for a client who has diabetes mellitus, the nurse should firstA. advise the client that bathing regularly is very important.B. ask which hygienic measures the client is presently using.C. demonstrate to the client the proper procedure for performing foot care.D. observe the client giving a return demonstration of cleansing his dentures.
• B. ask which hygienic measures the client is presently using.
• ATI Practice Test - Learning System Fundamentals 2A client returns from surgery with two Penrose drains in place. Anticipating frequent dressing changes,what should the nurse use to reduce skin irritation around the incision?A. Large absorbent padsB. Silicone sprayC. Hypoallergenic tapeD. Montgomery straps
• ATI Practice Test - Learning System Fundamentals 2A client is recovering from gallbladder surgery performed under general anesthesia. The nurse should encourage the client to use the incentive spirometer how many times per hour?A. Eight to 12B. One to twoC. Four to fiveD. 15 to 20

D. in the morning, on arising.