233 Chapter 2 - Perioperative Nursing

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  • 1. 
    The nurse is preparing a client for surgery. What is the most effective method for obtaining an accurate blood pressure reading from the client?
    • A. 

      Obtain a cuff that covers the upper one third of the client’s arm

    • B. 

      Position the cuff approximately 4 inches above the antecubital arm

    • C. 

      Use a cuff that is wide enough to cover the upper two thirds of the client’s arm

    • D. 

      Identify the Korotkoff sounds, and take a systolic reading at 10 mmHg after the first sound


  • 2. 
    Which of the following items on a client’s presurgery laboratory results would indicate a need to contact the surgeon?
    • A. 

      Platelet count of 250,000/cu.mm

    • B. 

      Total cholesterol of 325 mg/dl

    • C. 

      Blood urea nitrogen (BUN)) 17 mg/dl

    • D. 

      Hemoglobin 9.5 mg/dl


  • 3. 
    To prevent complications of immobility, which activities would the nurse plan for the first postoperative day after a colon resection?
    • A. 

      Turn, cough, and deep breathe every 30 minutes around the clock

    • B. 

      Get the client out of bed and ambulate to a bedside chair

    • C. 

      Provide passive range of motion three times a day

    • D. 

      It is not necessary to worry about complications of immobility on the first postoperative day


  • 4. 
    In the recovery room, the postoperative client suddenly becomes cyanotic. What is the most appropriate nursing action?
    • A. 

      Start administration of oxygen through a nasal cannula

    • B. 

      Call for assistance

    • C. 

      Reposition the head and determine patency of airway

    • D. 

      Insert an oral airway and suction the nasopharynx


  • 5. 
    A client is scheduled for surgery in the morning. Preoperative orders have been written. What is the most important to do before surgery?
    • A. 

      Remove all jewelries or tape wedding ring

    • B. 

      Verify that all laboratory work is complete

    • C. 

      Inform family or next of kin

    • D. 

      Have all consent forms signed


  • 6. 
    The nurse is caring for a first day postoperative surgical client. Prioritize the patient’s desired dietary progression. Arrange in sequence the dietary progression from 1 to 4: 1. Full liquid; 2. NPO; 3. Clear liquid; 4. Soft
    • A. 

      1, 2, 3, 4

    • B. 

      2, 3, 1, 4

    • C. 

      2, 1, 4, 3

    • D. 

      4, 3, 2, 1


  • 7. 
    A postoperative client receives a dinner tray with gelatin, pudding, and vanilla ice cream. Based on the foods on the client’s tray, what would the nurse anticipate the client’s current diet order to be:
    • A. 

      Bland diet

    • B. 

      Soft diet

    • C. 

      Full liquid diet

    • D. 

      Regular diet


  • 8. 
    The nurse is preparing the preoperative client for surgery. The following statements that indicate the client is knowledgeable about his impending surgery, except:
    • A. 

      “After surgery, I will need to wear the pneumatic compression device while sitting in the chair”

    • B. 

      “The skin prep area is going to be longer and wider than the anticipated incision”

    • C. 

      “I cannot have anything to drink or eat after midnight on the night before the surgery”

    • D. 

      “To ensure my safety, a ‘time out’ will be conducted in the operating room”


  • 9. 
    Which of the following is the primary purpose of maintaining NPO for 6 to 8 hours before surgery?
    • A. 

      To prevent malnutrition

    • B. 

      To prevent electrolyte imbalance

    • C. 

      To prevent aspiration pneumonia

    • D. 

      To prevent intestinal obstruction


  • 10. 
    The nurse will provide preoperative teaching on deep breathing, coughing and turning exercises. When is the best time to provide the preoperative teachings?
    • A. 

      Before administration of preoperative medications

    • B. 

      The afternoon or evening prior to surgery

    • C. 

      Several days prior to surgery

    • D. 

      Upon admission of the client in the recovery room


  • 11. 
    Which of the following factors ensure validity of informed written consent, except:
    • A. 

      The patient is of legal age with proper mental disposition

    • B. 

      If the patient is a child, secure consent from the parents or legal guardian

    • C. 

      The consent is secured before administration of preoperative medications

    • D. 

      If the patient is unable to write, the nurse signs the consent for the patient


  • 12. 
    Which of the following drugs is administered to minimize respiratory secretions preoperatively?
    • A. 

      Valium (diazepam)

    • B. 

