Care of the surgical patient

Perioperative

100

Five minutes after receiving a preoperative sedative medication by IV injection, a patient asks the nurse to get up to go to the bathroom to urinate. Which of the following is the most appropriate action for the nurse to take?

A) a. Assist patient to bathroom and stay next to door to assist patient back to bed when done. B) b. Allow patient to go to the bathroom since the onset of the medication will be more than 5 minutes. C) c. Offer the patient to use the urinal/bedpan after explaining the need to maintain safety. D) d. Ask patient to hold the urine for a short period of time since a urinary catheter will be placed in the operating room.

200

Which of the following is the primary reason for prioritizing the determination of the patient's current medications during a preoperative assessment?

A) a. Routine medications are usually withheld the day of surgery, requiring dosage and schedule adjustments. B) b. Some medications may alter the patient’s perceptions about surgery. C) c. Some medications may interact with anesthetics, altering the potency and effect of the drugs. D) d. Anesthetics alter renal and hepatic function, causing toxicity by other drugs.

300

As the nurse is preparing a patient for surgery, the patient refuses to remove a wedding ring. Which of the following is the most appropriate action by the nurse?

A) a. Note the presence of the ring in the nurse’s notes of the chart. B) b. Insist the patient remove the ring. C) c. Explain that the hospital will not be responsible for the ring. D) d. Tape the ring securely to the finger.

400

The nurse is preparing the patient for the OR. The physician has prescribed atropine to be administered immediately. The patient asks why they are receiving atropine. What is the nurse's best response?

A) "You are getting this medication because you have an arrhythmia" B)" You are receiving this medication to lower your heart rate" C) "You are receiving this medication to dry out the secretions in your mouth so you don't vomit during surgery" D) "This medication will lower your blood pressure"

500

The nurse is admitting a patient to the same day surgery unit. The patient tells the nurse that his last dose of warfarin was taken last evening at 5PM. What is the nurse's priority action?

A) Continue with the admitting process B) Call the PHCP and relay the information C) Have the lab draw a PT and INR D) Administer a dose of protamine sulfate

Nursing Management

100

The nursing goal of encouraging postoperative body movement is to?

a). contribute to optimal respiratory function b). improve circulation c). prevent venous stasis d). promote all of the above activities

200

The primary goal in withholding food before surgery is to prevent?

a). distention b). aspiration c). infection d). obstruction

300

Diabetics undergoing surgery are at risk for four complications? SELECT ALL THAT APPLY

a). hyperlipidemia b). hypoglycemia c). glucosuria d). acidosis e). hyperglycemia

400

Which medications should be stopped a few days prior to surgery? Select All that Apply

a) Aspirin b) Iron Sulfate c) Lisinopril d) Ibuprofin 

d) Calcium Carbonate

500

The physician is obtaining a consent from a patient for a surgical procedure. What is the nurse's primary responsibilty at this time?

a) Assist the physician in answering any questions the patient may have b) Act as a witness after the patient has signed the consent c) The nurse has no responsibility at this time  d) Explain the procedure to the patient

Intraoperative

100

The Circulating nurse's responsibilities, in contrast to the scrub nurse's responsibilities, include:

a). assisting the surgeon b). coordinating the surgical team c). setting up the sterile tables d). all of the above functions

200

While in the OR, the client develops muscle rigidity and a very high fever. Which medication should the nurse prepare to be administered?

a) Corticosteroids b) Atropine c) Calcum 

d) Dantrolene

300

What should the nurse assess for after the administration of IV Dantrolene?

a) Steven Johnson Syndrome b) Toxic Epidermal Necrolysis  c) Extravasation at the IV insertion site

 d) Cardiac arrhythmias 

400

If an operating nurse is to assist a patient to the Trendelenburg position, he or she would place the patient?

a). flat on his back with his arms next to his sides b). on his back with the head lowered so that the plane of his body meets the horizontal on an angle c). on his back with his legs and thighs flexed at right angles d). on his side with the uppermost led adducted and flexed at the knee

500

The nurse is developing a care plan for the patient while in the OR. Which nursing diagnosis is the priority?

a) Risk for injury related to the operative environment b) Alteration in comfort related to pain c) Potential for skin breakdown related to immobility d) Alteration in nutrition related to NPO 

Postoperative

100

When assessing a patient's surgical dressing on the first postoperative day, the nurse notes new bright-red drainage about 5 cm in diameter. In response to this finding, the nurse should do which of the following?

A) a. Assess the patient’s blood pressure and heart rate. B) b. Remove the dressing and assess the surgical incision. C) c. Recheck the dressing in 1 hour for increased drainage. D) d. Notify the surgeon of a potential hemorrhage.

200

The nurse is working on a surgical floor and is preparing to receive a postoperative patient from the postanesthesia unit. Which of the following should be the nurse's initial action upon the patient's arrival?

A) a. Check the physician’s postoperative orders. B) b. Assess the patient’s pain. C) c. Check the rate of the IV infusion. D) d. Assess the patient’s vital signs.

300

The nurse is preparing to administer cefazolin (Ancef) 2 grams in 100 ml IVPB to a postoperative patient. Which of the following IV rates will infuse this medication over 20 minutes

A) a. 100 ml/hr B) b. 150 ml/hr C) c. 200 ml/hr D) d. 300 ml/hr

400

In planning postoperative interventions to promote ambulation, coughing, deep breathing, and turning, the nurse recognizes that which of the following actions will best enable the patient to achieve the desired outcomes?

A) a. Giving the patient positive feedback when the activities are completed. B) b. Administering adequate analgesics to promote relative freedom from pain. C) c. Warning the patient about possible complications if the activities are not performed. D) d. Asking the patient to verbalize understanding of and demonstrate performance of activity.

500

The nurse is caring for a 75 year old patient who had their gallbladder removed 12 hours ago. The patient is complaining of right lower calf pain. What is the nurse's priority action at this time?

A) Contacting the PHCP B) Assessing VS C) Inspect the appearance of the right lower leg D) Ensure the patient is wearing the SCD's

Miscellaneous

100

A postoperative patient is transferred from the postanesthesia unit to the medical-surgical nursing floor. The nurse notes that the patient has an order for D5 ½ NS to infuse at 125 ml/hr. Until an IV pump is available, the nurse regulates the IV flow rate at which of the following drops (gtts)/min, noting that the tubing has a drop factor of 10 drops/ml?

A) a. 13 gtts/min B) b. 31 gtts/min C) c. 31 gtts/min D) d. 21 gtts/min

200

In order to promote wound healing, which foods should the nurse include in the education plan? Select all that Apply

a) Chicken b) Peanut butter c) Spaghetti d) Eggs

e) Apples

300

Because liver disease is associated with a high surgical mortality rate, the nurse knows to alert the physician for?

a). a lactate dehydrogenase concentration of 300 units b). a serum albumin of 5.0 g/dL c). a blood ammonia concentration of 180mg/dL d). a serum globulin concentration of 2.8 g/dL

400

The potential effects of medication therapy must be evaluated before surgery. A drug classification that may cause electrolyte imbalance is?

a). corticosteroids b). diuretics c). phenothaizines d). insulin

500

The nurse is caring for a patient who had an abdominal resection yesterday. The nurse's assessment findings include: absence of BS, vomiting green biliary like emesis, and abdominal distention. The physician confirms that the patient has a paralytic ileus. Which interventions would the nurse include in the plan of care? Select All that Apply

a) Maintain NPO status for the patient b) Maintain strict I & O c) Administer opioid pain meds around the clock 

d) Ambulate the patient every 2 hours e) Assess bowel sounds every shift