Mastery Quizzes 1

Which statement by the client indicates further teaching about epidural anesthesia is necessary? a) "I will become unconscious." b) "I will lose the ability to move my legs." c) "I will be able to hear the surgeon during the surgery." d) "A needle will deliver the anesthetic into the area around my spinal cord."

"I will become unconscious."

A novice nurse provides aftercare instructions to a client who has just had sutures removed. Which statement by the novice nurse requires the nurse preceptor to clarify?

"If the wound edges are red or raised, you should call your doctor."

You are the nurse working in an ambulatory surgery center. A teenage son of your clients ask you why so many people have surgery. What would be your best reply?

"Many people have diagnostic or short therapeutic surgical procedures."

For the client who is taking aspirin, it is important to stop taking this medication at least how many day(s) before surgery?

7

The nurse is preparing to discharge a patient from the PACU using a PACU room scoring guide. With what score can the patient be transferred out of the recovery room? 5 6 7 8

8

What is the blood glucose level goal for a diabetic client who will be having a surgical procedure? 80 to 110 mg/dL 150 to 240 mg/dL 250 to 300 mg/dL 300 to 350 mg/dL

80 to 110 mg/dL

A patient with renal failure is scheduled for a surgical procedure. When would surgery be contraindicated for this patient due to laboratory results?

A blood urea nitrogen level of 42 mg/dL

A client is scheduled for a surgical procedure. When planning the client's care, the nurse should consider that which of the following conditions will increase the client's risk of complications after surgery?

A history of diabetes

The nurse is concerned that a postoperative patient may have a paralytic ileus. What assessment data may indicate that the patient does have a paralytic ileus? Abdominal tightness Abdominal distention Absence of peristalsis Increased abdominal girth

Absence of peristalsis

A client refuses to remove her wedding band when preparing for surgery. What is the best action for the nurse to take?

Allow the client to wear the ring and cover it with tape.

A 78-year-old client is undergoing surgery to repair a right hip fracture. What nursing action is appropriate during the intraoperative phase?

Appropriately position the client using adequate padding and support.

A medical student scheduled to observe surgery enters the unrestricted surgical zone wearing jeans, a t-shirt, and tennis shoes. What is the best action by the nurse?

Educate the medical student on required attire for each surgical zone.

Which stage of surgical anesthesia is also known as excitement?

II

The nurse is providing preoperative care to a client who is anxious about total hip replacement surgery. "What if I can never walk again? I don't want to end up like my father!" What are some ways the nurse might help alleviate the client's anxiety? Select all that apply. Make sure the client understands what will happen during surgery. Listen empathetically to the client's concerns about the procedure. Remind the client that the chances of something going wrong are statistically low. Offer a sedative to help the client relax and feel more comfortable. Review the client's postoperative goals following the procedure. Ask the client if he would like to speak with a clergyperson.

Make sure the client understands what will happen during surgery. Listen empathetically to the client's concerns about the procedure. Review the client's postoperative goals following the procedure. Ask the client if he would like to speak with a clergyperson.

An instructor is developing for a class a teaching plan about agents used for intravenous (IV) anesthesia. Which of the following would the instructor include in this plan about these agents and this type of anesthesia? Select all that apply. Associated with more nausea Long duration of action More pleasant onset of anesthesia Ease of administration Need for little equipment

More pleasant onset of anesthesia Ease of administration Need for little equipment

After teaching a class about agents commonly associated with the development of malignant hyperthermia, the instructor determines that additional teaching is needed when the students identify which drug as a possible cause? Halothane Succinylcholine Epinephrine Morphine

Morphine

On postoperative day 2, a client requires care for a surgical wound using second-intention healing. What type of dressing change should the nurse anticipate doing? Packing the wound bed with sterile saline-soaked dressing and covering it with a dry dressing Covering the well-approximated wound edges with a dry dressing Cleaning the wound with sterile saline and applying cyanoacrylate tissue adhesive Cleaning the wound with soap and water, then leaving it open to the air

Packing the wound bed with sterile saline-soaked dressing and covering it with a dry dressing

The surgical client is at risk for injury related to positioning. Which of the following clinical manifestations exhibited by the client would indicate the goal was met of avoiding injury?

Peripheral pulses palpable

The nurse recognizes that written informed consent is required for insertion of a(n): Nasogastric tube. Urinary catheter. Peripherally-inserted central catheter. Oral airway.

Peripherally-inserted central catheter.

