To Be A Nurse, You Gotta Crack This Perioperative Quiz

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To Be A Nurse, You Gotta Crack This Perioperative Quiz - Quiz

The perioperative period is the time period of a patient's surgical procedure. It commonly includes ward admission, anesthesia, surgery, and recovery. To be a nurse, you gotta crack this Perioperative Quiz. ALL THE BEST


Questions and Answers
  • 1. 

    A 43-year-old client is scheduled to have a gastrectomy. Which of the following is a major preoperative concern?

    • A.

      The client’s brother had a tonsillectomy at age 11

    • B.

      The client smokes a pack of cigarettes a day

    • C.

      The client has an intravenous (IV) infusion.

    • D.

      The client has a history of employment as a computer programmer.

    Correct Answer
    B. The client smokes a pack of cigarettes a day
    Explanation
    The major preoperative concern in this case is the client's smoking habit. Smoking can have detrimental effects on the healing process and increase the risk of complications during and after surgery. It can impair lung function, decrease oxygen levels in the blood, impair immune function, and delay wound healing. Therefore, it is important to address the client's smoking habit prior to the gastrectomy to optimize their surgical outcomes and reduce the risk of complications.

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  • 2. 

    An appendectomy is appropriately documented by the nurse as:

    • A.

      Diagnostic surgery

    • B.

      Palliative surgery

    • C.

      Ablative surgery

    • D.

      Reconstructive surgery

    Correct Answer
    C. Ablative surgery
    Explanation
    An appendectomy is appropriately documented as ablative surgery because it involves the removal of the appendix. Ablative surgery refers to a procedure that removes or excises a diseased or non-functioning part of the body. In the case of an appendectomy, the appendix is surgically removed due to inflammation or infection. This procedure aims to alleviate symptoms and prevent complications associated with appendicitis. Therefore, the term "ablative surgery" accurately describes the nature of an appendectomy.

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  • 3. 

    An obese client is admitted for abdominal surgery. The nurse recognizes that this client is more susceptible to the postoperative complication of:

    • A.

      Anemia

    • B.

      Seizures

    • C.

      Protein loss

    • D.

      Dehiscence

    Correct Answer
    D. Dehiscence
    Explanation
    Obese clients are at a higher risk for postoperative complications such as dehiscence. Dehiscence is the separation or opening of the surgical incision. The excess adipose tissue in obese clients can impair wound healing due to poor blood supply and increased tension on the incision site. This can lead to the incision opening up and increasing the risk of infection. Therefore, it is important for nurses to closely monitor obese clients postoperatively to prevent and promptly manage any signs of dehiscence.

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  • 4. 

    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.

      78-year-old taking an analgesic agent

    • B.

      43-year-old taking an antihypertensive agent

    • C.

      27-year-old taking an anticoagulant agent

    • D.

      10-year-old taking an antibiotic agent

    Correct Answer
    C. 27-year-old taking an anticoagulant agent
    Explanation
    The 27-year-old taking an anticoagulant agent is at the greatest risk during surgery because anticoagulant medications can increase the risk of bleeding. Surgery involves cutting tissues and can result in bleeding, so the anticoagulant agent can further increase the risk of excessive bleeding during and after surgery. The other clients taking analgesic, antihypertensive, and antibiotic agents do not have the same level of risk as the client taking an anticoagulant agent.

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  • 5. 

    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.

      An increased tactile sensation

    • B.

      An increased metabolic rate

    • C.

      A relaxation of arterial walls

    • D.

      Reduced glomerular filtration rate

    Correct Answer
    D. Reduced glomerular filtration rate
    Explanation
    As people age, their kidneys undergo changes that can lead to a reduced glomerular filtration rate. Glomerular filtration rate refers to the rate at which the kidneys filter waste and excess fluid from the blood. A reduced glomerular filtration rate means that the kidneys are not able to filter blood as efficiently, leading to a buildup of waste products in the body. This can increase the risk for surgery as it may affect the body's ability to eliminate anesthesia and medications, and can also increase the risk for complications such as fluid overload and electrolyte imbalances.

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  • 6. 

    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.

      Hemoglobin (Hgb) 14 g/100 mL

    • B.

      Blood urea nitrogen (BUN) 15 mg/100 mL

    • C.

      Platelets 300,000/mm3

    • D.

      Serum creatinine 3.2 mg/100 mL

    Correct Answer
    D. Serum creatinine 3.2 mg/100 mL
    Explanation
    The preoperative assessment finding of a serum creatinine level of 3.2 mg/100 mL indicates a need to contact the surgeon. A normal serum creatinine level is typically between 0.6-1.3 mg/100 mL, indicating proper kidney function. A level of 3.2 mg/100 mL suggests impaired kidney function, which can increase the risk of complications during surgery. The surgeon should be notified to evaluate the client's kidney function and determine if any adjustments to the surgical plan or anesthesia are necessary.

