PeriOp Practice Questions

A nurse is reviewing the diagnostic test results of an older adult female client who is preoperative for a knee arthroplasty. The nurse should notify the surgeon of which of the following results? A. WBC count 20,000/mm3 B. Hematocrit 40% C. Creatinine 0.9 mg/dL D. Potassium 3.8 mEq/

A

The nurse understands that the immediate postoperative assessment upon admission to the PACU includes which of the following? (Select all that apply.) A. Medical history B. Full system review C. Neurological assessment D. Blood pressure E. Surgical-site drainage

CDE

A nurse is assessing a client who has developed atelectasis postoperatively. Which of the following findings should the nurse expect? A. Facial flushing B. Increasing dyspnea C. Decreasing respiratory rate D. Friction rub

B

A nurse is planning care for a client who is postoperative and at risk for paralytic ileus. Which of the following interventions should the nurse plan to take to promote peristalsis? A. Increase ambulation. B. Decrease fluid intake. C. Increase protein intake. D. Offer the client the bedpan every 2 hr.

A

A nurse is planning preoperative care for a client who will undergo surgery. Which of the following is the priority action by the nurse? A. Determine what the client knows about the surgery. B. Identify the client's usual coping mechanisms. C. Review the client's current home environment. D. Discuss if family members will assist with postoperative care.

A

The nurse understands that which actions are essential when providing support to the intraoperative patient and family during the OR experience? (Select all that apply.) A. Introduce the patient and family to the surgical team members. B. Give family members updates every 2 hours as possible during the procedure. C. Explain what to expect from the operative experience. D. Alert the family to mealtimes. E. Explain that once the procedure is complete, the surgeon will discuss surgery outcomes.

ABC

When planning discharge education for a 65-y.o. male who is having a hip replacement, it is appropriate for the nurse to consider which of the following? (Select all that apply.) A. The patient's resources at home for completing activities of daily living B. The number of stairs in the patient's home C. Transportation to follow-up appointments D. Pre-existing medical conditions E. The number of bathrooms in the home

ABCD

Which of the following is an airway used to support airway management? (Select all that apply.) A. MAC B. MH C. LMA D. ETT E. PCP

CD

During the initial assessment and admission questions, the nurse asks Maria for the time of her last oral intake. The patient replies, "I had dinner last night at 8 p.m., but I took a few sips of water this morning with my vitamins. The nurse's best response is which of the following? A. Explain to the patient that just a sip of water should not be a problem for anesthesia but that the vitamins may be a problem. That information will be passed on to the anesthesiologist. B. Tell the patient that the sip of water is not an issue because it was only a sip. C. Inform the patient that her surgery will not be performed today because the risk is too high for a negative outcome. D. Inform the patient that taking her vitamins before surgery was a good plan.

A

A nurse is assessing a client who is 48 hr postoperative following abdominal surgery. Which of the following findings should the nurse report to the provider? A. Blood pressure 102/66 mm Hg B. Straw-colored urine from an indwelling urinary catheter C. Yellow-green drainage on the surgical incision D. Respiratory rate 18/min

C

A nurse is caring for a client who is postoperative following abdominal surgery and reports incisional pain. The surgeon has prescribed morphine 4 mg IV bolus every 6 hr as needed. Before administering this medication, the nurse should complete which priority assessment? A. Blood pressure B. Apical heart rate C. Respiratory rate D. Temperature

C

A nurse is caring for a client who has returned to the unit following a surgical procedure. The client's oxygen saturation is 85%. Which of the following actions should the nurse take first? A. Administer oxygen at 2 L/min. B. Administer prescribed analgesic medication. C. Encourage coughing and deep breathing. D. Raise the head of the bed.

D

A nurse is caring for a client who is 2 days postoperative following abdominal surgery and observes that the client's wound has eviscerated. After calling for help, Which of the following actions should the nurse take first? A. Raise the head of the client's bed 15° to 20°. B. Place the client supine with knees bent. C. Assess the client for manifestations of shock. D. Cover the area with a sterile dressing, moistened with 0.9% sodium chloride irrigation.

