Nursing 1 Exam 3 Prep U- Perioperative Nursing

A client is having surgery through an ambulatory surgical center. Which information will the nurse provide to the client's family? "Be prepared to take the client home as soon as the surgery is over." "The client will go to the postanesthesia care unit after the surgery." "You can go home and I will call you in a day or two when the client can be discharged." "I will give you the name of the hospital that the client will be transferred to after the surgery."

"The client will go to the postanesthesia care unit after the surgery."

For the client who is taking aspirin, it is important to stop taking this medication at least how many day(s) before surgery? 1 3 5 7

7

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 nurse who has provided care in perioperative settings for many years has seen first-hand the trend toward increasing numbers of surgical procedures being performed in ambulatory surgical centers and on an outpatient basis. What factors have contributed most significantly to this trend? The emergence of managed care and the large number of Americans who lack health insurance The nursing shortage and decreasing numbers of health care providers who are choosing surgical specialties Advances in anesthesia and in the technology surrounding surgical techniques Pressure from health care consumers to avoid hospital stays and the decreasing incidence of acute illnesses

Advances in anesthesia and in the technology surrounding surgical techniques

A 78-year-old client is undergoing surgery to repair a right hip fracture. What nursing action is appropriate during the intraoperative phase? Discuss with the anesthesiologist the need for higher doses of anesthetic agents. Withhold pain medication due to decreased renal function. Appropriately position the client using adequate padding and support. Maintain an operating room temperature of 18°C to prevent hypothermia.

Appropriately position the client using adequate padding and support.

When should the nurse encourage the postoperative patient to get out of bed? Within 6 to 8 hours after surgery Between 10 and 12 hours after surgery As soon as it is indicated On the second postoperative day

As soon as it is indicated

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

Coordinating the surgical team

What medication should the nurse prepare to administer in the event the client has malignant hyperthermia? Dantrolene sodium Fentanyl citrate Naloxone Thiopental sodium

Dantrolene sodium

A client is receiving general anesthesia. The nurse anesthetist starts to administer the anesthesia. The client begins giggling and kicking her legs. What stage of anesthesia would the nurse document related to the findings? I II III IV

II

Which position is used for perineal surgical procedures? Lithotomy Trendelenburg Sims Dorsal recumbent

Lithotomy

The patient is having a repair of a vaginal prolapse. What position does the nurse place the patient in? Left lateral Sim's Prone position Lithotomy position Trendelenburg

Lithotomy position

The nurse positions the client in the lithotomy position in preparation for Renal surgery Pelvic surgery Perineal surgery Abdominal surgery

Perineal surgery

A nurse is reviewing the medications of a postoperative client. What medication related to the recent surgery may be of concern to the nurse? Furosemide Prednisone Digoxin Allopurinol

Prednisone

The client is undergoing a surgical procedure that is expected to last several hours. Which nursing diagnosis is most related to the duration of the procedure? Risk for perioperative positioning injury related to positioning in the OR Risk of latex allergy response related to possible exposure in the OR environment Disturbed sensory perception related to the effects of general anesthesia Anxiety related to ineffective coping with surgical concerns

Risk for perioperative positioning injury related to positioning in the OR

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

The nurse is caring for a client during an intraoperative procedure. When assessing vital signs, which result indicates a need to alert the anesthesiologist immediately? Pulse rate of 110 beats/min Respiratory rate of 18 breaths/min Blood pressure of 104/62 mm Hg Temperature of 102.5°F (39°C)

Temperature of 102.5°F (39°C)

A physician calls the nurse for an update on his client who underwent abdominal surgery 5 hours ago. The physician asks the nurse for the total amount of drainage collected in the Hemovac since surgery. The nurse reports that according to documentation, no drainage has been recorded. When the nurse finishes on the telephone, she goes to assess the client. Which assessment finding explains the absence of drainage? The client has been lying on his side for 2 hours with the drain positioned upward. The client has a nasogastric (NG) tube in place that drained 400 ml. The Hemovac drain isn't compressed; instead it's fully expanded. There is a moderate amount of dry drainage on the outside of the dressing.

The Hemovac drain isn't compressed; instead it's fully expanded.

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 client is scheduled for a prostatectomy, and the anesthesiologist plans to use a spinal (subarachnoid) block during surgery. In the operating room, the nurse positions the client according to the anesthesiologist's instructions. Why does the client require special positioning for this type of anesthesia? To prevent confusion To prevent seizures To prevent cerebrospinal fluid (CSF) leakage To prevent cardiac arrhythmias

To prevent cerebrospinal fluid (CSF) leakage

The nurse is caring for a client 6 hours post surgery. The nurse observes that the client voids urine frequently and in small amounts. The nurse knows that this most probably indicates what? Requirement of intermittent catheterization Calculus formation Urine retention Urinary infection

Urine retention

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. palpate the abdomen. change the client's position. insert a rectal tube.

auscultate bowel sounds.

