A patient asks a nurse what a PCA pump does. The nurse explains that a PCA pump allows postoperative patients to:

Be totally pain free

Take unlimited amounts of medication

Choose the type of pain medication

Administer their own analgesics

Answer and Explanation

The Correct Answer is D

Patient-controlled analgesia (PCA) gives the patient autonomy to push a button to receive a preset dose of analgesic, commonly IV opioid, with programmed lockouts and limits to prevent overdose.

Rationale for correct answer:

4. Administer their own analgesics: PCA lets the patient self-administer preset doses (usually opioid or other analgesic) when needed, within safety limits.

Rationale for incorrect answers:

1. Be totally pain free: PCA improves timely pain control but does not guarantee total absence of pain; goals are acceptable pain relief and function.

2. Take unlimited amounts of medication: PCA devices are programmed with fixed dose, lockout interval, and maximum limits to prevent overdose.

3. Choose the type of pain medication: The clinician prescribes the medication and PCA settings; the patient cannot change the drug.

Take home points:

PCA - patient-initiated analgesia within clinician-set dose and safety parameters.

PCA can improve pain control and patient satisfaction but requires monitoring for sedation and respiratory depression and teaching the patient proper use.

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Correct Answer is C

Explanation

Postoperative gas pain commonly results from anesthetic effects, decreased bowel motility, swallowed air, and manipulation of the bowel. Promoting early and frequent ambulation, position changes, and encouraging passing flatus are the most effective nonpharmacologic measures.

Rationale for correct answer:

3. Encourage frequent ambulation: Ambulation stimulates intestinal motility and helps move trapped gas, reducing distention and discomfort. It’s a first-line, low-risk intervention.

Rationale for incorrect answers:

1. Cough and deep breathe every 2 hours: Coughing and deep breathing primarily prevent pulmonary complications (atelectasis) and do not directly relieve intestinal gas.

2. Maintain NPO status for 48 hours: Prolonged NPO is unnecessary for routine gas pain and may delay return of bowel function; early oral intake as tolerated and activity often help.

4. Take vital signs every 4 hours: Monitoring vitals is important for overall postop care but will not directly relieve gas pain.

Take home points:

Early ambulation is the single most effective nursing intervention to relieve postoperative gas pain by stimulating bowel motility.
Use multimodal measures - positioning, ambulation, analgesia to allow activity, and ordered medications such as simethicone.

A. Obesity B. Prolonged bleeding time C. Delayed wound healing D. Ineffective vital capacity E. Immobility secondary to height

Correct Answer is ["A","C","D"]

Explanation

Certain chronic conditions (diabetes, obesity, respiratory impairment) predispose clients to complications such as infection, poor healing, and respiratory compromise. Identifying these risks allows the nurse to implement preventive measures.

Rationale for correct answers:

1. Obesity increases surgical risk because excess adipose tissue reduces blood supply to tissues, impairs wound healing, and increases strain on the respiratory and cardiovascular systems. It also makes positioning and anesthesia management more difficult.

3. Delayed wound healing: Diabetes interferes with tissue perfusion and impairs immune response, increasing the risk of delayed wound healing and postoperative infections.

4. Ineffective vital capacity: Obesity can restrict chest expansion, reduce lung volume, and impair effective ventilation. This puts the client at higher risk for atelectasis and hypoxemia postoperatively.

Rationale for incorrect answers:

2. Prolonged bleeding time: There’s no evidence in the scenario that this client has a bleeding disorder. Prolonged bleeding time is a concern with anticoagulant therapy or platelet dysfunction, not specifically linked to this patient.

5. Immobility secondary to height: Height alone is not a risk factor for immobility or surgical complications. Immobility is more commonly associated with obesity, fractures, or neurologic impairment.

Take home points:

Obesity and diabetes significantly increase surgical risks due to poor wound healing, infection risk, and respiratory limitations.
Risk assessment guides pre- and post-op nursing care e.g., strict glucose control, pulmonary hygiene, infection prevention.

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A patient asks a nurse what a PCA pump does. The nurse explains that a PCA pump allows postoperative patients to:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Gas pains are a common postoperative discomfort. Which of the following nursing actions implemented in the plan of care would be most likely to relieve gas pains?

Correct Answer is C

Explanation

The nurse prepares a patient with type 2 diabetes for a surgical procedure. The patient weighs 112.7 kg (248 lb) and is 157.4 cm (5 feet, 2 inches) in height. Which factors increase this patient’s risk for surgical complications? Select all that apply

Correct Answer is ["A","C","D"]

Explanation

Communication between a nurse caring for a patient in the preoperative holding area and the circulating nurse in the operating room (OR) can best be enhanced by which of the following? Select all that apply

An 85-year-old patient returns to the inpatient surgical unit after leaving the PACU. Which of the following place the patient at risk during surgery? Select all that apply

Mr. Ying is scheduled for surgery. He says to the nurse, “I am so frightened-what if I don’t wake up?” What would be the best response?

Which of the following surgical patients is at a greater risk for alterations in body image?

The nurse plans to remove the client’s sutures. Which action demonstrates appropriate standards of care? Select all that apply

Older adults often have reduced vital capacity as a result of normal physiologic changes. Which nursing intervention would be most important for the postoperative care of an older surgical patient specific to this change?

The client’s postoperative orders state “diet as tolerated.” The client has been NPO. The nurse will advance the client’s diet to clear liquids based on which assessment? Select all that apply