Preoperative Phase

Every question here, with the answer

1. A patient in the preoperative area says, “I signed the consent form, but I still do not understand the risks or alternatives.” What is the nurse’s priority action?

   1. Explain the surgical risks and alternatives independently, then document that informed consent was obtained.
   2. Tell the patient that detailed questions can be answered after the procedure.
   3. Ask the professional who will perform the procedure to discuss the procedure, risks, benefits, and alternatives with the patient before surgery.
   4. Proceed because the signed consent form is already in the chart.

   Answer: Ask the professional who will perform the procedure to discuss the procedure, risks, benefits, and alternatives with the patient before surgery.

   The nurse may witness a consent signature, but the responsibility for obtaining informed consent and confirming understanding belongs to the professional performing the procedure. Proceeding with an unclear consent or having the nurse obtain consent would not meet the section’s requirements.

2. The nurse is teaching a patient about skin preparation before surgery. Which instructions are appropriate? Select all that apply.

   1. Apply lotion after cleansing to protect the skin from dryness.
   2. Know whom to contact if there are questions about the preoperative routine.
   3. Do not remove hair at the surgical site at home.
   4. Shave the incision area within twenty-four hours before surgery.
   5. Use the instructed preoperative skin preparation product as directed.

   Answer: Know whom to contact if there are questions about the preoperative routine., Do not remove hair at the surgical site at home., Use the instructed preoperative skin preparation product as directed.

   Patients should receive clear directions for using the skin preparation product and should know whom to contact with questions. They should not remove hair at the surgical site; shaving within twenty-four hours before surgery is no longer recommended because it may increase irritation and infection risk.

3. The nurse is evaluating a patient’s understanding of fasting instructions before a procedure requiring anesthesia. Which patient statement requires follow-up teaching?

   1. “Fried or fatty foods and milk may require additional fasting time.”
   2. “I may be allowed to have carbohydrate-containing clear liquids up to two hours before surgery.”
   3. “A light meal such as toast and clear liquids may be allowed six hours before surgery.”
   4. “If my surgery is scheduled for the afternoon, I must still stop all food and fluids after midnight.”

   Answer: “If my surgery is scheduled for the afternoon, I must still stop all food and fluids after midnight.”

   The section explains that fasting-after-midnight instructions have been updated because extended fasting can cause problems, especially for afternoon surgery. The other statements match the listed common timing guidance for clear liquids, light meals, and fatty foods or milk.

4. A patient asks what to do with personal items on the day of surgery. Which instructions should the nurse include? Select all that apply.

   1. Cover jewelry with tape if it is difficult to remove.
   2. Remove rings and all body piercings before surgery.
   3. Leave valuables at home.
   4. Keep tongue jewelry in place unless the surgery involves the mouth.
   5. Do not wear cosmetics or use lotions before surgery.

   Answer: Remove rings and all body piercings before surgery., Leave valuables at home., Do not wear cosmetics or use lotions before surgery.

   The nurse should instruct the patient to leave valuables at home, avoid cosmetics and lotions, and remove jewelry and body piercings. Taping jewelry does not remove the risks, and nose, tongue, or lip jewelry can make airway management dangerous.

5. A patient scheduled for same-day surgery with conscious sedation says, “I will take a taxi home by myself.” What is the best nursing response?

   1. “You can drive yourself home if you wait until you feel fully awake.”
   2. “You may use a taxi alone if the driver agrees to walk you to your door.”
   3. “You need a driver, and a taxi or rideshare is prohibited unless an adult accompanies you and assumes responsibility.”
   4. “That is acceptable as long as you do not drive yourself.”

   Answer: “You need a driver, and a taxi or rideshare is prohibited unless an adult accompanies you and assumes responsibility.”

   For same-day surgery with conscious sedation, a driver is required. The section states that rideshares, including taxis, are prohibited unless an adult accompanies the patient and assumes responsibility.

6. The preoperative nurse is preparing a patient before transfer to the OR. Which actions are consistent with the preoperative stage of care? Select all that apply.

   1. Conduct preoperative assessments.
   2. Prepare the patient physically and emotionally for surgery.
   3. Make the first incision to begin the surgical procedure.
   4. Verify surgical consents.
   5. Educate the patient about the procedure.

   Answer: Conduct preoperative assessments., Prepare the patient physically and emotionally for surgery., Verify surgical consents., Educate the patient about the procedure.

   Preoperative care includes assessment, consent verification, education, and physical and emotional preparation. Making the first incision is not a preoperative nursing task and occurs after the patient has moved beyond the preoperative phase.