Perioperative Nursing Quiz Questions And Answers!

Obesity and smoking history significantly increase the risk of respiratory complications following surgery. An upper abdominal incision can further impair breathing by causing pain-induced shallow respiration, reducing lung expansion and increasing the risk of atelectasis and pneumonia. Postoperative care should emphasize incentive spirometry, deep breathing exercises, and early ambulation to reduce respiratory risks.

Postoperative dietary progression is carefully structured to prevent complications such as nausea, vomiting, and ileus. The patient is initially kept NPO (nothing by mouth) to allow the digestive system to rest. Once the patient is stable, they are advanced to a clear liquid diet, followed by a full liquid diet, and finally, a soft diet as tolerated. This gradual progression helps reintroduce nutrients while minimizing gastrointestinal distress. Individual cases may require adjustments based on surgical type and patient response.

Before surgery, obtaining informed consent is the highest priority. Informed consent ensures that the patient understands the procedure, potential risks, and available alternatives. This is both a legal and ethical requirement, protecting the patient’s autonomy and the medical team from liability. While other preoperative tasks are important, such as verifying lab results and removing jewelry, these do not take precedence over ensuring that the patient has provided explicit, informed permission for the surgery.

 

Under general anesthesia, the patient is completely unconscious and unaware of their surroundings. This state is induced using intravenous or inhaled anesthetic agents to eliminate pain and awareness during surgery. Unlike regional anesthesia, which only affects a specific part of the body, general anesthesia renders the entire body unresponsive. Close monitoring is required to ensure stable vital signs and a smooth recovery.

A nurse should not sign the consent for the patient. Informed consent must be obtained directly from the patient or their legally authorized representative. If the patient is unable to write, they can provide verbal consent, which should be witnessed and documented by another healthcare professional. Informed consent ensures the patient understands the procedure, its risks, and alternatives, promoting patient autonomy and legal compliance. It is a fundamental ethical and legal requirement in healthcare.

Apprehension and restlessness are often the earliest signs of poor oxygenation and tissue perfusion. These symptoms indicate that the brain is receiving insufficient oxygen, leading to neurological distress. If left untreated, this can progress to cyanosis, altered mental status, and even respiratory failure. After a thyroidectomy, swelling, hematoma formation, or laryngeal nerve damage can compromise airway patency, making early recognition and intervention crucial to preventing life-threatening complications.

Maintaining NPO (nothing by mouth) status before surgery is crucial in preventing aspiration pneumonia. During anesthesia, the body's natural protective reflexes are suppressed, increasing the risk of regurgitated stomach contents entering the lungs. This can lead to severe respiratory complications, including pneumonia and airway obstruction. By ensuring the stomach is empty before surgery, the risk of aspiration is significantly minimized, improving patient safety and reducing postoperative complications. Adhering to NPO guidelines is essential for safe anesthesia administration and optimal surgical outcomes.

Cyanosis indicates inadequate oxygenation, which can result from airway obstruction or respiratory distress. The priority intervention is to reposition the client’s head to open the airway, as a simple head-tilt or jaw-thrust maneuver can resolve obstruction in many cases. If cyanosis persists, additional measures, such as supplemental oxygen and emergency airway management, may be required. Immediate assessment and intervention are crucial to prevent hypoxia and ensure patient safety in the postoperative period.

Proper patient identification and verification of the surgical permit are the highest priorities when admitting a patient to the operating room. This prevents wrong-patient, wrong-site, or wrong-procedure errors, which are considered never events in healthcare. The nurse must confirm the patient’s identity, surgical site, and procedure with the surgical team before proceeding.

A hemoglobin level of 9.5 mg/dl suggests mild anemia, which can compromise the patient’s oxygen-carrying capacity. This is particularly concerning for surgery, as inadequate oxygen delivery to tissues can lead to perioperative complications, including delayed wound healing and increased risk of infection. The nurse should notify the surgeon to assess whether interventions such as a blood transfusion or iron supplementation are necessary before proceeding with the surgery. Monitoring hemoglobin levels is essential for optimizing patient outcomes and ensuring surgical safety.

Wound evisceration is a surgical emergency where internal organs protrude through a surgical incision. The immediate priority is to cover the exposed tissues with sterile saline-moistened gauze to prevent desiccation and infection. Dry gauze can adhere to the organs and cause further damage, while excessive moisture from water can lead to cell lysis. The patient should be kept in a low Fowler’s position with knees flexed to reduce tension on the wound while awaiting emergency surgical intervention.

