Assessment and Management of the Airway
Which of the following is breathing adequately?
A. A conscious male with respirations of 19 breaths/min and pink skin
B. A conscious female with facial cyanosis and rapid, shallow respirations
C. A conscious male with respirations of 18 breaths/min and reduced tidal volume
D. An unconscious 52-year old female with snoring respirations and coll, pale skin
What is "A" A conscious male with respirations of 19 breaths/min and pink skin
Pain tolerance is defined as the:
A. Decreased sensitivity to painful stimuli
B. Point at which a person does not feel pain
C. Maximum level of pain a person accepts
D. Disturbance of neural pain processes
What is "C" Maximum level of pain a person accepts
A 42 year old healthy male patient underwent endoscopic sinus surgery, and is preparing for discharge, the nurse instructs the patient to:
A. Notify the surgeon if having to change the mustache dressing more that once per hour
B. Attempt to keep swallowing secretions
C. Blow the nose gently with extreme caution
D. Apply a heating pad to the frontal sinus area
What is " A" notify the surgeon if having to change the mustache dressing more that once per hour
A 74 year old female patient, anxious for a vacation cruise, has scheduled an elective blepharoplasty. Postoperative instructions for the patient will include the application of intermittent ice compresses, resuming a regular diet, and minimum bending or heavy lifting. The patient should also be instructed to avoid which of the following for the first 24 hours?
A. Analgesics, as they will not be necessary
B. Applying antibiotic ointment to the incisions
C. Cold liquids with meals
D. Hot liquids with meals
What is "D" Hot liquids with meals
A patient was treated for laryngospasm with positive pressure and administration of succinylcholine. The perianesthesia nurse's plan for this patient is to:
A. Observe the patient for another hour before transfer to the floor
B. Continue ventilation until complete respiratory functioning has returned
C. install a dehumidifier in the patient's room
D. limit the patient's visitors in the room
What is "B" Continue ventilation until complete respiratory functioning has returned
In the recovery room, the postoperative patient suddenly becomes cyanotic. What is the most appropriate nursing action?
A. Start administration of oxygen through a nasal cannula
B. Call for assistance
C. Reposition the head and determine patency of the airway
D. Insert an oral airway and suction the nasopharynx
What is "C" Reposition the head and determine patency of the airway
A PACU patient status post ORIF left ankle has received hydromorphone IV, IV Fentanyl, and IV Ketorolac. Which of the following can be added to the regimen for multimodal pain management?
A. Ibuprofen PO
B. Ondansetron IV
C. Acetaminophen IV
D. Oxybutynin PO
What is "C" Acetaminophen IV
The dressing of a patient who underwent an otologic procedure is found to be wet with a colorless fluid. The fluid may be:
A. Cerebrospinal fluid
B. Plasma
C. Vitreous fluid
D. Lymphatic fluid
What is "A" Cerebrospinal fluid
Patient teaching regarding the proper method of instillation of eye drops include all of the following except:
A. Wash hands before using the drops
B. Rub the eyes gently to dispense the medication
C. Tilt the head back open with eye open
D. Pull down the tissue below the lower lid
What is " B" Rub the eyes gently to dispense the medication
During the. stir-up regime, the most important element of lung volume enhancement is the:
A. Timing of the cough
B. Expiratory effort
C. Number of deep breaths
D. Inspiratory hold
What is "D" Inspiratory hold
Early clinical signs of acute hypoxemia in the postoperative patient include:
A. 8 to 10 regular respirations per minute
B. Pulse oximetery measurement of 91% to 93%
C. Restless and anxiety
D. Bright flushing of the skin
What is "C" Restless and anxiety
The Perianesthesia nurse would discontinue narcotic administration when the patient's:
A. Blood pressure if 10% of baseline
B. FLACC scale is 6
C. Pasero Opioid Induced Sedation scale is 4
D. Respiratory rate is 12 breaths per minute
What is "C" Pasero Opioid Induced Sedation scale is 4
Anxious parents are at the bedside of a toddler who is crying, kicking, and thrashing following bilateral myringotomy and insertion of tympanostomy. The perianesthesia nuse informs the parents that this behavior is:
A. the emergence excitement phase after anesthesia
B. a temper tantrum often seen in toddlers
C. associated with the surgical procedure
D. uncommon in children of this age
What is "A" the emergence excitement phase after anesthesia
Which of the following is a pharmacological agent that constrict the pupil of the eye?
