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Peri-operative Nursing

100 Questions  I  By Abangjoseph
Medical-surgical nursing is a nursing specialty area concerned with the care of adult patients in a broad range of settings. The Academy of Medical-Surgical Nurses (AMSN) is a specialty nursing organization dedicated to nurturing medical-surgical nurses as they advance their careers. Traditionally, medical-surgical nursing was an entry-level position that most nurses viewed as a stepping stone to specialty areas. Medical-surgical nursing is the largest group of professionals in the field of nursing. Advances in medicine and nursing have resulted in medical-surgical nursing evolving into its own specialty.
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1.  A 36-year-old female diabetic client is having an elective breast augmentation procedure done. Which of the following tests must be done on the day of surgery?
A.
B.
C.
D.
2.  A 92-year-old client is scheduled for a colectomy. Which normal physiological change that accompanies the aging process increases this client’s risk for surgery?
A.
B.
C.
D.
3.  Which of the following factors ensure validity of informed written consent, except:
A.
B.
C.
D.
4.  A prostate biopsy is an acceptable procedure to be performed as an ambulatory surgery on an otherwise healthy adult male because the American Society of Anesthesiologists (ASA) considers that a:
A.
B.
C.
D.
5.  Which of the following client outcomes is most therapeutic for a preoperative client with a nursing diagnosis of deficient knowledge regarding preoperative requirements related to lack of exposure to information?
A.
B.
C.
D.
6.  You are the circulating nurse. Which task are you solely responsible for?
A.
B.
C.
D.
7.  An appendectomy is appropriately documented by the nurse as:
A.
B.
C.
D.
8.  A 64-year-old male client has been scheduled to undergo surgery for a total knee replacement. The client would like to be able to use his own blood for the surgery, if needed. The nurse explains that there are several advantages to the client's having an autologous infusion, but there are some drawbacks as well. Which of the following would be considered a drawback to an autologous infusion?
A.
B.
C.
D.
9.  The patient had undergone thyroidectomy. Which of the following are the earliest signs of poor tissue perfusion and poor respiratory function?
A.
B.
C.
D.
10.  The nurse is completing the preoperative checklist for an adult female client who is scheduled for an operative procedure later in the morning. Which of the following preoperative assessment findings for this client indicates a need to contact the surgeon?
A.
B.
C.
D.
11.  A 24-year-old male client has been scheduled to undergo surgery for an ACL repair of his right knee. The client states that he is confused about what the surgeon will be doing. The best response from the nurse is:
A.
B.
C.
D.
12.  Which of the following assessment data is most important to determine when caring for a patient who has received spinal anesthesia?
A.
B.
C.
D.
13.  Which of the following goals is most appropriate for a preoperative client with a nursing diagnosis of deficient knowledge regarding preoperative requirements related to lack of exposure to information?
A.
B.
C.
D.
14.  A client who is scheduled for surgery is found to have thrombocytopenia. A specific postoperative concern for the nurse for this client is:
A.
B.
C.
D.
15.  The anesthetist is coming to the unit to see a patient prior to surgery that is scheduled for tomorrow morning. What information, obtained during the admission assessment, should be given to the anesthetist during the visit?
A.
B.
C.
D.
16.  Following abdominal surgery, the nurse suspects that the client may be having internal bleeding. Which of the following findings is indicative of this complication?
A.
B.
C.
D.
17.  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.
B.
C.
D.
18.  Which surgical classification would be the most appropriate for a cardiac catheterization scheduled on a 44-year-old male client who is in the hospital with chest pain?
A.
B.
C.
D.
19.  The client asks the nurse the purpose of having medications (Demerol and Vistaril) given before surgery. The nurse should inform the client that these particular medications:
A.
B.
C.
D.
20.  A client who has type 2 diabetes is scheduled for the removal of a skin lesion on his right shoulder at an ambulatory surgery unit. The nursing diagnosis the client is at greatest risk for postoperatively is:
A.
B.
C.
D.
21.  Which of the following is the primary purpose of maintaining NPO for 6 to 8 hours before surgery?
A.