When is the ideal time to discuss preoperative teaching

Preadmission visit

The scrub nurse is responsible for:

Preparing the sterile instruments for the surgical procedure

What complication is the nurse aware of that is associated with deep venous thrombosis?

Pulmonary embolism

The circulating nurse is unsure whether proper technique was followed when an object was placed in the sterile field during a surgical procedure. What is the best action by the nurse?

Remove the entire sterile field from use.

Which method of wound healing is one in which wound edges are not surgically approximated and integumentary continuity is restored by granulation?

Second-intention healing

A client is undergoing thoracic surgery. What priority education should the nurse provide to assist in preventing respiratory complications?

Splint the incision site using a pillow during deep breathing and coughing exercises.

Nursing assessment findings reveal that the client is afraid of dying during the surgical procedure. Which surgical team member would be most helpful in addressing the client's concern? Anesthesiologist Circulating nurse Registered nurse first assistant Surgeon

Surgeon

x An unconscious patient with normal pulse and respirations would be considered to be in what stage of general anesthesia? Beginning anesthesia Excitement Surgical anesthesia Medullary depression

Surgical anesthesia

Which clinical manifestation is often the earliest sign of malignant hyperthermia?

Tachycardia (heart rate >150 beats per minute)

You are caring for a client who needs to ambulate. What considerations should be included when planning the postoperative ambulatory activities for the older adult? Respiratory depressive effects Tolerance Convalescent period Detailed medication history

Tolerance

The nurse is educating a community group about types of surgery. A member of the group asks the nurse to describe a type of surgery that is curative. What response by the nurse is true?

Tumor excision

The nursing instructor is talking with her class about spinal anesthesia. What would be the nursing care intervention required when caring for a client recovering from spinal anesthesia? Select all that apply.

Turn the client from side to side at least every 2 hours, if permitted. Assist the client to a sitting position at the side of the bed. Instruct the client to stay in bed until sensation and movement returns. Monitor respiratory rate and sensation every 2 hours or as per ordered.

A nurse is teaching a client with chronic bronchitis about breathing exercises. Which instruction should the nurse include in the teaching?

Use diaphragmatic breathing.

The scrub nurse is responsible for: a) Calling the "time-out" to verify the surgical site and procedure b) Monitoring the administration of the anesthesia c) Monitoring the operating-room personnel for breaks in sterile technique d) Preparing the sterile instruments for the surgical procedure

d) preparing the sterile instruments for the surgical procedure

During the surgical procedure, the client exhibits tachycardia, generalized muscle rigidity, and a temperature of 103°F. The nurse should prepare to administer: verapamil (Isoptin) dantrolene sodium (Dantrium) potassium chloride an acetaminophen suppository

dantrolene sodium (Dantrium)

When the indication for surgery is without delay, the nurse recognizes that the surgery will be classified as

emergency

A nurse is caring for a client who underwent a skin biopsy and has three stitches in place. This wound is healing by:

first intention.

In preparing the client for transfer to the operating room, which of the following actions by the nurse is inappropriate? Allow the client to wear dentures Remove all jewelry Have the client void Have client wear hospital gown.

have the client client dentures

In advance of a client's scheduled appendectomy, the nurse spends significant time explaining to the client what will happen,both before the procedure and after the procedure is complete. The primary reason the nurse puts so much effort into preoperative teaching is to:

increase the likelihood of a successful recovery.

The nurse understands that the purpose of the "time out" is to:

maintain the safety of the client.

During a procedure, a client's temperature begins to rise rapidly. This is likely the result of which complication?

malignant hyperthermia

56s Report this Question A client is undergoing a surgical procedure to repair an ulcerated colon. Which client education topics will be discussed preoperatively? Select all that apply. intravenous fluids and other lines and tubes the surgeon's fee and other hospital charges cough and deep-breathing exercises postoperative pain control the client's spouse's thoughts about the upcoming surgery

postoperative pain control cough and deep-breathing exercises intravenous fluids and other lines and tubes

The surgical client has been intubated and general anesthesia has been administered. The client exhibits cyanosis, shallow respirations, and a weak, thready pulse. The nurse recognizes that the client is in which stage of general anesthesia? Stage I Stage II Stage III Stage IV

stage IV

A nurse is working as a registered nurse first assistant as defined by the state's nurse practice act. This nurse practices under the direct supervision of which surgical team member

surgeon

A fractured skull would be classified under which category of surgery based on urgency?

urgent

The nurse has provided preoperative instructions to a client scheduled for surgery at an ambulatory care center. Which statement, made by the client, would indicate that further instruction is needed? "If I do not follow the instructions, my surgery could be cancelled." "The nurse will explain the details of the surgery before I sign a consent." "My medical records will be sent to the ambulatory care center prior to my surgery." "The physician will update my family after the procedure and provide specific discharge instructions."

