Perioperative Nursing
In order to prevent the possibility of venous stasis, a nurse is teaching a surgical client how to perform leg exercises. Which of the client's following statements indicates a sound understanding of leg exercises? A) "I'll practice these now and try to start them as soon as I can after my surgery." B) "I'll try to do these lying on my stomach so that I can bend my knees more fully." C) "I'll make sure to do these, as long as my doctor doesn't tell me to stay on bed rest after my operation." D) "I'm pretty sure my stomach muscles are strong enough to lift both of my legs off the bed at the same time."
A) "I'll practice these now and try to start them as soon as I can after my surgery."
Which of the following nursing interventions occurs in the postoperative phase of the surgical experience? A) Airway/oxygen therapy/pulse oximetry B) Teaching deep breathing exercises C) Reviewing the meaning of p.r.n. orders for pain medications D) Putting in IV lines and administering fluids
A) Airway/oxygen therapy/pulse oximetry
A postoperative home care client has developed thrombophlebitis in her right leg. What category of medications will probably be prescribed for this cardiovascular complication? A) Anticoagulants B) Antibiotics C) Antihistamines D) Antigens
A) Anticoagulants
The nurse is providing education to a client regarding pain control after surgery. What time does the nurse inform the client is the best time to request pain medication? A) Before the pain becomes severe B) When the client experiences a pain rating of "10" on a 1-to-10 pain scale C) When there is no pain, but it is time for the medication to be administered D) After the pain becomes severe and relaxation techniques have failed
A) Before the pain becomes severe
The telemetry unit nurse is reviewing laboratory results for a client who is scheduled for an operative procedure later in the day. The nurse notes on the laboratory report that the client has a serum potassium level of 6.5 mEq/L, indicative of hyperkalemia. The nurse informs the physician of this laboratory result because the nurse recognizes hyperkalemia increases the client's operative risk for which of the following? A) Cardiac problems B) Infection C) Bleeding and anemia D) Fluid imbalances
A) Cardiac problems
Upon assessment, a client reports that he drinks five to six bottles of beer every evening after work. Based upon this information, the nurse is aware that the client may require which of the following? A) Larger doses of anesthetic agents and larger doses of postoperative analgesics B) Larger doses of anesthetic agents and lower doses of postoperative analgesics C) Lower doses of anesthetic agents and lower doses of postoperative analgesics D) Lower doses of anesthetic agents and larger doses of postoperative analgesics
A) Larger doses of anesthetic agents and larger doses of postoperative analgesics
A client scheduled for major surgery will receive general anesthesia. Why is inhalation anesthesia often used to provide the desired actions? A) Rapid excretion and reversal of effects B) Safe administration in the client's own room C) Involves only the respiratory system and skin D) Slow onset of action and maintains reflexes
A) Rapid excretion and reversal of effects
A nurse is providing ongoing postoperative care to a client who has had knee surgery. The nurse assesses the dressing and finds it saturated with blood. The client is restless and has a rapid pulse. What should the nurse do next? A) Document the data and apply a new dressing. B) Apply a pressure dressing and report findings. C) Reassure the family that this is a common problem. D) Make assessments every 15 minutes for four hours.
B) Apply a pressure dressing and report findings.
Which of the following interventions are recommended guidelines for meeting client postoperative elimination needs? A) Assess abdominal distention, especially if bowel sounds are audible or are low pitched. B) Assess for the return of peristalsis by auscultating bowel sounds every four hours when the client is awake. C) Encourage food and fluid intake when ordered, especially dairy products and low-fiber foods. Assess for bladder distention by Palpating below the symphysis pubis if the client has not voided within eight hours after D) surgery.
B) Assess for the return of peristalsis by auscultating bowel sounds every four hours when the client is awake.
A female client is scheduled for liposuction surgery to reduce her weight. Based on urgency, how is this surgery classified? A) Urgent B) Elective C) Emergency D) Emergent
B) Elective
A nurse is assisting a physician during a cesarean section for a client. The client is administered epidural anesthesia. Which of the following is an advantage of epidural anesthesia? A) It counteracts the effects of conscious sedation. B) It decreases the risk of gastrointestinal complications. C) It prevents clients from remembering the initial recovery period. D) It acts on the central nervous system to produce loss of sensation.
B) It decreases the risk of gastrointestinal complications.
A nurse is reviewing results of preoperative screening tests and notes the client's potassium level is dangerously low. What should the nurse do next? A) Nothing; potassium levels have no influence on surgical outcome. B) Include the information in the postoperative end of shift report. C) Document the data and notify the physician who will do the surgery. D) Ask the client and family members why the potassium is low.
C) Document the data and notify the physician who will do the surgery.
An operating room nurse is preparing for a surgical procedure on an infant. The nurse's perioperative care is based on what physiologic factor that puts infants at greater risk from surgery than adults? A) Increased vascular rigidity B) Diminished chest expansion C) Lower total blood volume D) Decreased peripheral circulation
C) Lower total blood volume
After conducting a preoperative health assessment, the nurse documents that the client has physical assessments supporting the medical diagnosis of emphysema. Based on this finding, what postoperative interventions would be included on the plan of care? A) Perform sterile dressing changes each morning. B) Administer pain medications as needed. C) Conduct a head-to-toe assessment each shift. D) Monitor respirations and breath sounds.
D) Monitor respirations and breath sounds.