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  • 7. 

    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.

      Obtain the consent, because this is expected with preoperative anxiety

    • B.

      Teach the client all about the procedure

    • C.

      Ask the unit manager to assist with a teaching plan

    • D.

      Inform the surgeon so that information can be provided

    Correct Answer
    D. Inform the surgeon so that information can be provided
    Explanation
    The nurse should inform the surgeon so that information can be provided. This is the appropriate action because the nurse has determined that the client has not achieved the outcome of describing surgical procedures and postoperative treatment. By informing the surgeon, the nurse can ensure that the necessary information is provided to the client, which will help them understand the procedures and treatment better. This will ultimately contribute to the client's overall well-being and satisfaction with their healthcare experience.

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  • 8. 

    Which of the following statements most accurately reflects nursing accountability in the intraoperative phase?

    • A.

      “I would like to see the client have a regional anesthetic rather than a general anesthetic.”

    • B.

      “There seems to be a missing sponge, so a recount should be done of all the sponges that have been removed.”

    • C.

      “Did the client receive the medications and sign the consent?”

    • D.

      “The client looks to be reactive and stable.”

    Correct Answer
    B. “There seems to be a missing sponge, so a recount should be done of all the sponges that have been removed.”
    Explanation
    The statement "There seems to be a missing sponge, so a recount should be done of all the sponges that have been removed" reflects nursing accountability in the intraoperative phase because it demonstrates the nurse's responsibility for ensuring patient safety during surgery. The nurse is recognizing a potential error or missing item and taking action to address it, which is an important aspect of accountability in the operating room.

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  • 9. 

    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.

      Applying a splint directly over the lower abdomen

    • B.

      Keeping the client flat with her feet flexed

    • C.

      Turning the client onto the right side

    • D.

      Applying pressure above and below the incision

    Correct Answer
    A. Applying a splint directly over the lower abdomen
    Explanation
    Applying a splint directly over the lower abdomen helps decrease discomfort in the incisional area when the client coughs postoperatively because it provides support and stability to the incision site. By holding the incision together, the splint reduces tension and prevents the incision from pulling apart when the client coughs. This can help minimize pain and promote proper healing of the incision.

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  • 10. 

    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.

      Be sent to the intensive care unit

    • B.

      Be discharged back to his or her room on the nursing unit

    • C.

      Remain in the PACU until the score improves

    • D.

      Return to the operating room for surgical evaluation

    Correct Answer
    B. Be discharged back to his or her room on the nursing unit
    Explanation
    Based on an Aldrete score of 8, the nurse anticipates that the client will be discharged back to his or her room on the nursing unit. The Aldrete score is a tool used to assess the client's readiness for discharge from the PACU after anesthesia. A score of 8 or higher indicates that the client has met the criteria for safe discharge, including stable vital signs, ability to breathe adequately, and ability to move all extremities. Therefore, the client does not require further monitoring in the PACU and can be safely transferred to a regular nursing unit for continued care and recovery.

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  • 11. 

    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.

      Returned normal bowel sounds on auscultation

    • B.

      Pain that is relieved with noninvasive comfort measures

    • C.

      Voluntary bladder control and function

    • D.

      A subdued level of consciousness and neurological function

    Correct Answer
    D. A subdued level of consciousness and neurological function
    Explanation
    After a vagotomy and pyloroplasty, the client may experience a subdued level of consciousness and neurological function due to the effects of anesthesia and the surgical procedure. This is a normal expectation during the immediate postoperative period. The other options, such as returned normal bowel sounds, pain relief, and voluntary bladder control, are not specific to this stage of recovery and may vary depending on the individual client's condition.

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  • 12. 

    The client is scheduled for abdominal surgery and has just received the preoperative medications. The nurse should:

    • A.

      Keep the client quiet

    • B.

      Obtain the consent

    • C.

      Prepare the skin at the surgical site

    • D.

      Place the side rails up on the bed or stretcher

    Correct Answer
    D. Place the side rails up on the bed or stretcher
    Explanation
    Placing the side rails up on the bed or stretcher is the correct answer because it ensures the client's safety during and after the surgery. The side rails provide support and prevent the client from falling off the bed or stretcher while they are under the influence of the preoperative medications. This is important as the medications can cause drowsiness and disorientation. Keeping the client quiet, obtaining consent, and preparing the skin at the surgical site are also important steps in the preoperative process, but ensuring the client's safety takes priority in this situation.

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  • 13. 

    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.

      Temperature is 100° F.

    • B.

      Pulse is 90 beats per minute.

    • C.

      Respiratory rate is 20 breaths per minute.

    • D.

      Blood pressure is 130/74 mm Hg.

