Medical Surgical Perioperative Practice Questions

A nurse is receiving evening shift report on four clients who returned from the PACu that morning. Which of the following clients should the nurse assess first? a. a client who is post-op following a thoracotomy and has a chest tube with 150 mL of bright red blood in the collection chamber in the past 1 hour b. a client who is postoperative following a small bowel resection and has a temporary colostomy along with absent bowel sounds in all four quadrants c. a client who is post-op following a tonsillectomy and has had one [email protected] of coffee-ground emesis d. a client who is postoperative following a total knee arthroplasty and is reporting a pain level of 7

a.

A nurse is monitoring a client who received succinylcholine during a surgical procedure. Which of the following actions should the nurse take if the client develops manifestations of malignant hyperthermia? a. administer dantrolene b. institute seizure precautions c. remove the endotracheal tube d. administer IV atropine

a. administer dantrolene

A nurse is caring for a client who is 12 hr postoperative from a gastrectomy and has an NG tube set to continuous low suction. Which of the following findings requires intervention by the nurse? a. gastric distention b. absent bowel sounds c. urine output of 150 mL over the last 4 hr d. yellow drainage in the NG tube

a. gastric distention

A nurse is reviewing the medical record for a client who has a prescription for general anesthesia prior to surgery. Which of the following findings should the nurse report to the provider? a. potassium 2.8 mEq/L b. sodium 140 mEq/L c. INR 1.5 d. BUN 12 mg/dL

a. potassium 2.8 mEq/L

A surgical nurse enters a surgical suite to ensure surgical asepsis is maintained. For which of the following findings should the nurse intervene? a. the scrub technologist is wearing a watch under their scrubs b. the circulating nurse opens dressing packages before applying sterile gloves c. the surgeon has their hands folded 5 cm (2 in) above their waist d. the holding area nurse is performing client education

a. the scrub technologist is wearing a watch under their scrubs

A nurse is assessing a client who is 2 hr postoperative following an appendectomy. Which of the following findings should the nurse report to the provider? a. urine output of 20 mL/hr b. temperature of 36.5 C c. a 2 cm x 2 cm (0.79 in x 0.79 in) area of bloody drainage on the dressing d. WBC count 9000 mm^3

a. urine output of 20 mL/hr

A nurse is teaching a client who is in the immediate postoperative period about the use of a PCA pump. Which of the following statements should the nurse include in the teaching? a. "You will receive a dose of medication every time you push the button." b. "Do not allow visitors to push the PCA button if you are sleeping." c. "You cannot receive too much medication by pushing the button." d. "Do not push the PCA button until your pain reaches a severe level."

b. "Do not allow visitors to push the PCA button if you are sleeping."

A nurse is providing discharge instructions for a client who is postoperative following abdominal surgery. Which of the following client statements indicates an understanding of the teaching? a. "I will have an increase in yellow-colored drainage from my incision for 2 weeks" b. "I will eat foods that are high in protein and vitamin c during my recovery" c. "I should avoid taking over-the-counter pain medication if my pain is not severe" d. "I will remain on bed rest until my follow-up appointment with my doctor"

b. "I will eat foods that are high in protein and vitamin c during my recovery"

A nurse is providing preoperative teaching for a client who is scheduled to have a below-the-knee amputation. Which of the following instructions should the nurse include? a. "You should avoid lying on your abdomen after surgery." b. "Your surgeon might prescribe an antibiotic before surgery." c. "It is important for you to sit in a chair at the bedside for several hours every day to reduce the risk of pneumonia." d. "To promote would healing, it is important to reduce your intake of carbohydrates once you return home."

b. "Your surgeon might prescribe an antibiotic before surgery."

A nurse is caring for a client who is preoperative and is asking multiple questions about the risks of the procedure. Which of the following actions should the nurse take? a. explain the risks and benefits of the surgery to the client b. ask the surgeon to speak to the client for clarification c. reassure the client that the procedure is necessary for recovery d. notify the circulating nurse that the client has questions about the procedure

b. ask the surgeon to speak to the client for clarification

A nurse is creating a plan of care for a client who is preoperative for a total hip arthroplasty. The client informs the nurse that they practice Judaism and adhere to a kosher diet. Which of the following interventions is the nurse's priority? a. listen and allow the client to express feelings about the surgery b. determine if the client's faith conflicts with the treatment plan c. ensure the client's meal plan serves only kosher food following surgery d. teach the client how to perform various relaxation exercises

b. determine if the client's faith conflicts with the treatment plan

A nurse is assessing a client who is 2 days postoperative following a total prostatectomy. The nurse notes that the client's right calf is red, edematous, and warm to the touch. Which of the following actions should the nurse take? a. apply an ice pack to the client's right calf b. elevate the client's right extremity c. administer testosterone to the client d. gently massage the client's right calf

b. elevate the client's right extremity

A nurse is caring for a client who is 2 days postoperative following a cholecystectomy. The client has been vomiting for the past 24 hr and reports a pain level of 8 on a 0 to 10 scale. The nurse notes a hard, distended abdomen and absent bowel sounds. After conferring with the provider, which of the following actions should the nurse take first? a. draw the client's blood for electrolytes b. insert an NG tube c. administer pain medication d. initiate intake and output

b. insert an NG tube

A nurse is assessing a client who is preoperative. The nurse should identify that which of the following factors reported by the client increases the risk for a postoperative wound infection? a. frequent use of ecchinacae b. long-term use of corticosteroids c. history of osteoperosis d. diet high in vitamin C