A cleansing enema is ordered for a client who is scheduled to have colon surgery. What is the rationale for this procedure? A) Surgical clients routinely are given a cleansing enema. B) Cleansing enemas are given before surgery at the client's request. C) There will be less flatus and discomfort postoperatively. D) Peristalsis does not return for 24 to 48 hours after surgery.
D) Peristalsis does not return for 24 to 48 hours after surgery.
Your postsurgical patient is experiencing decreased lung sounds, dyspnea, cyanosis, crackles, restlessness, and apprehension. Which of the following conditions would you diagnose? a. Atelectasis b. Pneumonia c. Pulmonary embolus d. Thrombophlebitis
a. Atelectasis
Mr. Pete is an obese 62-year-old man scheduled for heart surgery. Which of the following surgical risks related to obesity should be considered when performing an assessment for this patient? a. Delayed wound healing and wound infection b. Alterations in fluid and electrolyte balance c. Respiratory distress d. Hemorrhage
a. Delayed wound healing and wound infection
Which of the following types of anesthesia is administered by injecting a local anesthetic around a nerve trunk supplying the area of surgery? a. Nerve block b. Subdural block c. Surface anesthesia d. Local infiltration with lidocaine
a. Nerve block
Which of the following is the most common postanesthesia recovery emergency? a. Respiratory obstruction b. Cardiac distress c. Wound infection d. Dehydration
a. Respiratory obstruction
Which of the following positions would be used in minimally invasive surgery of the lower abdomen or pelvis? a. Trendelenburg position b. Sims' position c. Lithotomy position d. Prone position
a. Trendelenburg position
Which of the following preoperative medications would be prescribed to decrease pulmonary and oral secretions and prevent laryngospasm? a. Narcotic analgesics b. Anticholinergics c. Neuroleptanalgesic agents d. Histamine-receptor antihistaminics
b. Anticholinergics
Which of the following interventions should be carried out by the nurse when a postoperative patient is in shock? a. Remove extra coverings on the patient to keep temperature down. b. Place the patient in a flat position with legs elevated 45 degrees. c. Do not administer any further medication. d. Place the patient in the Trendelenburg or "shock" position.
b. Place the patient in a flat position with legs elevated 45 degrees.
A 9-month-old baby is scheduled for heart surgery. When preparing this patient for surgery, the nurse should consider which of the following surgical risks associated with infants? a. Prolonged wound healing b. Potential for hypothermia or hyperthermia c. Congestive heart failure d. Gastrointestinal upset
b. Potential for hypothermia or hyperthermia
When preparing a patient who has diabetes mellitus for surgery, the nurse should be aware of which of the following potential surgical risks associated with this disease? a. Fluid and electrolyte imbalance b. Slow wound healing c. Respiratory depression from anesthesia d. Altered metabolism and excretion of drugs
b. Slow wound healing
Mr. Fischer has returned to your unit after cardiac surgery. Which of the following interventions would be appropriate to prevent cardiovascular complications for him? a. Position him in bed with pillows placed under his knees to hasten venous return. b. Keep him from ambulating until the day after surgery. c. Implement leg exercises and turn him in bed every 2 hours. d. Keep him cool and uncovered to prevent elevated temperature.
c. Implement leg exercises and turn him in bed every 2 hours.
When obtaining a consent form from a patient scheduled to undergo surgery, the nurse should consider which of the following facts? a. A consent form is legal, even if the patient is confused or sedated. b. The form that is signed is not a legal docu- ment and would not hold up in court. c. In emergency situations, the doctor may obtain consent over the telephone. d. The responsibility for securing informed consent from the patient lies with the nurse.
c. In emergency situations, the doctor may obtain consent over the telephone.
When teaching a postoperative patient about pain control, the nurse should consider which of the following statements? a. When giving pain medication p.r.n., the patient should ask for the medication when the pain becomes severe. b. The nurse is responsible for ordering and administering pain medications. c. Medications for pain usually are given by injection for the first few days or as long as the patient is NPO. d. Alternate pain control methods, such as TENS and PCA, should not be used after surgery.
c. Medications for pain usually are given by injection for the first few days or as long as the patient is NPO.
Which of the following would be an appropriate reaction to a patient experiencing pulmonary embolus? a. Try to overhydrate the patient with fluids. b. Instruct the patient to perform Valsalva's maneuver. c. Place the patient in semi-Fowler's position. d. Assist the patient to ambulate every 2 to 3 hours.
c. Place the patient in semi-Fowler's position.
To prevent postoperative complications, which of the following measures should be taken after surgery? a. The patient should be instructed to avoid coughing if possible to minimize damage to the incision. b. The patient should take shallow breaths to prevent collapse of the alveoli. c. The patient should be instructed to do leg exercises to increase venous return. d. The patient should not be turned in bed until the incision is no longer painful.
c. The patient should be instructed to do leg exercises to increase venous return.
Which of the following is a recommended physical preparation for a patient undergoing surgery? a. Shave the area of the incision with a razor. b. Empty the patient's bowel of feces. c. Do not allow the patient to eat or drink anything for 8 to 12 hours before surgery. d. Be sure the patient is well nourished and hydrated.
d. Be sure the patient is well nourished and hydrated.
Mr. Lemke, age 42, is scheduled for elective hernia surgery. While taking a medical history for Mr. Lemke, you find out he is taking antibiotics for an infection. To which of the following surgical risks would Mr. Lemke be predisposed because of his use of antibiotics? a. Hemorrhage b. Electrolyte imbalances c. Cardiovascular collapse d. Respiratory paralysis
d. Respiratory paralysis
