Med Surg: Ch 18 thePoint
25
A client requires minor surgery for removal of a basal cell tumor. The anesthesiologist administers the anesthetic ketamine hydrochloride. What effects should the nurse monitor the client for after the administration? Select all that apply. 1. Pain 2. Hallucinations 3. Extrapyramidal reactions 4. Hiccups 5. Respiratory depression
3
During a procedure, a client's temperature begins to rise rapidly. This is likely the result of which complication? 1. infection 2. hypothermia 3. malignant hyperthermia 4. fluid volume excess
2
The client vomits during the surgical procedure. The best action by the nurse is: 1. Increase the IV infusion rate to compensate for lost fluids. 2. Suction the client to remove saliva and gastric secretions. 3. Lower the head of the operating table to promote circulation to the brain. 4. Administer an anti-emetic to alleviate nausea.
3
The nurse positions the client in the lithotomy position in preparation for 1. Renal surgery 2. Pelvic surgery 3. Perineal surgery 4. Abdominal surgery
3
Which of the following is an inappropriate nursing action by the surgical nurse? 1. Covering the hair with a surgical cap 2. Wearing a surgical jacket with knitted cuffs on the sleeves 3. Wearing sterile gloves over artificial nails 4. Changing shoe covers that become torn
2
A nurse is monitoring a client recovering from moderate sedation that was administered during a colonoscopy. Which finding requires the nurse's immediate attention? 1. Heart rate of 84 beats/minute 2. Oxygen saturation (SaO2) of 85% 3. Decreased cough and gag reflexes 4. Blood-tinged stools
3
A nurse on the surgical team has been assigned the role of scrub nurse. What action by the scrub nurse is appropriate? 1. Leading the surgical team in a debriefing session 2. Keeping all records and adjusting lights 3. Handing instruments to the surgeon and assistants 4. Coordinating activities of other personnel
4
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? 1. "I'm so glad that I will be unconscious during the surgery." 2. "I won't feel it, but I'll have a tube to help me breathe." 3. "Only the surgical area will be numb." 4. "I'll be sleepy but able to respond to your questions."
4
An obese client is undergoing abdominal surgery. During the procedure a surgical resident states, "The amount of fat we have to cut through is disgusting." What is the best response by the nurse? 1. Ignore the comment. 2. Report the resident to the attending surgeon. 3. Discuss concerns regarding the comments with the charge nurse. 4. Inform the resident that all communication needs to remain professional.
2
The OR personnel responsible for maintaining the safety of the client and the surgical environment is the: 1. Anesthesiologist 2. Circulating nurse 3. Scrub nurse 4. Surgeon
4
The surgical client has been intubated and general anesthesia has been administered. The client exhibits cyanosis, shallow respirations, and a weak, thready pulse. The nurse recognizes that the client is in which stage of general anesthesia? 1. Stage I 2. Stage II 3. Stage III 4. Stage IV
2
What are the circulating nurse's responsibilities, in contrast to the scrub nurse's responsibilities? 1. Assisting the surgeon 2. Coordinating the surgical team 3. Setting up the sterile tables 4. Passing instruments
1
Which statement by the client indicates further teaching about epidural anesthesia is necessary? 1. "I will become unconscious." 2. "I will lose the ability to move my legs." 3. "I will be able to hear the surgeon during the surgery." 4. "A needle will deliver the anesthetic into the area around my spinal cord."
1
A registered nurse who is responsible for coordinating and documenting client care in the operating room is a 1. circulating nurse. 2. scrub nurse. 3. anesthetist. 4. anesthesiologist.
1
The nurse is completing a postoperative assessment for a patient who has received a depolarizing neuromuscular blocking agent. The nursing assessment includes careful monitoring of which body system? 1. Cardiovascular system 2. Endocrine system 3. Gastrointestinal system 4. Genitourinary system
1
The nurse recognizes older adults require lower doses of anesthetic agents due to: 1. decreased lean tissue mass. 2. increased tissue elasticity. 3. increased liver mass. 4. decreased bone mass.
1
The nurse recognizes that the older adult is at risk for surgical complications due to: 1. decreased renal function 2. increased cardiac output 3. increased skeletal mass 4. decreased adipose tissue
1
The surgical unit nurse is developing a postoperative plan of care. In which client's plan of care would the nurse document interventions of coughing and deep breathing, gastrointestinal assessment, and effective regulation of temperature? 1. A client with gastrointestinal surgery and general anesthesia 2. A client having a knee replacement and regional anesthesia 3. A client having lower extremity muscle repair and spinal anesthesia 4. A client with spinal stenosis and a regional nerve blockade
4
What medication should the nurse prepare to administer in the event the client has malignant hyperthermia? 1. Thiopental sodium 2. Fentanyl citrate 3. Naloxone 4. Dantrolene sodium