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. second intention. third intention. fourth intention.

first intention.

Which findings would be indicative of a nursing diagnosis of decreased cardiac output? urinary output > 60 ml; BP 90/60; tachypnea bradycardia; urinary output < 30 ml; confusion tachycardia; hemoglobin 10.9 gm/dL; BP 88/56 confusion; tachypnea; hemoglobin 14.2 gm/dL

tachycardia; hemoglobin 10.9 gm/dL; BP 88/56

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? "I'm so glad that I will be unconscious during the surgery." "I won't feel it, but I'll have a tube to help me breathe." "Only the surgical area will be numb." "I'll be sleepy but able to respond to your questions."

"I'll be sleepy but able to respond to your questions."

The nurse is preparing a patient for surgery. The patient is to undergo a hysterectomy without oophorectomy, and the nurse is witnessing the patient's signature on a consent form. Which comment by the patient would best indicate informed consent? "I know I'll be fine because the health care provider said he has done this procedure hundreds of times." "I know I'll have pain after the surgery." "The health care provider is going to remove my uterus and told me about the risk of hemorrhage." "Because the health care provider isn't taking my ovaries, I'll still be able to have children."

"The health care provider is going to remove my uterus and told me about the risk of hemorrhage."

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? Hair is pulled back and covered by a cap. Scrub top and drawstring are tucked into pants. Shoe covers are used. Mask is placed over nose and extends to bottom lip.

Mask is placed over nose and extends to bottom lip.

A nurse is monitoring a client recovering from moderate sedation that was administered during a colonoscopy. Which finding requires the nurse's immediate attention? Heart rate of 84 beats/minute Oxygen saturation (SaO2) of 85% Decreased cough and gag reflexes Blood-tinged stools

Oxygen saturation (SaO2) of 85%

A client is postoperative day 3 after surgical repair of an open abdominal wound and traumatic amputation of the right lower leg following a motorcycle crash. What is the highest priority nursing intervention? Assessing WBC count, temperature, and wound appearance Obtaining dietary consultation for improved wound healing Educating the client on safe bed-to-chair transfer procedures Administering pain medications within 1 hour of the client's request

Assessing WBC count, temperature, and wound appearance

Many medications are available to control nausea and vomiting without oversedating the patient. At what point should a nurse normally administer antiemetics to a surgical patient? Upon admission from PACU When the patient reports that he or she will soon vomit At the patient's first report of nausea When nonpharmacologic interventions are unsuccessful

At the patient's first report of nausea

You are admitting an insulin-dependent patient to the same-day surgical suite for carpal tunnel surgery. You know that this patient may be at risk for which metabolic disorder? Adrenal insufficiency Thyrotoxicosis Impaired acid base balance Hyperglycemia

Hyperglycemia

The nurse is changing the dressing of a client who is 4 days postoperative with an abdominal wound. The nurse has changed this dressing daily since surgery. Today, the nurse notes increased serosanguinous drainage, wound edges not approximated, and a ¼-inch (6 mm) gap at the lower end of the incision. The nurse concludes which of the following conditions exists? Dehiscence Evisceration Hemorrhage Normal healing by primary intention.

Dehiscence

A nurse is caring for a patient following surgery under a spinal anesthetic. What interventions can the nurse implement to prevent a spinal headache? Have the patient sit in a chair. Ambulate the patient. Limit fluids. Keep the patient lying flat.

Keep the patient lying flat.

You are the recovery room nurse who is admitting a patient from the OR. What is the first assessment you would make on a newly admitted patient? Heart rate Capillary refill Core temperature Patency of the airway

Patency of the airway

A nurse on a postsurgical unit is providing care for 20-year-old man who had an open appendectomy performed earlier this morning. Which of the following assessment findings should prompt the nurse to contact the patient's surgeon? The patient has put out 35 mL of urine in the 7 hours since admission. The patient is complaining of nausea and has received a dose of metoclopramide (Reglan). The patient's peripheral IV has gone interstitial. The patient has stated that he has no place to go after he is discharged and lacks a social support system.

The patient has put out 35 mL of urine in the 7 hours since admission.

A 17-year-old client is having same-day surgery. Solely during the intraoperative phase of perioperative care, the nurse: continuously monitors the sedated client. performs a complete assessment of the client. obtains a surgical consent from the client's mother. assesses how well the client is recovering from anesthesia.

continuously monitors the sedated client.

The nurse recognizes the client has reached stage III of general anesthesia when the client: lies quietly on the table displays agitation due to noise shouts, talks, or sings exhibits shallow respirations and a weak, thready pulse

lies quietly on the table

In which phase of perioperative care will the nurse prepare the client's skin, encourage the client to void, and remove the client's dentures? preoperative postoperative intraoperative transoperative

preoperative