Perioperative
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- Temp of 36.5 C C- A 2 cm X 2 cm area of bloody drainage on the dressing D- WBC 9,000 MM
A
A nurse is caring for a client who is 12 hours 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
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 hyperthemia? A- Administer dantrolene B- Institute seizure precautions C- Remove endotracheal tube D- Give IV atropine
A
A nurse is reviewing the medical record of a client who is to undergo eneral anesthesia for surgery. The nurse should report which of the following findings to the provider? A- K 2.8 B- Na 140 C- INR 1.5 D- Bun 12
A
A surgical nurse enters a surgical suite to ensure surgical asepsis is maintained. Which of the following findings requires intervention by the nurse? A- The scrub tech is wearing a watch under his scrubs B- The circulating nurse opens dressing packages before applying sterile gloves C- The surgeon has her hands folded 5 cm above her waist D- The holding area nurse is performing client education
A
A nurse is receiving evening shift report on four clients who returned from the PACU that morning. The nurse should assess which of the following clients first? A- A client who is postoperative following a thoracotomy and and has a chest tube with 150 mL of bringt-red blood in the collection chamber from the past 1 hr 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 postoperative following a tonsillectomy and has had one episode of coffee-ground emesis D- A client who is postoperative following a total knee arthroplasty and is reporting a knee pain level of 7 on a scale from 0 to 10
A Use ABCs, the nurse should assess the client who has 150 mL of blood in the collection chamber because this finding is above the expected reference range and can be indication of hemorrhage
A nurse is reviewing the medication administration record for a client who is scheduled for surgery the next day. The nurse should identify that which of the following medications places the client at risk for complications during surgery and should be reported to the provider? A- Clopidogrel B- Atorvastatin C- Ranitidine D- Alendronate
A clopidogrel is an oral antiplatelet med used to prevent coronary artery stenosis
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? Elevate the clients right extremity A nurse is assessing a client's recovery from spinal anesthesia. Which of the following sensations should the nurse expect to return to the client first? A- Apply an ice pack to the clients right calf B- Elevate the clients right extremity C- Administer testosterone to the client D- Gently massage the clients right calf
B
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 negative pressure when emptying the drain
B
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 scale on a scale from 0 to 10. 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 clients blood for LYTES B- Insert an NG tube C- Administer pain meds D- Initiate intake and output
B
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
A nurse is creating a plan of care for a client who is preoperative for a total hip arthroplasty, practices judaism, and adheres 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 clients 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
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 doc
B
A nurse is providing preoperative for a client who is about 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 wound healing, it is important for you to reduce your intake
B
A nurse is providing teaching for a client who is in the immediate postoperative period and has 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 your family 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
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 echinacea B- Long term use of steriods C- History of osteoporosis D- Diet high in vit C
B the use of steroids inhibit leukocyte response, which increases the clients risk for infection
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
A nurse in the PACU assessing a client who is postoperative. Which of the following findings should the nurse report to the provider? A- BP 10% lower than baseline B- Pain level of 4 on 0 to 10 scale C- Presence of inspiratory stridor D- Small amount of sanguinous drainage on dressing
C
A nurse is assessing a clients recovery 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
A nurse is caring for a client who is postoperative following abdominal surgery. Which of the following nursing interventions should the nurse perform to prevent respiratory complications? A- Instruct the client to exhale into the incentive spirometer every 1-2 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 hr
C
A nurse is caring for a client who is receiving moderate (conscious) sedation with midazolam. The clients respiratory rate decreases from 16/min to 6/min, and the 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
A nurse is planning care for a client who is postoperative and has a closed-wound drainage system in place. Which of the following interventions should the nurse plan to include? A- Check the patency of the drain every 12 hrs. B- Clamp the drain while the client is ambulating. C- Cleanse the drain plug with alcohol after emptying. D- Secure the drain
C
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
A client 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 a reverse Trendelenburg position D- Obtain vital signs to assess for shock
D
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 the endotracheal intubation C- Increase the clients flow of oxygen D- Use the head-tilt, chin-life method to open the airway
D
A nurse is caring for a client who has bradycardia following a surgical procedure 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
A nurse is providing preoperative teaching to a client who is schedule for a gastrectomy in 1 week. The client is anxious about the upcoming surgery. Which of the following actions should the nurse take? A- Sympathize with the clients feelings B- Reassure the client that the surgery will go fine C- Change the topic of discussion D- Provide concise, factual information
D
A nurse is 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 meds until after I have completed my range-of-motion exercises B- I should wait a week after surgery to start my hand strengthening exercises C- I will be able to lift up an object that weighs 10 pounds 2 weeks after my surgery D- I will be able to shower after the doctor removes the drain
D
A nurse is providing teaching for a client who is scheduled to undergo moderate sedation for a bronchoscopy. The nurse should verify that the client inderstands the procedure when the client states which of the following? A nurse is providing teaching for a client who is scheduled to undergo moderate sedation for a bronchoscopy. The nurse should verify that the client inderstands the procedure when the client states which of the following? A-I will need to complete a bowel prep the day before B- I will drink plenty of fluids the morning of the procedure C- I can eat as soon as the procedure is over D- I can expect to feel sleepy for several hours after the procedure
D
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 of complications? A- Cefazolin B- Digoxin C- Ondansetron D- Warfain
D