B.
C.
D.
22.  You are the circulating nurse for several surgeries today. What would be one of your major goals for each of these patients?
A.
B.
C.
D.
23.  The nurse is completing the preoperative checklist for an adult client who is scheduled for an operative procedure later in the morning. Which of the following preoperative assessment findings for this client indicates a need to contact the anesthesiologist?
A.
B.
C.
D.
24.  In the recovery room, the postoperative client suddenly becomes cyanotic. What is the most appropriate nursing action?
A.
B.
C.
D.
25.  A 43-year-old client is scheduled to have a gastrectomy. Which of the following is a major preoperative concern?
A.
B.
C.
D.
26.  As an OR nurse, you have an increased awareness regarding asepsis. You know that a basic guideline for maintaining surgical asepsis is what?
A.
B.
C.
D.
27.  A client with a history of sleep apnea has had a same-day surgery procedure that will require the administration of morphine postoperatively to manage pain. This client will be assessed most appropriately by the perioperative nurse for the risk for respiratory complications by frequently:
A.
B.
C.
D.
28.  Which of the following statements made by a nurse reflects the greatest insight into the responsibility an ambulatory care nurse has to the client’s family?
A.
B.
C.
D.
29.  The nurse is working in a postoperative care unit in an ambulatory surgery center. Of the following clients that have come to have surgery, the client at the greatest risk during surgery is a:
A.
B.
C.
D.
30.  You are caring for a male patient who has had spinal anesthesia. The patient is under a physician's order to lie flat postoperatively. When the patient asks to go to the bathroom, you encourage him to comply with the physician's order. What is the rationale for complying with this order?
A.
B.
C.
D.
31.  The female client on the surgical unit is being prepared for abdominal surgery with general anesthesia. In preparing this client for surgery, the nurse should:
A.
B.
C.
D.
32.  Which of the following best describes the primary nursing role regarding a client’s consent to surgery immediately before surgery?
A.
B.
C.
D.
33.  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.
B.
C.
D.
34.  You are packing a patient's abdominal wound with sterile, half-inch Iodoform gauze. You drop some of the gauze onto the patient's abdomen 2 inches (5 cm) away from the wound. What should you do?
A.
B.
C.
D.
35.  The client had surgery in the morning that involved the right femoral artery. To assess the client’s circulation status to the right leg, the nurse will make sure to check the pulse at the:
A.
B.
C.
D.
36.  A client scheduled for an ambulatory surgery procedure requiring anesthetics arrives with a low-grade fever and a productive sough. The postponement of the procedure is most likely a result of the:
A.
B.
C.
D.
37.  Which of the following statements made by the nurse shows the most informed understanding of the role of family in the client’s postoperative recovery?
A.
B.
C.
D.
38.  You note a colleague making an inappropriate remark about the patient's weight. The patient is unconscious at the time. What should you do?
A.
B.
C.
D.
39.  The nurse is very busy and needs to delegate some tasks to the nursing assistive personnel (NAP). Which of the following would be the most appropriate task to delegate?
A.
B.
C.
D.
40.  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.
B.
C.
D.
41.  Which of the following events subjects the surgical patient to possible injury in the intraoperative phase of the surgical experience? (Mark all that apply.)
A.
B.
C.
D.
E.
42.  Which of the following is most dangerous complication during induction of spinal anesthesia?
A.
B.
C.
D.
43.  Which of the following statements most accurately reflects nursing accountability in the intraoperative phase?
A.
B.
C.
D.
44.  What is the basis of the collaboration of the surgical team that results in the best outcome for the patient?
A.
B.
C.
D.
45.  Which of the following client evaluations is most reflective of compliance for a preoperative client with a nursing diagnosis of deficient knowledge regarding preoperative requirements related to lack of exposure to information?
A.
B.
C.
D.
46.  Which of the following is experienced by the patient who is under general anesthesia?
A.
B.
C.
D.
47.  Which of the following statements made by a nurse reflects the greatest insight into the planning needs of a same-day surgical experience?
A.
B.
C.
D.