"The nurse will explain the details of the surgery before I sign a consent."

Which of the following is the appropriate response to the statement, "I'm so nervous about my surgery"?

"You seem nervous about your surgery."

During the preoperative assessment, the nurse learns that the client has been taking prednisone. The nurse realizes that the client is at risk for:

Cardiovascular collapse.

A patient is in the operating room for surgery. Which individual would be responsible for ensuring that procedure and site verification occurs and is documented?

Circulating nurse

The OR personnel responsible for maintaining the safety of the client and the surgical environment is the:

Circulating nurse

What medication should the nurse prepare to administer in the event the client has malignant hyperthermia?

Dantrolene sodium

Nursing assessment findings reveal urinary output < 30 ml/hr, tachycardia, tachypnea, decreased hemoglobin, and acute confusion. The findings are indicative of which nursing diagnosis? Acute pain Ineffective airway clearance Decreased cardiac output Urinary retention

Decreased cardiac output

What action by the nurse best encompasses the preoperative phase? Documenting the application of sequential compression devices (SCDs) Educating clients on signs and symptoms of infection Monitoring vital signs every 15 minutes Shaving the client using a straight razor

Educating clients on signs and symptoms of infection

Informed consent from the surgical client is essential in all of the following categories of surgery except:

Emergent surgery

Which stage of anesthesia is referred to as surgical anesthesia?

III

A client is brought to the operating room for an elective surgery. What is the priority action by the circulating nurse? Verify consent. Document the start of surgery. Acquire ordered blood products. Count sponges and syringes.

Verify consent.

The nurse is caring for a patient with liver disease who had a surgical procedure. When should the nurse alert the physician?

When the patient's blood ammonia concentration reaches 180 mg/dL

Which of the following consequences may result if tranquilizers are withdrawn suddenly? a) seizures b) cardiovascular collapse c) hypotension d) respiratory depression

a) seizures

A client had a nephrectomy 2 days ago and is now complaining of abdominal pressure and nausea. The first nursing action should be to:

auscultate bowel sounds.

A 70-year-old patient who is to undergo surgery arrives at the operating room (OR). The nurse, when reviewing the patient's medical record, understands that this patient will require a lower dose of anesthetic agent because of which of the following? a) Increased anxiety level b) Increased tissue elasticity c) Decreased lean tissue mass d) Impaired thermoregulation

c) decreased lean tissue mass

Which of the following is an inappropriate nursing action by the surgical nurse? a) Covering the hair with a surgical cap b) Wearing a surgical jacket with knitted cuffs on the sleeves c) Wearing sterile gloves over artificial nails d) Changing shoe covers that become torn

c) wearing sterile gloves over artificial nails

After teaching a patient scheduled for ambulatory surgery using moderate sedation, the nurse determines that the patient has understood the teaching based on which of the following statements? a) "I'm so glad that I will be unconscious during the surgery." b) "I won't feel it, but I'll have a tube to help me breathe." c) "Only the surgical area will be numb." d) "I'll be sleepy but able to respond to your questions."

d) i'll be sleepy but able to respond to your questions

The operating nurse is caring for a patient who is receiving general anesthesia. Organize the nursing interventions in chronological order of the stages of general anesthesia, beginning with Stage I (1) and ending with Stage IV (4).

Keep discussions about the client to a minimum. Avoid auditory and physical stimuli. Place client into operative position. Prepare for and assist in treatment of cardiac and/or respiratory arrest.

As a circulating nurse, what task are you solely responsible for?

Keeping records.

Which position is used for perineal surgical procedures?

Lithotomy

Why should the nurse be vigilant with assessment of perioperative risks on the older adult client? Select all that apply.

Liver size decreases, reducing the metabolism of anesthetics. Fatty tissue increases, prolonging the effects of anesthesia. Ciliary action decreases, reducing the cough reflex.

Corticosteroids have which effect on wound healing?

Mask the presence of infection

A significant mortality rate exists for patients with alcoholism who experience delirium tremens postoperatively. When caring for the patient with alcoholism, the nurse should assess for symptoms of alcoholic withdrawal: Within the first 12 hours. About 24 hours postoperatively. On the second or third day. 4 days after surgery.

On the second or third day.

