Postoperative Quiz Questions And Answers

1. You are discharging your patient home from day surgery after a general anesthetic. What instruction would you give the patient prior to the patient leaving the hospital?

The patient is not to drive a vehicle

The patient should have a glass of brandy the first night home to help him or her sleep

Eat a large meal at home

Do not sign important papers for the first 12 hours after surgery

After a general anesthetic, the patient may experience drowsiness, dizziness, and impaired coordination, which can affect their ability to drive safely. Therefore, it is important to instruct the patient not to drive a vehicle to ensure their safety and the safety of others on the road.

Explanation

After a general anesthetic, the patient may experience drowsiness, dizziness, and impaired coordination, which can affect their ability to drive safely. Therefore, it is important to instruct the patient not to drive a vehicle to ensure their safety and the safety of others on the road.

2. Your patient is 2 hours postoperative with a Foley catheter in situ. The last hourly urine output you recorded for this patient was 10 mL. The tubing of the Foley is patent. What should you do?

Irrigate the Foley with 30 mL normal saline

Notify the physician, and continue to closely monitor the hourly urine output

Decrease the IV fluid rate

Have the patient sit in high-Fowler's position

A urine output of 10 mL per hour is considered to be very low and may indicate a potential issue with kidney function or fluid balance. It is important to notify the physician in order to assess the patient's condition and determine the appropriate course of action. Continuing to closely monitor the urine output is also necessary to track any changes and provide accurate information to the healthcare team.

Explanation

A urine output of 10 mL per hour is considered to be very low and may indicate a potential issue with kidney function or fluid balance. It is important to notify the physician in order to assess the patient's condition and determine the appropriate course of action. Continuing to closely monitor the urine output is also necessary to track any changes and provide accurate information to the healthcare team.

3. Your patient is in the recovery room following chest surgery. The patient complains of severe nausea. What would you do next?

Administer an analgesic

Apply a cool cloth to the patient's forehead.

Offer the patient a small number of ice chips.

Turn the patient completely to one side.

Turning the patient completely to one side is the correct answer because it helps prevent aspiration in case the patient vomits. By positioning the patient on their side, any vomit will be able to drain out of the mouth and not be inhaled into the lungs, reducing the risk of aspiration pneumonia. This is an important intervention to ensure the safety and well-being of the patient in the recovery room. Administering an analgesic, applying a cool cloth, or offering ice chips may not directly address the issue of severe nausea and the risk of aspiration.

Explanation

Turning the patient completely to one side is the correct answer because it helps prevent aspiration in case the patient vomits. By positioning the patient on their side, any vomit will be able to drain out of the mouth and not be inhaled into the lungs, reducing the risk of aspiration pneumonia. This is an important intervention to ensure the safety and well-being of the patient in the recovery room. Administering an analgesic, applying a cool cloth, or offering ice chips may not directly address the issue of severe nausea and the risk of aspiration.

4. You are caring for a postoperative patient in the medical-surgical unit. During each patient assessment, you evaluate your patient for infection. Which sign or symptom would be most indicative of infection?

Presence of an indwelling urinary catheter

Rectal temperature of 100ºF (37.8ºC)

Red, warm, tender incision

White blood cell (WBC) count of 8,000/mL

A red, warm, and tender incision is the most indicative sign of infection. These symptoms suggest that there may be an inflammatory response occurring at the site of the incision, which is often associated with infection. The presence of an indwelling urinary catheter (option A) may increase the risk of infection but does not directly indicate infection. A rectal temperature of 100°F (37.8°C) (option B) is within the normal range and may not necessarily be indicative of infection. A white blood cell (WBC) count of 8,000/mL (option D) is within the normal range and does not necessarily indicate infection.

Explanation

A red, warm, and tender incision is the most indicative sign of infection. These symptoms suggest that there may be an inflammatory response occurring at the site of the incision, which is often associated with infection. The presence of an indwelling urinary catheter (option A) may increase the risk of infection but does not directly indicate infection. A rectal temperature of 100°F (37.8°C) (option B) is within the normal range and may not necessarily be indicative of infection. A white blood cell (WBC) count of 8,000/mL (option D) is within the normal range and does not necessarily indicate infection.