    Correct Answer
    A. Temperature is 100° F.
    Explanation
    A temperature of 100° F indicates a mild fever, which may be a sign of an underlying infection. Infection can increase the risk of complications during surgery and may require adjustments in anesthesia management. Therefore, the nurse should contact the anesthesiologist to inform them about the client's elevated temperature and seek further guidance.

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  • 14. 

    In the postoperative period, the nurse recognizes that an early sign of malignant hyperthermia is:

    • A.

      Fever

    • B.

      Tachycardia

    • C.

      Muscle relaxtion

    • D.

      Skin pallor

    Correct Answer
    B. Tachycardia
    Explanation
    Malignant hyperthermia is a potentially life-threatening reaction to certain medications used during general anesthesia. It is characterized by a rapid rise in body temperature, muscle rigidity, and increased heart rate. Tachycardia, or a fast heart rate, is an early sign of malignant hyperthermia. It occurs due to the release of excessive calcium from muscle cells, leading to increased metabolism and heat production. Therefore, tachycardia is a crucial indicator that allows the nurse to identify and take immediate action to manage this dangerous condition.

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  • 15. 

    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.

      Directly remove excess secretions from the lungs

    • B.

      Increase pulmonary circulation

    • C.

      Promote lung expansion

    • D.

      Stimulate the cough reflex

    Correct Answer
    C. Promote lung expansion
    Explanation
    The incentive spirometer is a device used to promote lung expansion. By blowing into the tube, the client can take deep breaths and expand their lungs fully. This helps to prevent atelectasis, a condition where the lungs collapse or become partially collapsed. By promoting lung expansion, the client can improve their lung function and prevent complications such as pneumonia. Therefore, the specific purpose of using the incentive spirometer is to promote lung expansion.

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  • 16. 

    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.

      Leave all of her jewelry intact

    • B.

      Provide her with sips of water for a dry mouth

    • C.

      Remove her makeup and nail polish

    • D.

      Remove her hearing aid before transport to the operating room

    Correct Answer
    C. Remove her makeup and nail polish
    Explanation
    In preparing a client for abdominal surgery with general anesthesia, it is important to remove her makeup and nail polish. This is because during surgery, the healthcare team needs to monitor the client's skin color and nail beds to ensure proper oxygenation and circulation. Makeup and nail polish can interfere with this assessment and may also increase the risk of infection. Additionally, removing makeup and nail polish helps to maintain a sterile environment in the operating room.

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  • 17. 

    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.

      Reduce preoperative fear

    • B.

      Promote emptying of the stomach

    • C.

      Reduce body secretions

    • D.

      Ease the induction of the anesthesia

    Correct Answer
    D. Ease the induction of the anesthesia
    Explanation
    Demerol and Vistaril are given before surgery to ease the induction of anesthesia. This means that these medications help to make the process of administering anesthesia smoother and more comfortable for the patient. They may help to relax the patient and reduce anxiety, which can make it easier for the anesthesia to be administered.

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  • 18. 

    A client who receives general or regional anesthesia in an ambulatory surgery center:

    • A.

      Has to meet identified criteria in order to be discharged home

    • B.

      Will remain in the phase I recovery area longer than a hospitalized client

    • C.

      Is allowed to ambulate as soon as being admitted to the recovery area

    • D.

      Is immediately given liberal amounts of fluid to promote the excretion of the anesthesia

    Correct Answer
    A. Has to meet identified criteria in order to be discharged home
    Explanation
    A client who receives general or regional anesthesia in an ambulatory surgery center has to meet identified criteria in order to be discharged home. This means that they need to fulfill certain requirements, such as stable vital signs, ability to tolerate oral intake, absence of complications, and adequate pain control, before they can be allowed to go home. This is important to ensure the client's safety and well-being after the anesthesia wears off and to minimize the risk of post-operative complications.

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  • 19. 

    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.

      Increased blood pressure

    • B.

      Incisional pain

    • C.

      Abdominal distention

    • D.

      Increased urinary output

    Correct Answer
    C. Abdominal distention
    Explanation
    Abdominal distention is indicative of internal bleeding after abdominal surgery. It occurs when blood accumulates in the abdominal cavity, causing the abdomen to become swollen and distended. This can be a sign of bleeding because the blood collects in the abdominal space, leading to increased pressure and distention. Increased blood pressure may not necessarily indicate internal bleeding, as it can be a normal response to surgery or other factors. Incisional pain is common after surgery and may not specifically indicate bleeding. Increased urinary output is not directly related to internal bleeding and may be influenced by other factors such as hydration or medications.

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  • 20. 

    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.

      Every 15 minutes

    • B.

      Every 30 minutes

    • C.

      Every 1 hour

    • D.

