Exam 4 Practice Questions

A pt is discussing with the RN risks verses benefits of estrogen therapy (ET). Which of the following is a risk? A. cardiovascular disease B. osteoporosis C. reduction in hot flashes D. alzheimers disease

A. cardiovascular disease

Hormone Replacement Therapy (HRT) is generally used in menopausal women for... A. 6 mo B. <5 yrs C. <10 yrs D. 18 mo

B. <5 yrs

One benefit of hormone replacement therapy is protection against? A. bone cancer B. colon cancer C. lung cancer D. brain cancer

B. Colon cancer

The RN is discussing teaching on the drug alendronate with a student nurse. Which indicates the correct teaching? A. "This drug is for prevention of pregnancy." B. "Take this medication with Aspirin to reduce flushing." C. "It is important to take this drug with a full glass of water." D. "I don't need to monitor my calcium levels."

C. "It is important to take this drug with a full glass of water."

The pre-op RN is speaking to a pt who added garlic daily to her diet to help with her BP. What should the RN ask next? a. "What type of surgery are you having?" b. "What is your normal blood pressure?" c. "How much garlic are you eating?" d. "What type of anesthesia are you having?"

c. "How much garlic are you eating?"

Reloxafine is prescribed for a patient. What information in the patient's history should the nurse question all except? A. history of breast cancer B. history of smoking C. history of a DVT D. history of pregnancy

D. History of pregnancy

The pt has a latex allergy. What should the nurse teach the client to do before having surgery? Select all that apply a. Determine that there will be a latex-safe environment for surgery. b. Notify the health care providers (HCPs) at the surgery center. c. Ask to have the surgery at a hospital. d. Report symptoms of the latex allergy (rhinitis, conjunctivitis, flushing)

a. Determine that there will be a latex-safe environment for surgery. b. Notify the health care providers (HCPs) at the surgery center. d. Report symptoms of the latex allergy (rhinitis, conjunctivitis, flushing)

A client is scheduled to have surgery to relieve an intestinal obstruction. Prior to surgery, the nurse should verify that the client has followed which preoperative instructions? a. discontinued use of blood thinners b. eaten a low-residue diet c. performed abdominal tightening exercises d. signed a last will and testament

a. discontinued use of blood thinners

A client with benign prostatic hyperplasia doesn't respond to medical treatment and is admitted to the facility for prostate gland removal. Before providing preoperative and postoperative instructions to the client, the nurse asks the surgeon which prostatectomy procedure will be done. What is the most widely used procedure for prostate gland removal? a. transurethral resection of the prostate (TURP) b. suprapubic prostatectomy c. retropubic prostatectomy d. transurethral laser incision of the prostate

a. transurethral resection of the prostate (TURP)

Pt is being sent home from same-day surgery. Which statement indicates that the pt doesn't understand postop instructions? a. "My husband is taking the day off from work to drive me home." b. "I can drive myself home after surgery." c. I am taking a taxi home, and my daughter will meet me at home." d. "My son will be here at noon to take me home."

b. "I can drive myself home after surgery."

A client says, "I hate the idea of being an invalid after they cut off my leg." Which response by the nurse would be the most therapeutic? a. "At least you'll still have one good leg to use." b. "Tell me more about how you're feeling." c. "Let's finish the preoperative teaching." d. "You're lucky to have a wife to care for you."

b. "Tell me more about how you're feeling."

A nurse completes preoperative teaching for a client scheduled for a cholecystectomy. The client states, "If I lie still and avoid turning, I will avoid pain. Do you think this is a good idea?" What is the nurse's best response? a. "It is always a good idea to rest quietly after surgery, which will help minimize further pain." b. "Turn from side to side every 2 hours, and the nurse will administer pain medication to assist in movement." c. "The physician will probably order you to lie flat for 24 hours." d. "Why don't you decide about activity after you return from recovery?"

b. "Turn from side to side every 2 hours, and the nurse will administer pain medication to assist in movement."

Surgeon prescribed cefazolin 1g via IV at 0730 when the pt's surgery is scheduled at 0800. What is the rationale? a. Legally the medication has to be given at the prescribed time b. Antibx help prevent infection if given 30-60 mins prior to the incision. c. Postop dose of cefazolin should be started exactly 8 hours after the 1st. d. The peak and titer levels are needed for antibiotic therapy

b. Antibx help prevent infection if given 30-60 mins prior to the incision.