48.  The diabetic patient who had undergone abdominal surgery experiences wound evisceration. Which of the following is the most appropriate immediate nursing action?
A.
B.
C.
D.
49.  A 47-year-old female client has been scheduled to undergo surgery for removal of her gallbladder. Preoperatively the nurse is teaching the client what to expect when she wakes up in the postanesthesia care center. The nurse tells the client that her vision may be blurry due to which of the following reasons?
A.
B.
C.
D.
50.  Your patient is a 35-year-old female who has been administered general anesthesia. The patient is in stage II (the excitement stage) of anesthesia. Which intervention might you need to implement during this stage?
A.
B.
C.
D.
51.  To prevent complications of immobility, which activities would the nurse plan for the first postoperative day after a colon resection?
A.
B.
C.
D.
52.  An obese client is admitted for abdominal surgery. The nurse recognizes that this client is more susceptible to the postoperative complication of:
A.
B.
C.
D.
53.  Upon admission to the postanesthesia care unit (PACU), the client who has no orthopedic or neurological restrictions is positioned with the:
A.
B.
C.
D.
54.  A patient is scheduled for surgery the next day. What is the best approach to this surgery?
A.
B.
C.
D.
55.  Which of the following preoperative assessment findings would most likely delay a planned procedure requiring general anesthetic?
A.
B.
C.
D.
56.  Which of the following drugs is administered to minimize respiratory secretions preoperatively?
A.
B.
C.
D.
57.  Surgical asepsis is a requirement in the restricted zone of the operating suite. What personal protective equipment should the nurse wear at all times in the restricted zone of the operating room?
A.
B.
C.
D.
58.  Which of the following are not members of the sterile team in the operating room, except:
A.
B.
C.
D.
59.  The nursing student is preparing an elderly patient for surgery. The patient is scheduled for a general anesthetic. Which side effect should the nurse monitor the patient for?
A.
B.
C.
D.
60.  A nurse is caring for a patient following surgery under a spinal anesthetic. What interventions can the nurse implement to prevent a spinal headache?
A.
B.
C.
D.
61.  The nurse is evaluating the client in the hospital’s postanesthesia care unit (PACU) and determines that the Aldrete score is 8. Based on this assessment, the nurse anticipates that the client will:
A.
B.
C.
D.
62.  You are the circulating nurse caring for a 78-year-old patient who is scheduled for a total hip replacement. Which of the factors should you consider during the preparation of the patient in the operating room?
A.
B.
C.
D.
63.  The perioperative nurse realizes that the most effective means of evaluating the client’s understanding of previous teaching is to:
A.
B.
C.
D.
64.  The client is scheduled for abdominal surgery and has just received the preoperative medications. The nurse should:
A.
B.
C.
D.
65.  The nurse is preparing the preoperative client for surgery. The following statements that indicate the client is knowledgeable about his impending surgery, except:
A.
B.
C.
D.
66.  A client is scheduled for surgery in the morning. Preoperative orders have been written. What is the most important to do before surgery?
A.
B.
C.
D.
67.  The nurse knows that the client is most likely going to arrive for the surgical procedure having adhered to the required bowel preparation if:
A.
B.
C.
D.
68.  Which of the following postoperative patients is at risk for respiratory complications?
A.
B.
C.
D.
69.  What is the best rationale for intubation during a surgical procedure?
A.
B.
C.
D.
70.  You are a circulating nurse in the day surgery center. You know that each patient has the potential for complications intraoperatively. What are these complications? (Mark all that apply.)
A.
B.
C.
D.
E.
71.  You are the nurse caring for a patient who will receive a transsacral block. In what surgeries would a transsacral block be useful for pain control?
A.
B.
C.
D.
72.  A 21-year-old patient is positioned on the OR bed prior to knee surgery. The anesthesiologist administers the anesthetic. What is the next step in the care of this patient?
A.
B.
C.
D.
73.  The best position for kidney, chest, or hip surgery is:
A.
B.
C.
D.
74.  When discussing the details of having a procedure done in a facility's ambulatory surgery department, the nurse includes which of the following as advantages? (Select all that apply.)
