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Practice Question

The nurse in preadmission testing learns that a client scheduled for a total hip replacement in three weeks smokes one pack of cigarettes per day. Which action(s) should the nurse take? Select all that apply.

Answer Choices:

Correct Answer:

Explain the increased risk for venous thromboembolism after surgery.

Rationale:

Explain increased VTE risk:

Total hip replacement carries a high baseline risk for venous thromboembolism (VTE); smoking adds prothrombotic and endothelial-injury risks.

◈ Educating on VTE risk reinforces the importance of early ambulation, pharmacologic prophylaxis, and SCDs postoperatively.

◈ Understanding risk improves adherence to mobility goals and anticoagulation protocols if prescribed.

◈ This teaching ties smoking to perioperative complications, motivating behavior change.

◈ Clear risk discussion supports informed participation in the plan of care.

Provide cessation resources:

◈ Offering smoking-cessation resources (NRT, counseling, quit lines) is evidence-based and improves quit rates.

◈ Even a few smoke-free weeks preop improves pulmonary function and wound healing.

◈ Concrete resources convert advice into an actionable plan.

◈ Documenting resources given ensures continuity across the perioperative team.

◈ Empowering cessation enhances short- and long-term outcomes.

Encourage cessation before surgery:

Preoperative abstinence reduces atelectasis, pneumonia, bronchospasm, and SSI risk and may shorten LOS.

◈ The earlier the quit date, the greater the physiologic recovery (e.g., ciliary function and oxygenation).

◈ Setting a quit date and follow-ups raises success rates.

◈ Positive, nonjudgmental counseling improves engagement.

◈ Cessation aligns with enhanced recovery and safer anesthesia.

Notify the surgeon:

◈ Communicating smoking status to the surgeon/anesthesia team ensures planning for airway, analgesia, and pulmonary risk.

◈ The provider may initiate preop optimization (e.g., NRT) and adjust VTE prophylaxis or respiratory strategies.

◈ Team awareness promotes targeted postop monitoring for respiratory compromise.

◈ This handoff meets safety and documentation standards in preadmission testing.

◈ Early notification supports a coordinated perioperative plan.

Want to practice more questions like this?

This question is from Adult Nursing II-Exam 1 which contains 56 questions.

More Questions from This Exam
A surgical client has been in the PACU for the past 3 hours. What are the determining factors for the client to be discharged from the PACU? Select all that apply.

Answer Choices:

A. Adequate respiratory function
B. Absence of pain
C. Ability to tolerate oral fluids
D. Sufficient oxygen saturation
E. Stable blood pressure
The nurse in preadmission testing is educating a client about a scheduled surgery. Which response should the nurse give when the client asks about pain management following surgery?

Answer Choices:

A. "Lying still in bed will help control your pain."
B. "Don't worry—most clients do not have much pain from this surgery."
C. "Wait to ask for pain medication until the pain becomes intolerable."
D. "Your nurse will use a pain assessment scale to help rate and treat your pain."
A client waiting in the presurgical holding area asks the nurse, "Why exactly do they have to put a breathing tube into me? My surgery is on my knee." What is the best rationale for intubation during a surgical procedure that the nurse should describe?

Answer Choices:

A. The client's vital signs can be monitored with the tube.
B. The tube provides an airway for ventilation.
C. The tube protects the client's esophagus from trauma.
D. The client may receive an antiemetic through the tube.
From Exam
Adult Nursing II-Exam 1

56 Questions

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Question Details
  • Category: RN Nursing Exam(s)
  • Subcategory: Examplify Exam(s)
  • Domain: Medical-Surgical
  • Answer Choices: 5
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