The RN is removing staples from an abd incision when the pt sneezes & the incision opens. What should the RN do 1st? a. Press the emergency alarm to call the resuscitation team b. Cover the abd organs with sterile dressings moistened with sterile 0.9% NS c. Have all visitors and family leave the room d. Call the surgeon to come to the client's room immediately.

b. Cover the abd organs with sterile dressings moistened with sterile 0.9% NS

The client's identification armband was cut and removed to start an IV line as a part of the preoperative preparation. The transport team has arrived to transport the client to the operative room. The nurse notices that the client's identification band is not on either wrist. What should the nurse do? a. Send the removed armband with the medical record and the client to the operating room b. Place a new identification armband on the client's wrist before transportation. c. Tape the cut armband back onto the client's wrist. d. Send the client without an armband because the client is alert and can respond to questions about his or her identity.

b. Place a new identification armband on the client's wrist before transportation.

Alendronate (Fosamax) is prescribed for a patient with osteoporosis. The nurse teaches the patient that: a. the drug must be taken with food to prevent GI side effects. b. bisphosphonates prevent calcium from being taken from the bones. c. lying down after taking the drug prevents light-headedness and dizziness. d. taking the drug with milk enhances the absorption of calcium from the bowel.

b. bisphosphonates prevent calcium from being taken from the bones. Alendronate is a bisphosphonate that prevents calcium from being taken from the bones by inhibiting osteoclast-mediated bone resorption. Bisphosphonates should be taken with a full glass of water, 30 mins before food or other meds, and the pt should remain upright for at least 30 mins after administration. These precautions aid in drug absorption and decrease GI side effects (especially esophageal irritation).

Which nursing action does not aid in meeting the goal of clear breath sounds? a. offering pain relief before having the client cough b. providing a minimum of 1,000 mL of fluid per day c. using an incentive spirometer d. assisting with early ambulation

b. providing a minimum of 1,000 mL of fluid per day

The adult daughters of an older adult client inform the nurse that they fully expect their father to be combative after surgery. Preoperatively, they request that the nurse put all four side rails up and use restraints to keep him safe. What should the nurse tell the daughters? a. "Certainly; we will want to be sure to keep your father safe, too." b. "We will call the health care provider to get a prescription right away." c. "We will first try to keep him safe without restraint." d. "Restraint use is prohibited at our hospital at all times."

c. "We will first try to keep him safe without restraint."

Which patient would be at greatest risk for developing osteoporosis? a. A 73 yr old man who has 5 alcoholic drinks per week and limits sun exposure to prevent recurrence of skin cancer. b. An 84 yr old man who has recently been diagnosed with hypothyroidism and is prescribed levothyroxine (Synthroid). c. A 69 yr old woman who had a renal transplant 5 years ago and has been taking prednisone to prevent organ rejection. d. A 55 yr old woman who recently had a hysterectomy with bilateral salpingo-oophorectomy and refuses estrogen therapy.

c. A 69 yr old woman who had a renal transplant 5 years ago and has been taking prednisone to prevent organ rejection. Risk factors for osteoporosis include advanced age (>65), female gender, low body weight, white or Asian ethnicity, current cig smoking, non-traumatic Fx, inactive lifestyle, fam Hx of osteoporosis, diet low in Ca or vit D deficiency, excessive use of alcohol (>2 drinks/day), postmenopausal, including premature or surgical menopause, and long-term use of corticosteroids, thyroid replacements, heparin, long-acting sedatives, or anti-seizure meds. Long-term corticosteroid (such as prednisone) use is a major contributor to osteoporosis. The other patients have risk factors for osteoporosis, but the 69 yr old female is at highest risk.

When conducting the preoperative preparations, the nurse determines that the client does not speak English, and the nurse does not speak the client's language. The surgeon needs to obtain the client's informed consent. What is the best way for the nurse to obtain the client's informed consent? a. Have the client call a family member to act as interpreter. b. Have the client sign the Spanish surgical consent form. c. Call the Spanish interpreter to translate the surgeon's explanation of the procedure, risks, and alternative to obtain the client's consent and to answer the client's questions. d. Notify the surgical charge nurse of the situation.

c. Call the Spanish interpreter to translate the surgeon's explanation of the procedure, risks, and alternative to obtain the client's consent and to answer the client's questions.