D

A nurse is caring for client who just returned from the PACU with an IV fluid infusion and an NG tube in place following abdominal surgery. Which of the following data is the priority for the nurse to assess? A. The coping ability of the client B. The client's bowel sounds 24 to 48 C. The surgical dressing D. The patency of the NG tube

D

A nurse is caring for four clients who are postoperative from surgery 24 hr ago. At 1200 the nurse assesses the clients. Which of the following clients is the nurse's priority? A. A client who has a prescription for insulin and his premeal capillary blood glucose was 110 mg/dL and his post-meal capillary blood glucose is now 160 mg/dL B. A client whose wound drainage at 0800 was sanguineous and now it is serosanguineous C. A client who reports pain as 4 on a scale of 1 to 10 at 0800 now reports pain as 6 D. A client whose blood pressure at 0800 was 138/86 mm Hg and at 1200 is 106/60 mm Hg

D

The nurse caring for a patient in the supine position on the OR table incorporates which nursing diagnosis into the plan of care? A. Risk for fluid volume deficit B. Risk for knowledge deficit C. Risk for aspiration D. Risk for potential alteration in skin integrity

D

The nurse understands that a patient undergoing right upper lobe lobectomy requiring general anesthesia will receive recovery care in which of the following settings? A. Outpatient PACU B. Procedure area PACU C. Surgical center PACU D. Inpatient PACU

D

Which of the following is the identified leader of the surgical team? A. The circulating registered nurse B. The anesthesia provider C. The scrub nurse D. The surgeon

D

A nurse is caring for a client who is postoperative and is at risk for developing venous thromboembolism (VTE). The nurse should instruct the client to avoid which of the following unsafe actions? A. Elevating her feet B. Massaging her legs C. Flexing her ankles D. Ambulating soon after surgery

B

A nurse is caring for a client who is postoperative. The nurse should base her pain management interventions primarily on which of the following methods of determining the intensity of the client's pan? A. Vital sign measurement B. The client's self-report of pain severity C. Visual observation for nonverbal signs of pain D. The nature and invasiveness of the surgical procedure

B

A nurse is caring for a client who is preoperative. The nurse signs as a witness on the client's consent form. The nurse's signature on the consent form indicates which of the following? A. Determines the client does not have a mental illness B. Confirms the client appears competent to provide consent C. Asserts the nurse has explained the risks and benefits of the procedure D. Records that the client's spouse agrees the procedure is necessary

B

A nurse is providing teaching to a client who is postoperative following coronary artery bypass graft (CABG) surgery and is receiving opioid medications to manage discomfort. Aside from managing pain, which of the following desired effects of medications should the nurse identify as most important for the client's recovery? A. It decreases the client's level of anxiety. B. It facilitates the client's deep breathing. C. It enhances the client's ability to sleep. D. It reduces the client's blood pressure.

B

A nurse is receiving a client who is immediately postoperative following hip arthroplasty. Which of the following medications should the nurse plan to administer for DVT prophylaxis? A. Aspirin PO B. Enoxaparin subcutaneous C. Heparin infusion D. Warfarin PO

B

A nurse is working with an assistive personnel (AP) while caring for a surgical client who is 1 day postoperative. Which task should the nurse take responsibility for completing? A. Measuring vital signs B. Removing the abdominal dressing C. Helping the client into the shower D. Ambulating the client in the hallway

B

An assistive personnel (AP) reports to the nurse that a client who is 3 days postoperative following an abdominal hysterectomy has a dressing that is saturated with blood. Which of the following tasks should the nurse delegate to the AP? A. Change the abdominal dressing. B. Obtain vital signs. C. Palpate for possible bladder distention. D. Observe the incision site.

B

Maria's surgeon has asked that thromboembolic-deterrent (TED) stockings be placed on the patient before surgery as well as sequential compression devices on both legs to the knees. Maria asks the nurse what these devices will do for her. Which response by the nurse is most appropriate? A. "They work together to make sure that you do not have a decrease in arterial blood flow in your legs during the surgery." B. "They complement each other to prevent blood from backing up in your legs and causing a deep vein thrombosis due to your immobility during the surgery." C. "They prevent deep tissue clotting during the surgery." D. "The two devices do the same thing, but one is better during the surgery, and the other is better postoperatively."

B

Which of the following is an example of a local anesthetic? A. Diazepam B. Lidocaine C. Pavulon D. Morphine

B

Which statement is true about the complicated nature of managing pain medication in the immediate post-anesthesia patient? A. All patients respond to pain in the same way but have different medications ordered. B. All patients respond to pain in different ways, potentially requiring different medications. C. The synergy of all multimodal pain management is unpredictable. D. Nonpharmacological methods of pain control do not work in the PACU setting.