5. You are the nurse caring for a patient who just had surgery. What is your highest priority?

Assessing for hemorrhage

Maintaining a patent airway

Managing the patient's pain

Assessing vital signs every 15 minutes

The highest priority for a nurse caring for a patient who just had surgery is to maintain a patent airway. This is because a patent airway is essential for the patient's breathing and oxygenation. Any obstruction or compromise in the airway can lead to respiratory distress or even respiratory failure. Therefore, ensuring the patient has a clear and unobstructed airway is crucial for their immediate and long-term well-being.

Explanation

The highest priority for a nurse caring for a patient who just had surgery is to maintain a patent airway. This is because a patent airway is essential for the patient's breathing and oxygenation. Any obstruction or compromise in the airway can lead to respiratory distress or even respiratory failure. Therefore, ensuring the patient has a clear and unobstructed airway is crucial for their immediate and long-term well-being.

6. You admit a patient to the postanesthesia care unit with a blood pressure of 130/90 and a pulse of 68 beats per minute. After 30 minutes, the patient's blood pressure is 120/65, and the pulse is 100. You document the patient's skin as cold, moist, and pale. What is the patient showing signs of?

Hypothermia

Hypovolemic shock

Neurogenic shock

Malignant hypothermia

The patient is showing signs of hypovolemic shock. Hypovolemic shock occurs when there is a significant decrease in blood volume, leading to inadequate perfusion of organs and tissues. The decrease in blood pressure and increase in pulse rate suggest decreased cardiac output. The cold, moist, and pale skin is a result of vasoconstriction and reduced blood flow to the skin. These signs indicate that the patient is experiencing a severe loss of blood volume, possibly due to hemorrhage or fluid loss.

Explanation

The patient is showing signs of hypovolemic shock. Hypovolemic shock occurs when there is a significant decrease in blood volume, leading to inadequate perfusion of organs and tissues. The decrease in blood pressure and increase in pulse rate suggest decreased cardiac output. The cold, moist, and pale skin is a result of vasoconstriction and reduced blood flow to the skin. These signs indicate that the patient is experiencing a severe loss of blood volume, possibly due to hemorrhage or fluid loss.

7. The nursing instructor is discussing the difference between ambulatory surgical centers and hospital-based surgical units. A student asks why some patients have surgery in the hospital, and others are sent to ambulatory surgery centers. What is the instructor's best response?

“Patients who go to ambulatory surgery centers have more family support than patients admitted to the hospital.”

“Patients admitted to the hospital for surgery have multiple needs.”

“Only emergency and trauma patients are admitted to the hospital.”

“Patients who have surgery in the hospital can't afford the added expense of ambulatory surgery centers.”

The instructor's best response is B) "Patients admitted to the hospital for surgery have multiple needs." This answer provides a clear and concise explanation for why some patients have surgery in the hospital. It suggests that patients who require hospital admission have more complex medical needs that cannot be adequately addressed in an ambulatory surgery center. This response highlights the importance of providing comprehensive care and specialized resources for patients who require more intensive medical attention during and after surgery.

Explanation

The instructor's best response is B) "Patients admitted to the hospital for surgery have multiple needs." This answer provides a clear and concise explanation for why some patients have surgery in the hospital. It suggests that patients who require hospital admission have more complex medical needs that cannot be adequately addressed in an ambulatory surgery center. This response highlights the importance of providing comprehensive care and specialized resources for patients who require more intensive medical attention during and after surgery.

8. The nursing instructor is with a student nurse who is going to be changing an abdominal dressing. The first step is to provide the patient with information regarding the procedure. Which of the following is the best statement for completing this task?

“The dressing change is often painful, and we will be giving you pain medication prior to the procedure, so you do not have to worry.”

“During the dressing change, I will provide privacy at a time of your choosing, it should not be painful, and you can look at the incision and help with the procedure if you want to.”