A client is scheduled for a cholecystectomy. Which finding by the nurse is least likely to contribute to surgical complications? Pregnancy Diabetes Urinary tract infection Osteoporosis

Osteoporosis

A scrub nurse is diagnosed with a skin infection to the right forearm. What is the priority action by the nurse?

Report the infection to an immediate supervisor.

A client is undergoing thoracic surgery. What priority education should the nurse provide to assist in preventing respiratory complications? Splint the incision site using a pillow during deep breathing and coughing exercises. Pain medication should be taken before completing deep breathing and coughing exercises. Deep breathing and coughing exercises should be completed every 8 hours. Deep breathing and coughing exercises may be used as relaxation techniques.

Splint the incision site using a pillow during deep breathing and coughing exercises.

A client has been administered ketamine for moderate sedation. What is the priority nursing intervention?

frequently monitor vitals

Nursing students are reviewing information about agents used for anesthesia. The students demonstrate understanding when they identify which of the following as an inhalation anesthetic?

halothane

The nurse discovers that the client did not sign the operative consent before receiving the preoperative medication. The appropriate nursing action is:

notify the surgeon

Which health care profession has the ultimate responsibility to provide appropriate information regarding a nonemergent surgery?

physician

A client is at postoperative day 1 after abdominal surgery. The client is receiving 0.9% normal saline at 75 mL/h, has a nasogastric tube to low wall suction with 200 mL every 8 hours of light yellow fluid, and a wound drain with 50 mL of dark red drainage every 8 hours. The 24-hour urine output total is 2430 mL. What action by the nurse is most appropriate?

Assess for signs and symptoms of fluid volume deficit.

A postanesthesia care unit (PACU) nurse is caring for a client with the following assessment data: pale, cool, moist skin; thready pulse of 122; blood pressure 78/60; urine output of 25 mL/h; temperature 99.2°F. What interventions by the nurse are appropriate? Select all that apply. Raise the head of the bed 30 degrees Maintain a patent airway Frequently monitor neurological status Administer blood products per orders Apply oxygen per orders Apply a warming blanket.

Maintain a patent airway. Frequently monitor neurological status. Administer blood products per orders. Apply oxygen per orders.

What is the priority action when the circulating nurse is completing a second verification of the surgical procedure and surgical site? Ask the surgeon whether the marked surgical site is correct. Obtain the attention of all members of the surgical team. Discuss the surgical procedure and surgical site with the client. Review complications and allergies with the anesthesiologist.

Obtain the attention of all members of the surgical team.

A PACU nurse is caring for a postoperative client who received general anesthesia and has a hard, plastic oral airway in place. The patient has clear lung sounds, even and unlabored respirations of 16, and 98% oxygen saturation. The client is minimally responsive to painful stimuli. What action by the nurse is most appropriate? Continue with frequent client assessments. Remove the oral airway. Notify the physician of impaired neurological status. Obtain vital signs, including pulse oximetry, every 5 minutes.

Continue with frequent client assessments.

What are the circulating nurse's responsibilities, in contrast to the scrub nurse's responsibilities? a) Assisting the surgeon b) Coordinating the surgical team c) Setting up the sterile tables d) Passing instruments

Coordinating the surgical team

The anesthesiologist administered a transsacral conduction block. Which documentation by the nurse is consistent with the anesthesia being administered?

Denies sensation to perineum and lower abdomen

Which of the following actions by the nurse is appropriate? Touching the edges of an open sterile package Touching sterile items with a clean-gloved hand Reaching over the sterile field Discarding an object that comes in contact with the 1-inch border

Discarding an object that comes in contact with the 1-inch border

A postoperative client is being discharged home after minor surgery. The PACU nurse is reviewing discharge instructions with the client and the client's spouse. What actions by the nurse are appropriate? Select all that apply. Educate on activity limitations. Discuss wound care. Have the spouse review when to notify the physician. Have the client sign his or her advance directive form. Provide information on health promotion topics.

Discuss wound care. Provide information on health promotion topics. Educate on activity limitations. Have the spouse review when to notify the physician.`

The nurse recognizes the client has reached stage III of general anesthesia when the client:

Has small pupils that react to light

The nurse is teaching the client about usual side effects associated with spinal anesthesia. Which of the following should the nurse include when teaching?

Headache

A client is undergoing preoperative assessment. During admission paperwork, the client reports having enjoyed a hearty breakfast this morning to be ready for the procedure. What is the nurse's next action?

Notify the surgeon.