      Every 4 hours

    Correct Answer
    C. Every 1 hour
    Explanation
    The nurse will plan to measure the client's vital signs every 1 hour because the client has been in the surgical nursing unit for 1.5 hours without experiencing any complications or difficulties. This time interval allows for regular monitoring of the client's vital signs while also allowing the client to rest and recover without unnecessary interruptions.

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  • 21. 

    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.

      Radial artery

    • B.

      Ulnar artery

    • C.

      Brachial artery

    • D.

      Dorsalis pedis artery

    Correct Answer
    D. Dorsalis pedis artery
    Explanation
    After surgery involving the right femoral artery, the nurse needs to assess the client's circulation status to the right leg. The dorsalis pedis artery is located on the top of the foot and is a good indicator of blood flow to the lower extremities. Checking the pulse at the dorsalis pedis artery will provide information about the circulation in the right leg. The radial artery is located in the wrist and does not provide information specific to the leg. The ulnar artery is also located in the wrist and is not relevant to assessing circulation in the leg. The brachial artery is located in the upper arm and is not specific to the leg either.

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  • 22. 

    Upon admission to the postanesthesia care unit (PACU), the client who has no orthopedic or neurological restrictions is positioned with the:

    • A.

      Bed flat and the client’s arms to the sides

    • B.

      Client’s neck flexed and body positioned laterally

    • C.

      Head of the bed slightly elevated with the client’s head to the side

    • D.

      Client’s arms crossed over the chest and the bed in high-Fowler’s position

    Correct Answer
    C. Head of the bed slightly elevated with the client’s head to the side
    Explanation
    Upon admission to the postanesthesia care unit (PACU), the client is positioned with the head of the bed slightly elevated and the client's head to the side. This position helps to maintain a clear airway and prevent aspiration in case of vomiting or regurgitation. It also promotes optimal oxygenation and ventilation. Additionally, positioning the head to the side helps to prevent airway obstruction and facilitates drainage of oral secretions.

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  • 23. 

    A client who is scheduled for surgery is found to have thrombocytopenia. A specific postoperative concern for the nurse for this client is:

    • A.

      Hemorrhage

    • B.

      Wound infection

    • C.

      Fluid imbalance

    • D.

      Respiratory depression

    Correct Answer
    A. Hemorrhage
    Explanation
    Thrombocytopenia refers to a low platelet count, which can impair the clotting process and increase the risk of bleeding. Therefore, the specific postoperative concern for a client with thrombocytopenia would be hemorrhage, as their blood may not clot properly, leading to excessive bleeding during or after surgery.

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  • 24. 

    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.

      Physical status class 1

    • B.

      Physical status class 2

    • C.

      Physical status class 4

    • D.

      Physical status class 5

    Correct Answer
    A. Physical status class 1
    Explanation
    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 it as a physical status class 1. This means that the patient is a normal healthy individual without any systemic disease and is able to carry out normal daily activities without any limitations. Therefore, the patient is at a low risk for complications during the procedure and can safely undergo the biopsy as an outpatient.

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  • 25. 

    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.

      “A client’s family deserves the attention of the nursing staff.”

    • B.

      “Family is important to my client, and so family is important to me.”

    • C.

      “I consider myself as having several clients: the surgical client and all the family that’s present.”

    • D.

      “I am responsible for keeping the family informed of the status of their loved one both during and after the procedure.”

    Correct Answer
    C. “I consider myself as having several clients: the surgical client and all the family that’s present.”
    Explanation
    The correct answer reflects the greatest insight into the responsibility an ambulatory care nurse has to the client's family because it acknowledges the importance of not only caring for the surgical client but also recognizing the family as clients as well. This shows an understanding of the nurse's role in providing support, communication, and information to the family members during and after the procedure. It demonstrates a holistic approach to care that includes the client's family as an integral part of the healthcare team.

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  • 26. 

    Which of the following statements made by a nurse reflects the greatest insight into the planning needs of a same-day surgical experience?

    • A.

      “Time is a precious resource in same-day surgery units; being organized allows for the best utilization of time.”

    • B.

      “Everything must be checked and verified as being ready before the client is admitted into the surgical area.”

    • C.

      “With only a few hours from time of admission to the beginning of the procedure, things have to be effectively organized.”

    • D.

      “I take the time to review the client’s preadmission and preoperative data in order to formulate the most individualized plan of care possible.”

    Correct Answer
    D. “I take the time to review the client’s preadmission and preoperative data in order to formulate the most individualized plan of care possible.”
    Explanation
    The correct answer reflects the greatest insight into the planning needs of a same-day surgical experience because it emphasizes the importance of reviewing the client's preadmission and preoperative data. This shows that the nurse understands the need for a thorough assessment and individualized plan of care, which is crucial in ensuring a successful surgical experience. By taking the time to review the client's data, the nurse can identify any potential risks or special considerations that need to be taken into account during the procedure, thus enhancing the overall quality of care provided.