“The dressing change should not be painful, but you can never be sure, and infection is always a concern.”

“The best time for doing a dressing change is during lunch, so we are not interrupted. I will provide privacy, and it should not be painful.”

The best statement for completing this task is B) "During the dressing change, I will provide privacy at a time of your choosing, it should not be painful, and you can look at the incision and help with the procedure if you want to." This statement addresses the patient's concerns about privacy and pain during the procedure. It also offers the patient the opportunity to be involved and informed about the process by allowing them to look at the incision and help if they desire. This approach promotes patient autonomy and comfort during the dressing change.

Explanation

The best statement for completing this task is B) "During the dressing change, I will provide privacy at a time of your choosing, it should not be painful, and you can look at the incision and help with the procedure if you want to." This statement addresses the patient's concerns about privacy and pain during the procedure. It also offers the patient the opportunity to be involved and informed about the process by allowing them to look at the incision and help if they desire. This approach promotes patient autonomy and comfort during the dressing change.

9. Your patient is a 78-year-old male who has had outpatient surgery. You are getting him up for his first walk postoperatively. To decrease the potential for orthostatic hypotension, what should you plan to have the patient do?

Sit in a chair for 10 minutes prior to ambulating

Drink plenty of fluids to increase circulating blood volume

Stand upright for 2 to 3 minutes prior to ambulating

Sit upright on the side of the bed for 15 minutes prior to ambulating

To decrease the potential for orthostatic hypotension, it is important to gradually transition the patient from a lying or sitting position to a standing position before ambulating. This allows the body to adjust to the change in position and prevents a sudden drop in blood pressure. Standing upright for 2 to 3 minutes prior to ambulating gives the patient's body enough time to stabilize and minimize the risk of orthostatic hypotension.

Explanation

To decrease the potential for orthostatic hypotension, it is important to gradually transition the patient from a lying or sitting position to a standing position before ambulating. This allows the body to adjust to the change in position and prevents a sudden drop in blood pressure. Standing upright for 2 to 3 minutes prior to ambulating gives the patient's body enough time to stabilize and minimize the risk of orthostatic hypotension.

10. You are the nurse in the emergency department (ED). You are caring for a man who has returned to the ED after receiving ten stitches for a knife wound while cleaning fish. The wound is now infected, the stitches were removed, and the wound is cleaned and packed with gauze. The ED doctor plans to have the man return tomorrow to remove the packing and resuture the wound. You are aware that the wound will now heal by what?

Late intention

Second intention

The third intention

First intention

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Explanation

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11. You are the nurse in a same-day surgery center. What can you do to ensure patient safety and recovery?

Record vital signs and intake and output

Document all your assessment findings

Report to the home health nurse all of the pertinent details

Provide expert teaching

Providing expert teaching is crucial for ensuring patient safety and recovery in a same-day surgery center. By providing education and instructions to patients, nurses can help them understand their condition, post-operative care, and any potential complications to watch out for. This empowers patients to actively participate in their own recovery and take necessary precautions. Expert teaching also includes educating patients on medication management, wound care, and lifestyle modifications. By equipping patients with knowledge and skills, nurses can contribute to better patient outcomes and reduce the risk of complications.

Explanation

Providing expert teaching is crucial for ensuring patient safety and recovery in a same-day surgery center. By providing education and instructions to patients, nurses can help them understand their condition, post-operative care, and any potential complications to watch out for. This empowers patients to actively participate in their own recovery and take necessary precautions. Expert teaching also includes educating patients on medication management, wound care, and lifestyle modifications. By equipping patients with knowledge and skills, nurses can contribute to better patient outcomes and reduce the risk of complications.

12. You are the intraoperative nurse transferring a patient from the OR to the PACU after replacement of the right knee. The patient is a 73-year-old female. You know that special attention must be paid to what?

