Perioperative nursing
Which assessment questions should the nurse ask a preoperative patient preparing for surgery? (Select all that apply.) A: "Are you experiencing any pain?" B: "Do you exercise on a daily basis?" C: "When do you regularly take your medications?" D: "Do you have any medication allergies?" E: "Do you use drugs and/or tobacco products?"
A D E
Which of the following techniques could the nurse use to decrease pre-operative anxiety prior to obtaining informed consent? Select all that apply. A: Allow a family member to sit with the client B: Administer an anti-anxiety medication C: Have spiritual care visit D: Administer a sedative E: Validate fear and anxiety
A C E
A postoperative patient experiences tachypnea during the first hour of recovery. Which nursing intervention is a priority? A: Elevate the head of the patient's bed. B: Give ordered oxygen through a mask at 4 L/min. C: Ask the patient to use an incentive spirometer. D: Position the patient on one side with the face down and the neck slightly extended so that the tongue falls forward.
A
The nurse is discussing preoperative education with a client. The client asks if a family member can also listen. Which is the best response by the nurse? A: "Yes. It is helpful for everyone to support in your recovery." B: "No. This information is private." C: "There is no need for an additional person. I will give you written instruction." D: "There is not that much information so you can remember it."
A
The nurse is getting the client ready for surgery and completing the preoperative checklist. Which of the following is not part of the preoperative checklist? A: Conducting a "time out" B: Signing the informed consent C: Ask the client about allergies D: Removal of jewelry
A
Which is the best intervention the nurse should implement to promote bowel function? A: Early ambulation B: Deep-breathing exercises C: Repositioning on the left side D: Lowering the head of the patient's bed
A
Which statement is incorrect regarding an informed consent signed by a client? A: The intraoperative nurse is responsible for obtaining the consent for surgery. B: The nurse can witness the client signing the consent form. C: Clients under 18 years of age may need a parent or legal guardian to sign a consent form. D: The nurse needs to verify the client's identity
A
An 85-year-old patient returns to the inpatient surgical unit after leaving the PACU. Which of the following place the patient at risk during surgery? (Select all that apply.) A: Stiffened lung tissue B: Reduced diaphragmatic excursion C: Increased laryngeal reflexes D: Reduced blood flow to kidneys E: Increased cholinergic transmission
A B D
A patient who returned from surgery 3 hours ago following a kidney transplant is reporting pain at a 7 on a scale of 0 to 10. The nurse has tried repositioning with no improvement in the patient's pain report. Unmanaged surgical pain can lead to which of the following problems? (Select all that apply.) A: Delayed ambulation B: Reduced ventilation C: Catheter-associated urinary tract infection D: Retained pulmonary secretions E: Reduced appetite
A B D E
While David is in the operating room, one of the surgical nurses is stuck with a suture needle. How could needlesticks be prevented? Select all that apply. A: Use a hands free technique for passing sharps B: Use blunt suture needles C: Have only the surgeon touch the needles D: Wear only a single layer of gloves E: Dispose of used needles quickly and appropriately
A B E
Review the scenario: David Egan is a 62-year-old male who arrives to the preoperative area for a below the knee amputation of the right lower extremity. On the day of surgery, his medication(s) should include which of the following? Select all that apply. A: Insulin (glargine) 20 units daily B: Aspirin 325mg daily C: Lisinopril 20 mg daily
A C
The nurse prepares a patient with type 2 diabetes for a surgical procedure. The patient weighs 112.7 kg (248 lb) and is 5 feet, 2 inches in height. Which factors increase this patient's risk for surgical complications? (Select all that apply.) A: Obesity B: Prolonged bleeding time C: Delayed wound healing D: Ineffective vital capacity E: Immobility secondary to height
A C
A nurse cares for a postoperative patient in the PACU. Upon assessment, the nurse finds the surgical dressing is saturated with serosanguineous drainage. Which interventions are a priority? (Select all that apply.) A: Notify surgeon. B: Maintain the intravenous fluid infusion. C: Provide 2 L/min of oxygen via nasal cannula. D: Monitor the patient's vital signs every 5 to 10 minutes. E: Reinforce the dressing.
A E
David had the following post-op nursing diagnoses related to loss of limb: Impaired Skin Integrity Acute Pain Risk for Disturbed Body Image Impaired Mobility Which diagnosis should the nurse address first? A: Risk for Disturbed Body Image B: Impaired Mobility C: Impaired Skin Integrity D: Acute Pain
D
A client is crying and grimacing post-surgery but denies pain and refuses pain medication because "my brother is a drug addict and has ruined our lives." What is the priority intervention for this client? A: Provide accurate information about the use of pain medication. B: Encourage expression of fears and past experiences. C: Explain that addiction is unlikely among acute care clients. D: Seek family assistance in resolving this problem.
