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

Obesity

Prolonged bleeding time

Delayed wound healing

Ineffective vital capacity

Immobility secondary to height

Answer and Explanation

Correct Answer : A,C,D

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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Correct Answer is B

Explanation

Preoperative anxiety is common; patients need empathy and a safe space to express fears. The nurse’s best immediate response acknowledges the feeling and opens a conversation so underlying concerns (fear of death, anesthesia, pain, loss of control) can be explored, corrected, and managed. Therapeutic communication (open-ended invitation, active listening) improves trust.

Rationale for correct answer:

2. “Let’s talk about how you are feeling.” Invites the patient to express concerns, shows empathy, and lets the nurse assess the intensity and content of the fear.

Rationale for incorrect answers:

1. “You have a wonderful doctor.” Diverts attention from the patient’s feelings and gives a vague reassurance rather than exploring fear.

3. “Everyone wakes up from surgery!” False reassurance; minimizes the patient’s worry and may undermine trust.

4. “Don’t worry, you will be just fine.” Dismissive; it shuts down emotional expression instead of addressing it.

Take home points:

Use open-ended, empathetic statements that invite expression rather than offering premature reassurance.
Exploring fears lets you assess need for teaching, more explanation from anesthesia, or anxiolytic interventions-don’t dismiss or minimize.

A. A 19-year-old woman who had a repair of large facial laceration B. A 42-year-old woman who has had gallbladder surgery C. A 14-year-old boy who underwent a repair of a fractured clavicle D. A 52-year-old man who has had an inguinal hernia repair

Correct Answer is A

Explanation

Body image refers to an individual’s perception of their physical self. Surgery that alters visible body parts (face, breasts, limbs) or sexual/reproductive organs carries the highest psychosocial impact. Nurses must anticipate these concerns, provide support, and involve counseling when needed.

Rationale for correct answer:

1. 19-year-old woman, facial laceration: Adolescents and young adults are particularly vulnerable to changes in body image because appearance and social acceptance are critical at this stage of psychosocial development.

Rationale for incorrect answers:

2. 42-year-old woman, gallbladder surgery: While scars may form, they are often small and hidden; adults in this age group generally have a more stable self-concept and body image compared to adolescents.

3. 14-year-old boy, fractured clavicle repair: Although body image is important in adolescence, clavicle repairs usually result in minimal visible long-term changes and full functional recovery.

4. 52-year-old man, inguinal hernia repair: Body image changes are minimal with this procedure, and psychosocial adaptation at this age tends to be less influenced by appearance.

Take home points:

Visible surgical changes (especially on the face or reproductive areas) increase risk for disturbed body image.
Age and developmental stage influence how strongly clients react to body image changes - adolescents and young adults are at greater risk.

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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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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?

Correct Answer is B

Explanation

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

Correct Answer is A

Explanation

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?

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

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?

A nurse cares for a postoperative patient in the PACU. Upon assessment, the nurse finds the surgical dressing is saturated with serosanguineous drainage. Which two interventions are a priority? Select all that apply

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

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

Mr. Moreno has had a surgical procedure that necessitated a thoracic incision. The nurse anticipates that he will have a higher risk for postoperative complications involving which body system?