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  • 27. 

    The perioperative nurse realizes that the most effective means of evaluating the client’s understanding of previous teaching is to:

    • A.

      Provide written material on the subject to be reviewed after discharge

    • B.

      Reinforce the material with family as the procedure is being performed

    • C.

      Discuss it with the client and family in the immediate preoperative period

    • D.

      Offer to answer any questions that the client or family have just before discharge

    Correct Answer
    C. Discuss it with the client and family in the immediate preoperative period
    Explanation
    Discussing the previous teaching with the client and family in the immediate preoperative period is the most effective means of evaluating their understanding. This allows for a direct conversation where any misunderstandings or questions can be addressed in real-time. Providing written material to review after discharge may not ensure that the client and family fully comprehend the information. Reinforcing the material with family during the procedure may be distracting and not allow for a focused discussion. Offering to answer questions just before discharge may not provide enough time for the client and family to fully process the information.

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  • 28. 

    Which of the following preoperative assessment findings would most likely delay a planned procedure requiring general anesthetic?

    • A.

      A cough and low-grade fever

    • B.

      The pulse oximetry reading of 97% on room air

    • C.

      A blood pressure that is 10 systolic points higher than baseline

    • D.

      The client’s report of “being so nervous about this procedure”

    Correct Answer
    A. A cough and low-grade fever
    Explanation
    A cough and low-grade fever can indicate an underlying respiratory infection, such as bronchitis or pneumonia. These conditions can increase the risk of complications during a general anesthesia procedure, such as a higher risk of developing respiratory distress or pneumonia postoperatively. Therefore, the presence of a cough and low-grade fever would most likely delay a planned procedure requiring general anesthesia to ensure that the infection is properly treated and the client's respiratory status is optimized before undergoing the procedure.

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  • 29. 

    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.

      Question the client’s daughter

    • B.

      Review the client’s past medical records

    • C.

      Present the questions in a simple format

    • D.

      Rely on the client’s preadmission survey

    Correct Answer
    C. Present the questions in a simple format
    Explanation
    Presenting the questions in a simple format would be the most effective way for the nurse to secure the necessary preoperative interview information. The client has dysphasia, which is a difficulty in understanding and expressing language, due to a cerebral vascular accident. By using a simple format, the nurse can ensure that the client understands the questions and can provide accurate information. Questioning the client's daughter may not be as effective, as she may not have all the necessary information or may not accurately convey the client's responses. Reviewing the client's past medical records or relying on the preadmission survey may not provide the specific information needed for the preoperative interview.

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  • 30. 

    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.

      Risk for injury

    • B.

      Risk for infection

    • C.

      Impaired wound healing

    • D.

      Imbalanced nutrition: less than body requirements

    Correct Answer
    C. Impaired wound healing
    Explanation
    A client with type 2 diabetes is at greatest risk for impaired wound healing postoperatively. Diabetes can affect the body's ability to heal wounds due to high blood sugar levels, which can impair the function of white blood cells and decrease the production of collagen. Additionally, diabetes can lead to poor circulation and nerve damage, further hindering the healing process. Therefore, impaired wound healing is the nursing diagnosis that the client is at greatest risk for.

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  • 31. 

    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.

      Listening to breath sounds

    • B.

      Monitoring pulse oximetry

    • C.

      Evaluating spirometer use

    • D.

      Counting respirations per minute

    Correct Answer
    A. Listening to breath sounds
    Explanation
    The client with a history of sleep apnea is at risk for respiratory complications postoperatively, especially when administered morphine for pain management. Listening to breath sounds is the most appropriate assessment technique to monitor for any changes or abnormalities in the client's respiratory status. This allows the nurse to detect any signs of respiratory distress, such as decreased breath sounds, wheezing, or crackles, which may indicate a complication related to sleep apnea or the administration of morphine. Monitoring pulse oximetry, evaluating spirometer use, and counting respirations per minute are important assessments but may not provide as direct and immediate information about the client's respiratory status as listening to breath sounds.

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  • 32. 

    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.

      Client’s increased risk for a respiratory tract infection

    • B.

      Possibility of a respiratory complication during anesthesia

    • C.

      Increased risk for the client's infecting staff and other clients

    • D.

      Client’s impaired resistance as a result of a respiratory tract infection

    Correct Answer
    B. Possibility of a respiratory complication during anesthesia
    Explanation
    The postponement of the procedure is most likely a result of the possibility of a respiratory complication during anesthesia. Anesthesia can have a negative impact on the respiratory system, and if the client already has a low-grade fever and a productive cough, it indicates the presence of a respiratory tract infection. Performing the procedure under anesthesia in such a condition increases the risk of further complications, such as respiratory distress or infection. Therefore, it is safer to postpone the procedure to allow the client's respiratory tract infection to improve and reduce the risk of complications during anesthesia.

