Operative

1- Ensure that the client has voided

20) A nurse is preparing a preoperative client for transfer to the operating room. The nurse should take which action in the care of the client at this time? 1- Ensure that the client has voided 2- Administer all the daily medications 3- Practice postoperative breathing exercises 4- Verify that the client has not eaten for the last 24 hours

1- Increasing restlessness

3) A nurse is monitoring the status of a postoperative client. The nurse would become most concerned with which of the following signs that could indicate an evolving complication? 1- Increasing restlessness 2- A negative Homan's sign 3- Hypoactive bowel sounds in all four quadrants 4- Blood pressure of 110/70 mm Hg and a pulse of 86 beats/min

2- Prednisone (Deltasone)

4) A nurse is reviewing a physician's order sheet for a preoperative client that states that the client must be NPO after midnight. The nurse would telephone the physician to clarify whether which of the following medications should be given to the client and not withheld? 1- Ferrous Sulfate 2- Prednisone (Deltasone) 3- Cyclobenzaprine (Flexeril) 4- Conjugated estrogen (Premarin)

1- Pneumonia

9) A postoperative client asks a nurse why it is so important to deep-breathe and cough after surgery. In formulating a response, the nurse incorporates the understanding that retained pulmonary secretions in a postoperative client can lead to: 1- Pneumonia 2- Fluid imbalance 3- Pulmonary edema 4- Carbon dioxide retention

2- Serous drainage

1) A nurse assesses a client's surgical incision for signs of infection. Which of the following by the nurse would be interpreted as a normal finding at the surgical site? 1- Red, hard, skin 2- Serous drainage 3- Purulent drainage 4- Warm, tender skin

3- Curl the drain tightly and tape it firmly to the body

10) A client is admitted to a surgical unit postoperatively with a wound drain in place. Which action should the nurse avoid in the care of the drain? 1- Check the drain for patency 2- Observe for bright red bloody drainage 3- Curl the drain tightly and tape it firmly to the body 4- Maintain aseptic technique when emptying the drain

4- Apply a cloth barrier to the client's arm under a blood pressure cuff when taking the blood pressure

11) A nurse is developing a plan of care for a preoperative client who has a latex allergy. Which intervention should be included in the plan? 1- Avoid using medications from glass ampules 2- Avoid using IV tubing that is made of polyvinyl chloride 3- Use medications that are from ampules with rubber stoppers 4- Apply a cloth barrier to the client's arm under a blood pressure cuff when taking the blood pressure

1- Have the client void immediately before surgery

12) A nurse is developing a plan of care for a client scheduled for surgery. The nurse should include which activity in the nursing care plan for the client on the day of surgery? 1- Have the client void immediately before surgery 2- Avoid oral hygiene and rinsing with mouthwash 3- Verify that the client has not eaten for the last 24 hours 4- Report immediately any slight increase in blood pressure or pulse

4- Deep-breathing exercises

13) A nurse is developing a list of home care instructions for the client being discharged after a laparoscopic cholecystectomy. Which of the following instructions would be least appropriate to include in the postoperative discharge plan of care? 1- Wound care 2- Follow-up care 3- Activity restrictions 4- Deep-breathing exercises

3- Pain with dorsiflexion of food

14) A nurse is monitoring a postoperative client after abdominal surgery for signs of complications. The nurses assesses the client for the presence of Homan's sign and determines that this sign is positive if which of the following is noted? 1- Incisional pain 2- Absent bowel sounds 3- Pain with dorsiflexion of foot 4- Crackles on auscultation of the foot

3- Nerve and muscle damage

15) An operating room nurse is positioning a client on the operating room table to prevent the client's extremities from dangling over the sides of the table. A nursing student who is observing for the day asks the nurse why this is so important. The nurse responds that this is done to prevent: 1- An increase in pulse rate 2- A drop in blood pressure 3- Nerve and muscle damage 4- Muscle fatigue in the extremities

4- Obtain a telephone consent from a family member, following agency policy

16) A client with a perforated gastric ulcer is scheduled for surgery. The client cannot sign the operative consent form because of sedation from the opioid analgesics that have been administered. The nurse should take which appropriate action in the care of this client? 1- Obtain a court order for the surgery 2- Send the client to surgery without the consent form being signed 3- Have the hospital chaplain sign the informed consent immediately 4- Obtain a telephone consent from a family member, following agency policy

3- Can you share with me what you've been told about your surgery?