b. long-term use of corticosteroids

A nurse is assessing a client who received a preoperative IV dose of metoclopramide 1 hr ago. For which of the following findings should the nurse notify the provider? a. dry mouth b. muscle rigidity c. tinnitus d. diarrhea

b. muscle rigidity

A nurse is caring for a client who has a surgical wound with a Penrose drain in place. Which of the following interventions should the nurse plan to perform? a. cut a slit in a 4-inch square gauze pad to place around the drain b. use the sterile technique when performing dressing changes c. establish a clamping schedule prior to removal d. apply negaitve pressure when emptying the drain

b. use sterile technique when performing dressing changes

A nurse is providing discharge teaching for a client who is postoperative following a rhinoplasty using general anesthesia. Which of the following instructions should the nurse include? a. "lie on your side when resting for the first week after surgery" b. "limit intake to clear liquids for the first 24 hours after surgery" c. "use cool compresses on your eyes, nose, and face" d. "close your mouth when you are about to sneeze"

c. "use cool compresses on your eyes, nose, and face"

A nurse is reviewing the medical record of a client who is scheduled for an elective surgery. Which of the following medications should the nurse expect the provider to discontinue prior to surgery to minimize the risk for complications? a. cefazolin b. digoxin c. ondansetron d. warfarin

d. warfarin

A nurse is caring for a client who is postoperative following abdominal surgery. Which of the following interventions should the nurse perform to prevent respiratory complications? a. instruct the client to exhale into the incentive spirometer every 1 to 2 hr. b. minimize the amount of pain medication the client receives to prevent sedation c. advise the client to splint the surgical incision when coughing and deep breathing d. reposition the client every 8 hr for the first 48 hrs

c. advise the client to split the surgical incision when coughing and deep breathing

A nurse is planning care for a client who is postoperative and has a closed-wound drainage system is place. Which of the following interventions should the nurse plan to include? a. check the patency of the drain every 12 hr b. clamp the drain while the client is ambulating c. cleanse the drain plug with alcohol after emptying d. secure the drain to the client's bed sheet

c. cleanse the drain plug with alcohol after emptying

A nurse is caring for a client who is receiving moderate (conscious) sedation with midazolam. The client's respiratory rate decreases from 16/min to 6/min, and their oxygen saturation decreases from 92% to 85%. Which of the following medications should the nurse administer? a. atropine b. acetylcysteine c. flumazenil d. protamine sulfate

c. flumazenil

A circulating nurse is monitoring the temperature in a surgical suite. The nurse should identify that cool temperatures reduce a client's risk for which of the following potential complications of surgery? a. malignant hyperthermia b. blood clots c. infection d. hypoxia

c. infection

A nurse in a PACU is assessing a client who is postoperative. Which of the following findings should the nurse report to the provider? a. blood pressure 10% lower than baseline b. pain level of 4 on a 0 to 10 scale c. presence of inspiratory stridor d. small amount of sanguineous drainage on dressing

c. presence of inspiratory stridor

A nurse is assessing a client who is recovering from spinal anesthesia. Which of the following sensations should the nurse expect to return to the client first? a. pain b. cold c. touch d. warmth

c. touch

A nurse is providing teaching for a client who is scheduled to undergo moderate sedation for a bronchoscopy. Which of the following client statements indicates an understanding of the teaching? a. "I will need to complete a bowel prep the day before the procedure" b. "I will drink plenty of fluids the morning of the procedure" c. "I can eat as soon as the procedure is open" d. "I can expect to feel sleepy for several hours after the procedure"

d. "I can expect to feel sleepy for several hours after the procedure"

A nurse if providing preoperative teaching to a client who is scheduled to have a mastectomy with reconstructive surgery. Which of the following statements by the client indicates an understanding of the teaching? a. "I should wait to take my pain medication until after I completed my range-of-motion exercises" b. "I should wait until a week after surgery to state my hand-strengthening exercises" c. "I will be able to lift an object that weighs 10 pounds 2 weeks after my surgery" d. "I will be able to shower after the doctor removes that drain"

d. "I will be able to shower after the doctor removes that drain"

A nurse caring for a client who has bradycardia following a surgical procedure using spinal anesthesia. The nurse should plan to administer which of the following medications to the client? a. amiodarone b. propranolol c. methyldopa d. epinephrine

d. epinephrine

A nurse is caring for a client who had an open transverse colectomy 5 days ago. The nurse enters the client's room and recognizes that the wound has eviscerated. After covering the wound with a sterile, saline-soaked dressing, which of the following actions should the nurse take? a. go to the nurses' station to seek assistance b. reinsert the organs into the abdominal cavity c. place the client in reverse Trendelenburg position d. obtain vital signs to assess for shock

d. obtain vital signs to assess for shock

A nurse is providing preoperative teaching to a client who is scheduled for a gastrectomy in 1 week. The client expresses anxiety about the upcoming surgery. Which of the following actions should the nurse take? a. sympathize with the client's feelings b. reassure the client that the surgery will go fine c. change the topic discussion d. provide concise, factual information

d. provide concise, factual information

A client is transferred from the surgical suite to the PACU following oral surgery. While monitoring the client's vital signs, the nurse finds that the client's tongue has become swollen and is obstructing the airway. Which of the following actions should the nurse take first? a. contact the anesthesiologist b. assist with endotracheal inubation c. increase the client's flow of oxygen d. use the head-lift, chin-lift method to open the airway

d. use the head-tilt, chin-lift to open the airway