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  • 33. 

    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.

      Client will understand the need for scheduled surgery before leaving the provider’s office.

    • B.

      Client will understand the preoperative routines of surgical care before leaving provider’s office.

    • C.

      Client will present for drawing of preoperative laboratory blood at least 48 hours before scheduled surgery.

    • D.

      Client will be able to successfully accomplish the preoperative bowel preparation by morning of scheduled surgery.

    Correct Answer
    B. Client will understand the preoperative routines of surgical care before leaving provider’s office.
    Explanation
    The most appropriate goal for a preoperative client with a nursing diagnosis of deficient knowledge regarding preoperative requirements related to lack of exposure to information is for the client to understand the preoperative routines of surgical care before leaving the provider's office. This goal focuses on providing the client with the necessary knowledge and information about the preoperative process, which is essential for their understanding and preparation for surgery. By understanding the preoperative routines, the client will be better equipped to follow the necessary steps and requirements for a successful surgical outcome.

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  • 34. 

    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.

      Client will share the preoperative routines of surgical care with family to facilitate compliance.

    • B.

      Client will understand the preoperative routines of surgical care before leaving provider’s office.

    • C.

      Client will call laboratory to schedule appointment for preoperative blood draw for required testing.

    • D.

      Client will present for drawing of preoperative laboratory blood at least 48 hours before scheduled surgery.

    Correct Answer
    D. Client will present for drawing of preoperative laboratory blood at least 48 hours before scheduled surgery.
    Explanation
    The most therapeutic client outcome for a preoperative client with deficient knowledge regarding preoperative requirements is for the client to present for drawing of preoperative laboratory blood at least 48 hours before scheduled surgery. This outcome ensures that the client understands the importance of preoperative testing and follows the necessary steps to prepare for surgery. It also indicates that the client has gained the necessary knowledge and is taking proactive steps towards meeting the preoperative requirements.

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  • 35. 

    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.

      Client will present for scheduled blood laboratory work 48 hours before surgery.

    • B.

      Client’s preoperative blood laboratory work results are present on preoperative chart.

    • C.

      Client will share the preoperative routines of surgical care with family to facilitate compliance.

    • D.

      Client will understand the preoperative routines of surgical care before leaving provider’s office.

    Correct Answer
    B. Client’s preoperative blood laboratory work results are present on preoperative chart.
    Explanation
    The correct answer is "Client’s preoperative blood laboratory work results are present on preoperative chart." This answer reflects compliance with the nursing diagnosis of deficient knowledge regarding preoperative requirements because it indicates that the client has followed the requirement to have blood laboratory work done before surgery and that the results are available for review. This demonstrates that the client has received the necessary information and has taken the appropriate steps to meet the preoperative requirements.

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  • 36. 

    Which of the following best describes the primary nursing role regarding a client’s consent to surgery immediately before surgery?

    • A.

      Explaining the procedure to the client in a fashion that is easily understood

    • B.

      Placing the signed consent in the client’s medical record

    • C.

      Ensuring that the client understands the possible risks of the procedure before signing the consent

    • D.

      Reviewing the client’s surgical consent as a part of the routine preoperative checklist

    Correct Answer
    D. Reviewing the client’s surgical consent as a part of the routine preoperative checklist
    Explanation
    The primary nursing role regarding a client's consent to surgery immediately before surgery is to review the client's surgical consent as a part of the routine preoperative checklist. This ensures that all necessary documentation is in place and that the client has provided informed consent for the procedure. This step is important to ensure patient safety and to prevent any legal or ethical issues. The other options mentioned, such as explaining the procedure to the client, placing the signed consent in the client's medical record, and ensuring that the client understands the possible risks, are also important aspects of the nursing role but not specifically related to immediately before surgery.

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  • 37. 

    The initial client education–related nursing action by the preadmission nurse is to:

    • A.

      Respond to questions presented by the family regarding the client’s surgery

    • B.

      Call the client before the surgery to restate presurgery routine

    • C.

      Provide the client with a list of preoperative requirements

    • D.

      Arrange a time for presurgical blood work to be drawn

    Correct Answer
    B. Call the client before the surgery to restate presurgery routine
    Explanation
    The initial client education-related nursing action by the preadmission nurse is to call the client before the surgery to restate the presurgery routine. This action ensures that the client is aware of the necessary preparations and understands what needs to be done before the surgery. It allows the nurse to provide specific instructions tailored to the client's individual needs and address any concerns or questions they may have. By initiating this communication, the nurse can help alleviate anxiety and ensure that the client is well-prepared for the upcoming procedure.

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  • 38. 

    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.

      "The family will be the ones you will be dealing with regarding postoperative needs."