17) A preoperative client expresses anxiety to a nurse about upcoming surgery. Which response by the nurse is most likely to stimulate further discussion between the client and the nurse? 1- If it's any help, everyone is nervous before surgery 2- I will be happy to explain the entire surgical procedure to you 3- Can you share with me what you've been told about your surgery? 4- Let me tell you about the care you'll receive after surgery and the amount of pain you can anticipate

4- The best results are achieved when sitting up for with the head of the bed elevated 45 to 90 degrees

18) A nurse is conducting preoperative teaching with a client about the use of an incentive spirometer. The nurse should include which piece for information in discussions with the client? 1- Inhale as rapidly as possible 2- Keep a loose seal between the lips and the mouthpiece 3- After a maximum inspiration, hold the breath for 15 seconds and exhale 4- The best results are achieved when sitting up for with the head of the bed elevated 45 to 90 degrees

4- I need to continue to take the Aspirin until the day of surgery

19) A nurse has conducted a preoperative teaching for a client scheduled for surgery in 1 week. The client has a history of arthritis and has been taking acetylsalicylic acid (aspirin). The nurse determines that the client needs additional teaching if the client states: 1- Aspirin can cause bleeding after surgery 2- Aspirin can cause my ability to clot blood to be abnormal 3- I need to discontinue the Aspirin 48 hours before the scheduled surgery 4- I need to continue to take the Aspirin until the day of surgery

3- Apply a sterile dressing soaked with normal saline

2) When performing a surgical dressing change of a client's abdominal dressing, a nurse notes an increase in the amount of drainage and separation of the incision line. The underlying tissue is visible to the nurse. The nurse should do which of the following in the initial care of this wound? 1- Leave the incision open to the air to dry the area 2- Irrigate the wound and apply a sterile dry dressing 3- Apply a sterile dressing soaked with normal saline 4- Apply a sterile dressing soaked in povidone-iodine (Betadine)

2- Hemoglobin 8.0 g/dL

5) A client who has undergone preadmission testing has had blood drawn for serum laboratory studies, including a complete blood count, coagulation studies, and electrolytes and creatinine levels. Which of the following laboratory results should be reported to the surgeon's office by the nurse, knowing that it could cause surgery to be postponed? 1- Sodium, 141 mEq/L 2- Hemoglobin, 8.0 g/dL 3- Platelets, 210,000/mm3 4- Serum creatinine, 0.8mg/dL

3- Every 15 minutes for the first hour, every 30 minutes for 2 hours, every hour for 4 hours, and then every 4 hours as needed

6) A nurse in a surgical unit receives a postoperative client from the post anesthesia care unit. After the initial assessment of the client, the nurse plans to continue with postoperative assessment activities: 1- Every hour for 2 hours, then every 4 hours as needed. 2- Every 30 minutes for the first hour, every hour for 2 hours, and then every 4 hours as needed 3- Every 15 minutes for the first hour, every 30 minutes for 2 hours, every hour for 4 hours, and then every 4 hours as needed 4- Every 5 minutes for the first half-hour, every 15 minutes for 2 hours, every 30 minutes for 4 hours, then every hour as needed.

1- Assess the patency of the airway

7) A nurse receives a telephone call from the post-anesthesia care unit stating that a client is being transferred to the surgical unit. The nurse plans to do which of the following first on arrival of the client? 1- Assess the patency of the airway 2- Check tubes or drains for patency 3- Check the dressing to assess for bleeding 4- Assess the vital signs to compare with preoperative measurements

1- Urinary output of 20 mL/hr

8) A nurse has just reassessed the condition of a post-operative client who was admitted 1 hour ago to the surgical unit. The nurse plans to monitor which of the following parameters most carefully during the next hour? 1- Urinary output of 20 mL/hr 2- Temperature of 37.6C (99.6F) 3- Blood pressure of 100/70 mm Hg 4- Serous drainage on the surgical dressing