The anesthesiologist will use moderate (conscious) sedation during the client's surgical procedure. The circulating nurse will expect the client to:

Respond verbally during the procedure

A 55-year-old patient arrives at the operating room. The nurse is reviewing the medical record and notes that the patient has a history of osteoporosis in her lower back and hips. The patient is scheduled to receive epidural anesthesia. Which of the following nursing diagnoses would be a priority for this patient? Risk for injury related to effects of anesthetic agents Risk for perioperative positioning injury related to operative position Anxiety related to the surgical experience Disturbed sensory perception related to sedation

Risk for perioperative positioning injury related to operative position

A nurse is caring for a client who is three hours post op from open abdominal surgery. During routine assessment, the nurse notes the previously stable client now appears anxious, apprehensive, and has a blood pressure of 90/56. What does the nurse consider is the most likely cause of the client's change in condition? The client is displaying early signs of shock. The client is showing signs of a medication reaction. The client is displaying late signs of shock. The client is showing signs of an anesthesia reaction.

The client is displaying early signs of shock.

A perioperative nurse is conducting an in-service education program about maintaining surgical asepsis during the intraoperative period. Which of the following would the nurse emphasize?

The edges of a sterile package, once opened, are considered unsterile.

When does the nurse understand the patient is knowledgeable about the impending surgical procedure? The patient participates willingly in the preoperative preparation The patient discusses stress factors causing the patient to feel depressed The patient expresses concern about postoperative pain The patient verbalizes fears to family.

The patient participates willingly in the preoperative preparation.

The nurse is teaching the client about patient-controlled analgesia. Which of the following would be appropriate for the nurse to include in the teaching plan? The client can self-administer oral pain medication as needed with patient-controlled analgesia. Family members can be involved in the administration of pain medications with patient-controlled analgesia. Therapeutic drug levels can be maintained more evenly with patient-controlled analgesia. There are no advantages of patient-controlled analgesia over a PRN dosing schedule.

Therapeutic drug levels can be maintained more evenly with patient-controlled analgesia.

Which nursing statement would best decrease a client's anxiety before an emergency operative procedure? "You will be just fine; the operating room nurses will take good care of you." "It is best to take deep breaths and relax before the procedure." "Let me explain to you what will happen next." "We will keep your family informed of your progress."

"Let me explain to you what will happen next."

What is the most important postoperative instruction a nurse must give to a client who has just returned from the operating room after receiving a subarachnoid block? "Avoid drinking liquids until the gag reflex returns." "Avoid eating milk products for 24 hours." "Notify a nurse if you experience blood in your urine." "Remain supine for the time specified by the physician."

"Remain supine for the time specified by the physician."

The nurse is working in the preoperative area with a client going to surgery for a cholecystectomy. The client has histamine2-receptor antagonists ordered preoperatively. The client asks the nurse why these medications are needed. What would be the nurse's best answer?

"These medications decrease gastric acidity and volume."

A student nurse is scheduled to observe a surgical procedure. The nurse provides the student nurse with education on the dress policy and provides all attire needed to enter a restricted surgical zone. Which observation by the nurse requires immediate intervention? A. Hair is pulled back and covered by a cap. B. Scrub top and drawstring are tucked into pants. C. Shoe covers are used. D. Mask is placed over nose and extends to bottom lip.

D. The mask should fit tightly, covering the nose and mouth. The mask should extend down past the chin. The mask may not effectively cover the mouth if extended only to the bottom lip. The hair, scrub top, drawstring, and shoe covering are all appropriate and do not require intervention

When a client with a history of chronic alcoholism is admitted to the hospital for surgery, the nurse anticipates that the client may show signs of alcohol withdrawal delirium during which time period?

Up to 72 hours after alcohol withdrawal

The perioperative nurse has a number of major responsibilities when a patient is admitted to a surgical unit or center. Which of the following is the most important function? Completes preoperative assessment Develops a plan of care Verifies that operative consent is signed Provides psychological support

Verifies that operative consent is signed

At what point does the preoperative period end?

When the client is transferred onto the operating table

Monitored anesthesia care differs from moderate sedation in that monitored anesthesia care: is used as an adjunct to spinal anesthesia. may result in the administration of general anesthesia. is a type of regional anesthesia. requires the introduction of an anesthetic agent into the epidural space.

may result in the administration of general anesthesia.

A postoperative client is experiencing a flash pulmonary edema. What finding in the client's sputum is consistent with this problem? Pink color Copious red blood in the sputum Foul smell Pieces of vomitus

pink color