Atropine sulfate is commonly used preoperatively to reduce respiratory secretions. Excessive secretions can obstruct the airway during anesthesia, increasing the risk of aspiration and respiratory complications. Atropine works by inhibiting the parasympathetic nervous system, decreasing mucus production in the respiratory tract. This helps maintain a clear airway, reducing the likelihood of intraoperative and postoperative complications related to excessive secretions.

Spinal headaches result from cerebrospinal fluid (CSF) leakage following spinal anesthesia. Keeping the patient flat for 6 to 8 hours reduces the risk of headache by allowing the puncture site to seal properly. Adequate hydration and caffeine consumption may also help alleviate symptoms if they occur. If a spinal headache persists, an epidural blood patch may be required for relief.

A urine output of less than 30 ml/hr may indicate inadequate renal perfusion or impending acute kidney injury (AKI). In a postoperative patient, this could be due to hypovolemia, shock, or impaired kidney function following anesthesia and surgery. Early detection of low urine output allows for timely intervention, such as fluid resuscitation or further diagnostic assessments. The nurse should notify the physician immediately to prevent renal failure or other serious complications.

Monitoring respiration is critical following spinal anesthesia. Although spinal anesthesia primarily affects the lower body, high spinal anesthesia can impact the diaphragm and respiratory muscles, leading to breathing difficulties. Early detection of respiratory depression ensures timely intervention and prevents severe complications.

To obtain an accurate blood pressure reading, it is crucial to use a cuff that covers two-thirds of the client’s upper arm. Using an improperly sized cuff can lead to inaccurate readings, either overestimating or underestimating blood pressure. The width of the cuff should be sufficient to ensure accurate compression and measurement. A cuff that is too small may give falsely high readings, while one that is too large may give falsely low readings. Proper technique is essential for reliable assessment and treatment planning.

Early ambulation is key to preventing postoperative complications such as deep vein thrombosis (DVT), pulmonary embolism, and atelectasis. Mobilization promotes circulation, prevents blood pooling in the lower extremities, and enhances lung expansion. Encouraging the patient to move out of bed and sit in a chair as soon as medically feasible helps reduce the risk of complications related to prolonged immobility. The nurse should assess the patient’s pain level, provide assistance as needed, and reinforce the importance of movement in recovery.

Gradually changing a patient’s position helps prevent a sudden drop in blood pressure (postural hypotension), which can occur due to fluid shifts and vasodilation after anesthesia. Rapid position changes may lead to dizziness, fainting, or even falls, especially in postoperative patients who may already have compromised circulation. This practice ensures better hemodynamic stability, prevents orthostatic hypotension, and promotes safer patient movement during transfer from the postanesthesia care unit (PACU) to the surgical unit.

Preoperative teaching on deep breathing, coughing, and turning exercises is most effective when provided before administering preoperative medications. This timing ensures the patient is fully alert, allowing them to comprehend and retain essential postoperative care instructions. These exercises are vital in preventing complications such as pneumonia and atelectasis by promoting lung expansion and clearing secretions. Educating patients in advance helps reduce anxiety and ensures they can actively participate in their recovery, leading to improved postoperative outcomes.

Pain management should be individualized based on the patient’s pain level, vital signs, and response to previous interventions. Before administering analgesics, the nurse must assess the intensity, location, and nature of the pain, as well as monitor for potential complications like infection, hematoma formation, or prosthetic dislocation. Pain assessment ensures that the intervention chosen—whether medication, repositioning, or other comfort measures—is appropriate for the patient’s condition and safety.

Hypotension is a serious complication during spinal anesthesia induction. The anesthetic blocks sympathetic nerve activity, causing vasodilation and a drop in blood pressure. Severe hypotension can lead to inadequate blood flow to vital organs, including the brain and heart, requiring prompt intervention with fluids, vasopressors, and positioning strategies to maintain circulation. Continuous monitoring is essential to prevent complications.

The sterile team in the operating room consists of the surgeon, surgical assistants, and scrub nurse, who must adhere to strict aseptic techniques to prevent surgical site infections. Radiology technicians, however, work outside the sterile field, performing imaging procedures when necessary. They wear appropriate protective attire but do not scrub in or handle sterile instruments. Circulating nurses also do not maintain sterility, as their role involves managing equipment, documentation, and patient advocacy.