A.
B.
C.
D.
E.
F.
75.  The circulating nurse meets the patient in a warm and friendly manner. The nurse discusses what the patient can expect in surgery. What basic communication skills does the nurse use?
A.
B.
C.
D.
76.  You are the circulating nurse in an outpatient surgery center. Your patient is scheduled to receive moderate sedation. You know that a patient receiving this form of anesthesia should what?
A.
B.
C.
D.
77.  You are the nurse performing wound care on a 68-year-old male patient. Which of the following practices violates surgical asepsis?
A.
B.
C.
D.
78.  Given a rationale for preoperative and postoperative procedures, the client is better prepared to participate in care. For which of the following should the nurse provide instruction and rationale?
A.
B.
C.
D.
79.  The client will have an incision in the lower left abdomen. Which of the following measures by the nurse will help decrease discomfort in the incisional area when the client coughs postoperatively?
A.
B.
C.
D.
80.  The initial client education–related nursing action by the preadmission nurse is to:
A.
B.
C.
D.
81.  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.
B.
C.
D.
82.  The operating room nurse is taking the patient into the OR when the patient informs the operating nurse that his grandmother spiked a 104°F temperature in the operating room and nearly died 15 years ago. What relevance does this information have regarding your patient?
A.
B.
C.
D.
83.  A client who receives general or regional anesthesia in an ambulatory surgery center:
A.
B.
C.
D.
84.  The nurse recognizes which of the following as the greatest barrier to meeting a preoperative client’s nursing diagnosis of deficient knowledge regarding surgical procedure?
A.
B.
C.
D.
85.  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.
B.
C.
D.
86.  In the postoperative period, the nurse recognizes that an early sign of malignant hyperthermia is:
A.
B.
C.
D.
87.  After discharge from the postanesthesia care unit (PACU), the client returned to the surgical nursing unit at 10:00 AM. It is now 11:30 AM, and the client is not experiencing any complications or difficulties. The nurse will plan to measure the client’s vital signs:
A.
B.
C.
D.
88.  What position used for surgery can cause irreparable nerve damage?
A.
B.
C.
D.
89.  The nurse will provide preoperative teaching on deep breathing, coughing and turning exercises. When is the best time to provide the preoperative teachings?
A.
B.
C.
D.
90.  The nurse is evaluating the outcome “Client describes surgical procedures and postoperative treatment” and determines that the client has not achieved this outcome. The nurse should:
A.
B.
C.
D.
91.  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.
B.
C.
D.
92.  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.
B.
C.
D.
93.  A 48-year-old male client with a history of chronic obstructive pulmonary disease (COPD) is scheduled for an inguinal hernia repair. The nurse instructs that client that he can expect the health care provider to order which of the following tests before surgery?
A.
B.
C.
D.
94.  The client tells the nurse that “blowing into this tube thing (incentive spirometer) is a ridiculous waste of time.” The nurse explains that the specific purpose of the therapy is to:
A.
B.
C.
D.
95.  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.
B.
C.
D.
96.  A 74-year-old is accompanied by his daughter to the ambulatory surgery department for the surgical removal of a suspicious skin lesion. The client has experienced dysphasia since a cerebral vascular accident 3 years ago. The most effective way for the nurse to secure the necessary preoperative interview information is to:
A.
B.
C.
D.
97.  A client is in the postanesthesia care unit (PACU) recovering from a vagotomy and pyloroplasty. Which of the following is a normal expectation of the client in this stage of recovery?
A.
B.
C.
D.
98.  You are preparing to take your patient into the operating room. As the circulating nurse, one of your responsibilities is to review the patient's record. What are you reviewing the record for?
A.
B.
C.
D.
99.  You are the circulating nurse in an operating room that has several surgeries scheduled. You would know to monitor which patient during the intraoperative period because he or she is at increased risk for hypothermia?
A.
B.
C.
D.
100.  Which of the following items on a client’s presurgery laboratory results would indicate a need to contact the surgeon?
A.
B.
C.
D.
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