B

A nurse is caring for four postoperative clients. The nurse can delegate obtaining vital signs to an assistive personnel (AP) for which of the following clients? A. A client who is 1 hr postoperative following a thyroidectomy B. A client who is 2 hr postoperative following an abdominal hysterectomy C. A client who is 3 days postoperative following gastric bypass surgery D. A client who is 3 days postoperative following a craniotomy

C

A nurse is developing a plan of care for a client who is postoperative. Which of the following interventions should the nurse include in the plan to prevent pulmonary complications? A. Perform range-of-motion exercises B. Place suction equipment at the bedside C. Encourage the use of an incentive spirometer D. Administer an expectorant

C

A nurse is preparing to witness informed consent for a client who is preoperative. The client asks the nurse, "Are there other options besides surgery?" Which of the following responses should the nurse make? A. "It is time to sign the consent so your treatment can begin." B. "I would not have this type of surgery if I were you." C. "Have you discussed other treatments with your provider?" D. "I can inform the surgeon you do not want the surgery."

C

A nurse on a medical-surgical unit is caring for four clients who are 24 to 36 hr postoperative. Which of the following surgical procedures places the client at risk for deep-vein thrombosis? A. Myringotomy B. Laparoscopic appendectomy C. Hip arthroplasty D. Cataract extraction

C

The nurse understands PACUs are designed for which of the following? A. Managing the transition from anesthesia to long-term care B. Managing the transition from anesthesia through phase III of recovery C. Managing the transition from anesthesia through phase II of recovery D. Managing the transition from anesthesia through rehabilitation

C

Upon patient admission to the PACU, the nurse understands that the priority intervention is which of the following? A. Administer antiemetics. B. Administer pain medication. C. Connect patient to the monitor. D. Start IV fluid.

C

Which of the following patients presents the greatest risk for a negative response to anesthesia? A. A 40-y.o. male with high blood pressure B. A 20-y.o. female with no prior surgical history C. A 29-y.o. female with a history of stage II acute renal failure D. An 85-y.o. male who drinks one glass of scotch every night

C

You are preparing a patient for surgery and have asked her to verify her information on her patient identification band. She tells you that the birth date is incorrect on her identification band. The most appropriate action by the nurse at this time is which of the following? A. Cross out the birth date and put the correct one in its place with the nurse's initials. B. Ask the family members to validate the patient's birth date. C. Call the surgeon's office to validate the birth date. D. Ask the admissions office to please send a corrected identification band.

D

The OR nurse is completing a perioperative assessment for a patient who is scheduled for exploratory surgery. Which of the following interventions must be completed prior to this patient going into the OR? (Select all that apply.) A. Verify operative consent has been signed. B. Ensure allergy and ID bands are in place. C. Remove the patient's personal clothing. D. Determine evidence of advance directive. E. Validate completed patient history and physical examination. F. Determine NPO status (last food/fluid consumed).

ABCDEF

The nurse should report which of the following findings from a patient's history as increasing the risk for DVTs postoperatively? (Select all that apply.) A. History of smoking B. Age C. History of DVTs with previous pregnancy D. Borderline hypertension E. Allergies

ACD

A nurse is providing preoperative teaching for a client who will undergo surgery. The nurse explains that the client will wear antiembolism stockings during and after the procedure. When the client asks what the stockings do, which of the following responses should the nurse make? A. "They protect your legs and heels from skin breakdown." B. "They help keep you warm after your surgery." C. "They improve your circulation to keep blood from pooling in your legs." D. "They make it easier for you to do leg exercises after your surgery."

C

A nurse is caring for a client who returns to the nursing unit from the recovery room after a sigmoid colon resection for adenocarcinoma. The client had an episode of intraoperative bleeding. Which finding indicates to the nurse that the client may be developing hypovolemic shock? A. Decrease in the respiratory rate from 20 to 16/min. B. Decrease in the urinary output from 50 mL to 30 mL per hour. C. Increase in the temperature from 37.5° C (99.5° F) to 38.6° C (101.5° F). D. Increase in the heart rate from 88 to 110/min.

D