Cardiovascular status

Positioning

Keeping the patient warm

Keeping the patient hydrated

After a knee replacement surgery, it is important to keep the patient warm during the transfer from the operating room to the post-anesthesia care unit (PACU). This is because the patient may experience a drop in body temperature due to exposure during the surgery and the use of cold irrigation solutions. Maintaining a warm body temperature helps prevent complications such as hypothermia and shivering, which can negatively impact the patient's recovery. Therefore, special attention must be paid to keeping the patient warm during this transfer.

Explanation

After a knee replacement surgery, it is important to keep the patient warm during the transfer from the operating room to the post-anesthesia care unit (PACU). This is because the patient may experience a drop in body temperature due to exposure during the surgery and the use of cold irrigation solutions. Maintaining a warm body temperature helps prevent complications such as hypothermia and shivering, which can negatively impact the patient's recovery. Therefore, special attention must be paid to keeping the patient warm during this transfer.

13. You are the PACU nurse caring for a 45-year-old male patient who had a left lobectomy. You assess your patient frequently for airway patency and cardiovascular status. You know that the most common cardiovascular complications seen in the PACU include what? (Mark all that apply.)

Hypotension

Hypervolemia

Heart murmurs

Dysrhythmias

Hypertension

The most common cardiovascular complications seen in the PACU include hypotension, dysrhythmias, and hypertension. Hypotension may occur due to factors such as blood loss during surgery or the effects of anesthesia. Dysrhythmias may occur as a result of the stress of surgery on the heart or the effects of anesthesia. Hypertension may occur due to pain, anxiety, or the body's response to stress. Hypervolemia and heart murmurs are not commonly seen as cardiovascular complications in the PACU.

Explanation

The most common cardiovascular complications seen in the PACU include hypotension, dysrhythmias, and hypertension. Hypotension may occur due to factors such as blood loss during surgery or the effects of anesthesia. Dysrhythmias may occur as a result of the stress of surgery on the heart or the effects of anesthesia. Hypertension may occur due to pain, anxiety, or the body's response to stress. Hypervolemia and heart murmurs are not commonly seen as cardiovascular complications in the PACU.

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14. What are the determining factors for a patient to be discharged from the PACU? (Mark all that apply.)

Temperature within normal limits

Stable blood pressure

Ability to respond to voice commands

Adequate oxygen saturation

Adequate respiratory function

The determining factors for a patient to be discharged from the PACU include stable blood pressure, adequate oxygen saturation, and adequate respiratory function. These factors ensure that the patient's vital signs and oxygen levels are within normal limits, indicating that they are stable and able to breathe properly. Temperature within normal limits and the ability to respond to voice commands are not mentioned as determining factors for discharge from the PACU.

Explanation

The determining factors for a patient to be discharged from the PACU include stable blood pressure, adequate oxygen saturation, and adequate respiratory function. These factors ensure that the patient's vital signs and oxygen levels are within normal limits, indicating that they are stable and able to breathe properly. Temperature within normal limits and the ability to respond to voice commands are not mentioned as determining factors for discharge from the PACU.

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15. You are discharging a patient home from a same-day surgery center. You have gone over all of the discharge instructions with the patient and her caregiver. What else should you do before letting the patient leave the facility? (Mark all that apply.)

Provide all discharge instructions in writing

Provide the nurse's or surgeon's telephone number

Give prescriptions to the patient

Give advice on nutrition to the caregiver

Provide dates and times of new appointments

Before letting the patient leave the facility, it is important to provide all discharge instructions in writing to ensure that the patient and caregiver have a clear understanding of what needs to be done post-surgery. Providing the nurse's or surgeon's telephone number is also crucial in case the patient or caregiver has any questions or concerns after leaving the facility. Additionally, giving prescriptions to the patient ensures that they have the necessary medications to follow the post-surgery instructions.

Explanation

Before letting the patient leave the facility, it is important to provide all discharge instructions in writing to ensure that the patient and caregiver have a clear understanding of what needs to be done post-surgery. Providing the nurse's or surgeon's telephone number is also crucial in case the patient or caregiver has any questions or concerns after leaving the facility. Additionally, giving prescriptions to the patient ensures that they have the necessary medications to follow the post-surgery instructions.

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