B
The nurse is called to the phone for an inquiry about David. The caller identifies herself as David's sister. She wants to know his condition. What should the nurse tell the caller? A: "He is in room 226 if you want to visit." B: "I am sorry but I can't give out that information. May I have your name?" C: "David is doing very well after his amputation." D: "David's wife is here. I am going to put you on hold and get her."
B
The nurse is caring for a surgical client when the client asks what perioperative nursing means. What should the nurse's response be? A: Perioperative nursing occurs in the post-anesthesia care unit (PACU). B: Perioperative nursing includes preoperative, intraoperative, and postoperative activities. C: Perioperative nursing occurs only in the operating room suite. D: Perioperative nursing occurs in preadmission, operating room, and PACU
B
What interventions must the nurse implement to prevent respiratory complications? Select all that apply. A: Bed rest B: Deep breathing C: Incentive spirometry D: Monitoring vital signs E: Coughing F: Dressing changes
B C D E
Communication between a nurse caring for a patient in the preoperative holding area and the circulating nurse in the operating room (OR) can best be enhanced by which of the following? (Select all that apply.) A: Documenting assessment findings in the medical record B: Using a standardized SBAR tool C: Being responsive in using nonverbal communication techniques D: Giving specific information to a transport technician E: Listening to the OR nurse's questions
B C E
Select which nurse(s) work in the perioperative setting. Select all that apply. A: Home Care Nurse B: PACU Nurse C: ICU Nurse D: Circulating Nurse
B D
A client arrives to the unit after surgery. Which of the following would the nurse consider an expected outcome of the post-operative period? Select all that apply. A: Client will report localized numbness, tingling, or changes in sensation B: Client will verbalize that pain is relieved or controlled C: Client will demonstrate decreased orientation D: Client will maintain a normal and effective respiratory pattern E: Client will verbalize the effects of the procedure and potential complications
B D E
The postoperative nurse is focused on which of the following aftereffects of anesthesia? Select all that apply. A: Incisional bleeding B: Impaired neurological functioning C: Pain D: Impaired airway E: Cardiovascular complications
B D E
As the client is brought into the operating room suite, the client starts to shiver uncontrollably. What action should the nurse take first? A: Take the client's temperature. B: Adjust the thermostat in the room. C: Apply warm blankets. D: Page the surgeon for further orders.
C
Before surgery, why does the preoperative nurse physically assess the client? A: To select the proper operating room equipment B: To prepare for postoperative education C: To establish a client's baseline of normal function D: To plan for care after the procedure
C
Individuals at each end of the age spectrum are at (blank) risk during surgery due to immature or aging (blank) systems, inability to regulate body (blank) and fragile (blank). A: higher, cardiac, pressure, skin B: lower, immune, temperature, skin C: higher, immune, temperature, skin D: higher, cardiac, pressure, skin
C
The nurse is caring for a postoperative client who reports pain. Based on recent evidence-based guidelines, which approach would be best? A: Standing orders by protocol B: Opioid dosage based on valid numerical scale C: Multimodal strategies D: Intravenous patient-controlled analgesia (PCA)
C
When a nurse witnesses a client's signature on an informed consent, the nurse is witnessing which of the following? A: Client has no questions regarding the surgery B: Client understands the risks and benefits of surgery C: Client signed without coercion or altered mental state D: Client has talked with the surgeon
C
Which postoperative intervention best prevents atelectasis? A: Use of intermittent compression stockings B: Heel-toe flexion C: Use of the incentive spirometer D: Abdominal splinting when coughing
C
A __________________is conducted, right before incision, as a final confirmation of the correct client, procedure, site, and implants. A: Side out B: Check out C: Site out D: Time out
D
The client is very restless and verbalizes being "scared to death" and worried about the surgery. The partner asks the nurse what can be done to help. How can the nurse address the psychological comfort of the client? A: Hug the client. B: Let the partner come back to the operating room (OR). C: Give the client a sedative. D: Allow verbalization of fears and concerns.
D
Which client's statements is of most concern to the nurse? A: "I feel anxious." B: "I can't imagine my life with my leg." C: "Can my partner be in the preoperative area with me?" D: "Do you think I really need this surgery?"
D