      Phenergan (promethazine)

    • C. 

      Atropine sulfate

    • D. 

      Demerol (Meperidine)


  • 13. 
    Which of the following is experienced by the patient who is under general anesthesia?
    • A. 

      The patient is unconscious

    • B. 

      The patient is awake

    • C. 

      The patient experiences slight pain

    • D. 

      The patient experiences loss of sensation in the lower half of the body


  • 14. 
    Which of the following is most dangerous complication during induction of spinal anesthesia?
    • A. 

      Cardiac arrest

    • B. 

      Hypotension

    • C. 

      Hyperthermia

    • D. 

      Respiratory paralysis


  • 15. 
    Which of the following postoperative patients is at risk for respiratory complications?
    • A. 

      The obese patient with long history of smoking who had undergone upper abdominal surgery

    • B. 

      The patient with normal pulmonary function who had undergone upper abdominal surgery

    • C. 

      An adolescent patient with diabetes mellitus who had undergone cholecystectomy

    • D. 

      A football player who had undergone knee replacement surgery


  • 16. 
    The patient had undergone spinal anesthesia for appendectomy. To prevent spinal headache, the nurse should place the patient in which of the following positions?
    • A. 

      Semi-Fowler’s

    • B. 

      Flat on bed for 6 to 8 hours

    • C. 

      Prone position

    • D. 

      Modified Trendelenburg position


  • 17. 
    The nurse is admitting a patient to the operating room. Which of the following nursing actions should be given highest priority by the nurse?
    • A. 

      Assessing the patient’s level of consciousness

    • B. 

      Checking the patient’s vital signs

    • C. 

      Checking the patient’s identification and correct operative permit

    • D. 

      Positioning and performing skin preparation to the patient


  • 18. 
    Which of the following assessment data is most important to determine when caring for a patient who has received spinal anesthesia?
    • A. 

      The time of return of motion and sensation in the patient’s legs and toes

    • B. 

      The character if the patient’s respiration

    • C. 

      The patient’s level of consciousness

    • D. 

      The amount of wound drainage


  • 19. 
    The nurse is transferring the patient from the postanesthesia care unit to the surgical unit. Which of the following is the primary reason for gradual change of position of the patient?
    • A. 

      To prevent muscle injury

    • B. 

      To prevent sudden drop of blood pressure

    • C. 

      To prevent respiratory distress

    • D. 

      To promote comfort


  • 20. 
    The nurse is caring for a patient who had undergone exploratory laparotomy. Which of the following postop findings should the nurse report to the physician?
    • A. 

      The patient pushes out the oral airway with his tongue

    • B. 

      The patient’s urine output is 20 ml/hr for the past 2 hours

    • C. 

      The patient’s vital signs are as follows: BP = 100/70 mmHg; PR = 95 bpm; RR = 9 minute; T = 36.8°C

    • D. 

      The patient’s wound drainage


  • 21. 
    The patient had undergone thyroidectomy. Which of the following are the earliest signs of poor tissue perfusion and poor respiratory function?
    • A. 

      Cyanosis, lethargy

    • B. 

      Fast, thready pulse, bradypnea

    • C. 

      Apprehension and restlessness

    • D. 

      Faintness, pallor


  • 22. 
    The diabetic patient who had undergone abdominal surgery experiences wound evisceration. Which of the following is the most appropriate immediate nursing action?
    • A. 

      Cover the wound with sterile gauze moistened with sterile normal saline

    • B. 

      Cover the wound with sterile dry gauze

    • C. 

      Cover the wound with water-soaked gauze

    • D. 

      Leave the wound uncovered and pull the skin edges together


  • 23. 
    The patient had undergone total hip replacement. He complains of pain in the operative site. Which of the following is the appropriate initial nursing action?
    • A. 

      Administer the ordered analgesic

    • B. 

      Instruct the patient to do deep breathing and coughing exercises

    • C. 

      Assess the patient’s pain level and vital signs

    • D. 

      Change the patient’s position


  • 24. 
    Which of the following are not members of the sterile team in the operating room, except:
    • A. 

      Surgeon

    • B. 

      Scrub nurse

    • C. 

      Radiology technician

    • D. 

      Circulating nurse


  • 25. 
    The best position for kidney, chest, or hip surgery is:
    • A. 

      Supine

    • B. 

      Trendelenburg

    • C. 

      Lithotomy

    • D. 

      Lateral


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