    • B.

      "When the family is more relaxed about caring for the client, the client is more relaxed."

    • C.

      "The more the family understands what to expect during recovery, the more comfortable they are in caring for the client."

    • D.

      "Teaching the family what they need to know before the surgery will maximize their effectiveness regarding the client’s postoperative care."

    Correct Answer
    D. "Teaching the family what they need to know before the surgery will maximize their effectiveness regarding the client’s postoperative care."
    Explanation
    The nurse's statement that teaching the family what they need to know before the surgery will maximize their effectiveness regarding the client's postoperative care demonstrates the most informed understanding of the role of family in the client's recovery. By educating the family about what to expect during the recovery process, they will be better prepared to provide appropriate care and support to the client. This knowledge will not only increase the family's comfort in caring for the client but also enhance their effectiveness in meeting the client's postoperative needs.

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  • 39. 

    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.

      Effects of preoperative medication

    • B.

      Complicated nature of the information

    • C.

      Fear or anxiety regarding the procedure

    • D.

      Emotional denial regarding surgical outcomes

    Correct Answer
    C. Fear or anxiety regarding the procedure
    Explanation
    Fear or anxiety regarding the procedure can be the greatest barrier to meeting a preoperative client's nursing diagnosis of deficient knowledge regarding the surgical procedure because it can hinder the client's ability to process and retain information. When a client is fearful or anxious, they may have difficulty focusing, comprehending, and remembering the information provided by the nurse. This can prevent them from fully understanding the surgical procedure, potential risks, and postoperative care instructions. Therefore, addressing and alleviating the client's fear or anxiety is crucial in order to effectively educate them about the surgical procedure.

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  • 40. 

    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.

      The client understands the need for the laxative

    • B.

      The laxative ordered is pleasant tasting

    • C.

      The bowel preparation is an uncomplicated process

    • D.

      The client has the appropriate support at home

    Correct Answer
    A. The client understands the need for the laxative
    Explanation
    The nurse knows that the client is most likely going to arrive for the surgical procedure having adhered to the required bowel preparation if the client understands the need for the laxative. This is because if the client understands the purpose and importance of the laxative in the bowel preparation process, they are more likely to follow the instructions and take it as directed. Understanding the need for the laxative indicates that the client is informed and motivated to comply with the bowel preparation, increasing the likelihood of adherence.

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  • 41. 

    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.

      Major

    • B.

      Minor

    • C.

      Ablative

    • D.

      Elective

    Correct Answer
    A. Major
    Explanation
    A cardiac catheterization is a procedure that involves inserting a catheter into the heart to diagnose and treat various heart conditions. It is considered a major surgical classification because it involves invasive techniques and carries a certain level of risk. Additionally, the fact that the patient is in the hospital with chest pain suggests that the procedure is being done to address a potentially serious cardiac issue. Therefore, major is the most appropriate surgical classification for this cardiac catheterization.

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  • 42. 

    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.

      Complete blood count (CBC)

    • B.

      Blood glucose

    • C.

      Serum electrolytes

    • D.

      Coagulation studies

    Correct Answer
    B. Blood glucose
    Explanation
    Blood glucose levels must be tested on the day of surgery for a diabetic client undergoing an elective breast augmentation procedure. This is important because diabetes can affect blood sugar levels, and high blood glucose levels can increase the risk of complications during surgery, such as delayed wound healing and infection. By monitoring blood glucose levels, the healthcare team can ensure that the client's blood sugar is well-controlled before proceeding with the surgery.

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  • 43. 

    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.

      Human immunodeficiency virus (HIV) antibody

    • B.

      Prolactin level

    • C.

      Pulmonary function test

    • D.

      Glucose tolerance test

    Correct Answer
    C. Pulmonary function test
    Explanation
    A 48-year-old male client with a history of chronic obstructive pulmonary disease (COPD) is scheduled for an inguinal hernia repair. Given the client's history of COPD, it is important to assess his pulmonary function before surgery. A pulmonary function test is a diagnostic test that evaluates lung function by measuring how much air the client can inhale and exhale, how quickly they can exhale, and how well their lungs deliver oxygen to the bloodstream. This test helps determine the severity of COPD and assesses the client's lung capacity and respiratory efficiency, which is crucial information for the healthcare provider to ensure the client's safety during surgery.

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  • 44. 

    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.

      The client has a decreased risk for contracting HIV.

    • B.

      There is an decreased risk for infection.

    • C.

      The client has less risk for a transfusion reaction.

    • D.

      The client may have a decreased hemoglobin and hematocrit level on the day of surgery.