A. Rocuronium
B. Atracurium
C. Vecuronium
D. Succinylcholine
What is" D" Succinylcholine
The patient with a pneumonectomy should never be positioned:
A. On the non-operative side
B. On the operative side
C. Supine
D. In semi-fowler's position
What is "A" On the non-operative side
Some patients who have been intubated for surgery may complain of sore throat postoperatively. The Perianesthesia nurse should:
A. Administer oxygen to soothe the throat
B. Observe the oropharynx and auscultate the chest
C. Apply heat to the patient's neck to relieve the symptoms
What is "B" Observe the oropharynx and auscultate the chest
When caring for a 3 year old with pain, which assessment tool is the most useful?
A. Simple descriptive pain intensity scale
B. 0-10 numerical rating scale (NRS)
C. FACE pain rating scale
D. McGill-Melzack pain questionnaire
What is "C" McGill-Melzack pain questionnaire
An ambulatory surgery patient who is post direct laryngoscopy with general anesthesia exhibits stridor. The perianesthesia nurse anticipates orders for:
A. Percussion of the anterior chest
B. Administration of nebulized racemic epinephrine
C. Administration of naloxone IV
D. Suctioning the pharynx
What is "B" Administration of nebulized racemic epinephrine
What sterile irrigation is used for ophthalmic procedures?
A. Sterile water
B. Balanced Salt Solution (BSS)
C. Refresh Tears
D. Systane Ultra
What is "B" Balanced Salt Solution (BSS)
One of the earliest physical assessment findings in tension pneumothorax is:
A. Generalized cyanosis
B. A deviated point of maximal intensity (PMI)
C. Laryngeal stridor
D. A decreased in breath sounds
What is "D" A decreased in breath sounds
In the absence of a peripheral nerve stimulator, the best indication of a patient’s readiness for Extubation in the Phase I PACU is the ability to:
A. Follows verbal commands
B. Wiggle their fingers
C. Opens their eyes
D. Lift the head for 5 seconds
What is "D" Lift the head for 5 seconds
When administering an analgesic to manage pain, what is the priority?
A. Administer the smallest dose that provides relief with the fewest side effects
B. Titrate upward until the patient is pain free
C. Titrate downwards to prevent toxicity
D. Ensure that the drug is adequate to meet the patient's subjective needs
What is " A" Administer the smallest dose that provides relief with the fewest side effects
Within 20 minutes of admission to the PACU after a uvulopalatopharyngoplasty (UVPP) a previously responsive patient but drowsy patient is observed to have decreased SpO2 and shallow respiratory effort. Prompt intervention includes which of the following?
A. Draw up naloxone because the patient is over narcotized
B. Prepare for probable intubation with a 8 endotracheal tube
C. Stimulate the patient and prepare to apply continuous positive airway pressure
D. Wake the patient to teach use of the incentive spirometer
What is " C" Stimulate the patient and prepare to apply continuous positive airway pressure
Tetracaine drops are used in ophthalmologic procedures to:
A. Numb the surface of the eye and surrounding structures
B. To decrease redness around eye
C. To decrease eye blinking
D. To decrease swelling around the eye and surrounding structures
What is " A" Numb the surface of the eye and surrounding structures
A patient was brought to PACU post left pneumonectomy. Tha perianesthesia nurse should position the patient:
A. Prone
B. On the right side
C. On the left side
D. Trendelenburg
What is "C" On the left side