A client in a general hospital is to undergo surgery in 2 days and is experiencing moderate anxiety about the procedure and its outcome. What should the nurse do to help the client reduce anxiety? a. Distract the client with games and television. b. Provide reassurance that the client that will come through surgery without incident. c. Explain the surgical procedure to the client and what happens before and after surgery. d. Ask the surgeon to refer the client to a psychiatrist who can work with the client to diminish anxiety.

c. Explain the surgical procedure to the client and what happens before and after surgery.

The nurse is preparing to administer a preoperative medication that includes a sedative to a client who is having abdominal surgery. What should the nurse do first? a. Have the family present b. Ensure that the operative area has been shaved c. Have the client empty the bladder d. Make sure the client is covered with a warm blanket

c. Have the client empty the bladder

The nurse is working with a licensed practical nurse (LPN) and delegating the taking of vital signs for a preoperative client. Upon review of the chart as the client is leaving for the operating room, the nurse notes that the temperature is 101.1 F (38.4 C) and the pulse is 110 bpm. What are the nurse's initial actions? a. Have the LPN take the vital signs again, phone the operating room, and cancel the surgery b. Take the vital signs, and in the future do not delegate this preoperative responsibility c. Notify the surgeon and await the surgeon's decision; reinforce with the LPN the importance of reporting abnormal preoperative vital signs. d. Sign off the chart but flag that vital signs are abnormal; allow the client to go to the operating room.

c. Notify the surgeon and await the surgeon's decision; reinforce with the LPN the importance of reporting abnormal preoperative vital signs.

Pt scheduled for abd surgery says, "I talked about several different things w/ my MD, but I don't understand." What next? a. Teach the client all the details of the planned procedure b. Utilize a second witness when the client signs for consent c. Notify the surgeon of the client's expressed lack of understanding d. Administer the prescribed preoperative narcotics and/or sedatives.

c. Notify the surgeon of the client's expressed lack of understanding

When the nurse asks the client who is having abdominal surgery today if the client understands the procedure, the client replies, "No, not really; I talked about several different things with my surgeon, and I'm just not sure." What should the nurse do next? a. Teach the client al the details of the planned procedures b. Utilize a second witness when the client signs for consent. c. Notify the surgeon of the client's expressed lack of understanding. d. Administer the prescribed preoperative narcotics and/or sedatives.

c. Notify the surgeon of the client's expressed lack of understanding.

The RN is interviewing a preop pt who had a total hip replacement 3 yrs ago. Why should the RN tell this to the circulator? a. Prosthesis may cause a prob w/ the electrosurgical unit b. The perioperative RN can inform the rest of the team about the total hip c. The pt should not have her hop externally rotated when she is positioned. d. There isn't enough time to notify the surgeon & note this on the chart

c. The pt should not have her hop externally rotated when she is positioned.

The nurse is assessing a client admitted to the hospital for surgery to repair an abdominal aortic aneurysm. Prior to surgery, the nurse should assess the client for which factor that puts the client at risk for rupture? a. anemia b. dehydration c. high blood pressure d. hyperglycemia

c. high blood pressure

A pt decides not to use hormone therapy after menopause. What instructions should the nurse provide to this pt to decrease the serious effects of menopause? a. Take 800 mg of Ca every day b. Supplement the diet with vitamin E c. Maintain a high-protein, low-fat diet d. Engage in aerobic, weight-bearing exercises

d. Engage in aerobic, weight-bearing exercises

A total abdominal hysterectomy is scheduled for a 42 yr old woman with multiple leiomyomas. What would be appropriate for the nurse to include during preoperative teaching? a. She will need to take hormone therapy postoperatively to prevent symptoms of menopause b. Correct use of the PCA machine to prevent postoperative pain. c. A retention catheter will be used to help her maintain bed rest during the first 2 postoperative days. d. Leg exercises and early. frequent ambulation help to prevent common complications of hysterectomy.

d. Leg exercises and early. frequent ambulation help to prevent common complications of hysterectomy. Leg exercises with early and frequent ambulation are necessary to prevent common complications of hysterectomy.

A client who is to receive general anesthesia has a serum potassium level of 5.8 mEq/L. What does the RN do first? a. Call the operating room to cancel the surgery. b. Send the client to surgery c. Make a note on the client's record d. Notify the anesthesiologist

d. Notify the anesthesiologist

Which nursing intervention is most important in preventing postoperative complications? a. progressive diet planning b. pain management c. bowel and elimination monitoring d. early ambulation

d. early ambulation