    Correct Answer
    D. The client may have a decreased hemoglobin and hematocrit level on the day of surgery.
    Explanation
    An autologous infusion involves using the client's own blood for the surgery. One drawback of this method is that the client may have a decreased hemoglobin and hematocrit level on the day of surgery. This is because the client's blood is collected in advance and stored, which can lead to a decrease in these levels over time. This may result in a higher risk of anemia or other complications during and after the surgery.

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  • 45. 

    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.

      "The surgeon went over this procedure with you in his office"

    • B.

      "Let me get the surgeon to talk with you before we proceed so that you fully understand what will be happening"

    • C.

      To share with the client what he can expect in regard to the procedure

    • D.

      "This is just a simple procedure—you should feel much better afterwards"

    Correct Answer
    B. "Let me get the surgeon to talk with you before we proceed so that you fully understand what will be happening"
    Explanation
    The best response from the nurse is to offer to get the surgeon to talk with the client before proceeding so that the client fully understands what will be happening. This response shows that the nurse values the client's understanding and wants to ensure that they are well-informed about the procedure. It also demonstrates good communication and patient-centered care, as the nurse recognizes the client's confusion and takes steps to address it. This approach promotes trust and collaboration between the healthcare team and the client, leading to better outcomes and patient satisfaction.

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  • 46. 

    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.

      The client’s blood pressure may be high from the postoperative pain.

    • B.

      The client may be slow to arouse from the anesthesia, causing her vision to be blurred upon waking.

    • C.

      The anesthesia provider applies ointment to clients’ eyes to prevent corneal damage.

    • D.

      The lighting in the postanesthesia area will be subdued, causing the client to have blurred vision upon waking.

    Correct Answer
    C. The anesthesia provider applies ointment to clients’ eyes to prevent corneal damage.
    Explanation
    The correct answer is that the anesthesia provider applies ointment to clients' eyes to prevent corneal damage. This is because during surgery, the client's eyes are often closed and not able to blink, which can lead to dryness and potential damage to the cornea. The ointment helps to keep the eyes lubricated and prevent any complications.

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  • 47. 

    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.

      Incentive spirometry

    • B.

      Specific details regarding the progression of diet

    • C.

      Working the call button for the nurse

    • D.

      Using the patient-controlled analgesia (PCA) pump

    Correct Answer
    A. Incentive spirometry
    Explanation
    The nurse should provide instruction and rationale for incentive spirometry. Incentive spirometry is a preoperative and postoperative procedure that helps the client improve lung function and prevent complications such as atelectasis and pneumonia. By providing instruction and rationale, the nurse can educate the client on the importance of using the incentive spirometer and how it can help them breathe deeply and expand their lungs. This will empower the client to actively participate in their care and improve their postoperative outcomes.

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  • 48. 

    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.

      Postoperative client teaching

    • B.

      Demonstrating postoperative exercises

    • C.

      Transporting the preoperative client from the unit to the holding area

    • D.

      Reviewing the preoperative assessment to make sure that the client’s vital signs have been documented

    Correct Answer
    C. Transporting the preoperative client from the unit to the holding area
    Explanation
    The most appropriate task to delegate in this situation would be transporting the preoperative client from the unit to the holding area. This task does not require any specialized medical knowledge or skills and can be safely and effectively performed by the nursing assistive personnel (NAP). Postoperative client teaching and demonstrating postoperative exercises require the expertise of a nurse, while reviewing the preoperative assessment requires careful attention to detail and accuracy, which is best done by the nurse.

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  • 49. 

    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.

      Facilitates faster postsurgical recovery

    • B.

      Reduces hospital-oriented expenses

    • C.

      Allows for more one-on-one attention by staff

    • D.

      Cuts preparation time for surgical procedures

    • E.

      Minimizes risk for acquiring a nosocomial infection

    • F.

      The anesthetic drugs used result in faster "wake-up" time

    Correct Answer(s)
    A. Facilitates faster postsurgical recovery
    B. Reduces hospital-oriented expenses
    E. Minimizes risk for acquiring a nosocomial infection
    F. The anesthetic drugs used result in faster "wake-up" time
    Explanation
    The nurse includes the following as advantages of having a procedure done in a facility's ambulatory surgery department:
    - Facilitates faster postsurgical recovery: Ambulatory surgery allows patients to recover at home, which can lead to a quicker recovery compared to staying in the hospital.
    - Reduces hospital-oriented expenses: Ambulatory surgery is typically less costly than a hospital stay, resulting in reduced expenses.
    - Minimizes risk for acquiring a nosocomial infection: Ambulatory surgery reduces the exposure to hospital-acquired infections since the patient spends less time in the hospital.
    - The anesthetic drugs used result in faster "wake-up" time: The anesthetic drugs used in ambulatory surgery allow patients to wake up faster after the procedure.

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Quiz Review Timeline +

Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

  • Current Version
  • Mar 22, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Mar 07, 2012
    Quiz Created by
    Justin82
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