Question 1

In which situation might surgery be delayed?

Accepted Answer

A)  The patient has taken Dilantin today. 
B)  An illegible signature is on the consent form. 
C)  The patient is still taking anticoagulants. 
D)  The admission office is unable to confirm insurance coverage. 
A)  The patient has taken Dilantin today. 
B)  An illegible signature is on the consent form. 
C)  The patient is still taking anticoagulants. 
D)  The admission office is unable to confirm insurance coverage. C

Question 2

A patient is transferred from the operating room to the recovery room after undergoing an open reduction and internal fixation (ORIF) of his left ankle. Which is the first assessment to make?

Accepted Answer

A)  Check ankle dressings for hemorrhage. 
B)  Check airway for patency. 
C)  Check intravenous site. 
D)  Check pedal pulse. 
A)  Check ankle dressings for hemorrhage. 
B)  Check airway for patency. 
C)  Check intravenous site. 
D)  Check pedal pulse. B

Question 3

The patient who had a nephrectomy yesterday has not used the patient-controlled analgesia (PCA) delivery system but admits to being in pain but fearful of addiction. What is the nurse's best response?

Accepted Answer

A)  "Modern analgesic drugs do not cause addiction." 
B)  "Pain relief is worth a short period of addiction." 
C)  "Addiction rarely occurs in the brief time postsurgical analgesia is required." 
D)  "Addiction could be a real concern." 
A)  "Modern analgesic drugs do not cause addiction." 
B)  "Pain relief is worth a short period of addiction." 
C)  "Addiction rarely occurs in the brief time postsurgical analgesia is required." 
D)  "Addiction could be a real concern." C

Question 4

The nurse explains that to promote deep breathing and improve lung expansion and oxygenation the patient should use the _____________ ______________ at regular intervals during the day.

Accepted Answer

incentive spirometer
The incen

Question 5

Which of the following early postoperative observations should be reported immediately?

Accepted Answer

A)  "Coffee ground" emesis 
B)  Shivering 
C)  Scanty urine output 
D)  Evidence of pain 
A)  "Coffee ground" emesis 
B)  Shivering 
C)  Scanty urine output 
D)  Evidence of pain

Question 6

The nurse would include the nursing diagnosis of deficient knowledge, postoperative, when the patient scheduled for a bowel resection tomorrow remarks:

Accepted Answer

A)  "I am going to have adequate pain medication after surgery." 
B)  "I know you all are going to make me cough and walk soon after surgery." 
C)  "I am glad I will get to go home tomorrow evening." 
D)  "I will have to put up with dressing changes." 
A)  "I am going to have adequate pain medication after surgery." 
B)  "I know you all are going to make me cough and walk soon after surgery." 
C)  "I am glad I will get to go home tomorrow evening." 
D)  "I will have to put up with dressing changes."

Question 7

Which medication would cause surgery to be delayed if it had not been discontinued several days before surgery?

Accepted Answer

A)  Analgesic agent 
B)  Antihypertensive agent 
C)  Anticoagulant agent 
D)  Antibiotic agent 
A)  Analgesic agent 
B)  Antihypertensive agent 
C)  Anticoagulant agent 
D)  Antibiotic agent

Question 8

What should the nurse do to minimize the potential for venous stasis?

Accepted Answer

A)  Place pillows under the knee in a position of comfort 
B)  Assist patient to sit with feet flat on the floor 
C)  Assist with early ambulation 
D)  Perform gentle leg massage 
A)  Place pillows under the knee in a position of comfort 
B)  Assist patient to sit with feet flat on the floor 
C)  Assist with early ambulation 
D)  Perform gentle leg massage

Question 9

A postoperative patient who had a left inguinal hernia repair is ready for his discharge instructions. Which information should the nurse provide? (Select all that apply.)

Accepted Answer

A)  Care of the wound site and any dressings 
B)  When he may operate a motor vehicle 
C)  Signs and symptoms to report to the physician 
D)  Call the physician's office once he arrives home 
E)  Report bowel movements to the physician
F) Actions and side effects of any medications 
A)  Care of the wound site and any dressings 
B)  When he may operate a motor vehicle 
C)  Signs and symptoms to report to the physician 
D)  Call the physician's office once he arrives home 
E)  Report bowel movements to the physician
F) Actions and side effects of any medications

Question 10

Which interventions in preparing the patient for abdominal surgery may be delegated to unlicensed assistive personnel (UAP)?

Accepted Answer

A)  Vital signs 
B)  Insertion of N/G tube 
C)  Enema 
D)  Height and weight 
E)  Obtaining operative consent
F) Sterile gowning 
A)  Vital signs 
B)  Insertion of N/G tube 
C)  Enema 
D)  Height and weight 
E)  Obtaining operative consent
F) Sterile gowning

Question 11

Which circumstance could prevent the patient from signing his informed consent for a cholecystectomy?

Accepted Answer

A)  The patient complains of pain radiating to the scapula. 
B)  The patient received an injection of Demerol, 75 mg IM, 1 hour ago. 
C)  The patient is 85 years of age. 
D)  The patient is concerned over his lack of insurance coverage. 
A)  The patient complains of pain radiating to the scapula. 
B)  The patient received an injection of Demerol, 75 mg IM, 1 hour ago. 
C)  The patient is 85 years of age. 
D)  The patient is concerned over his lack of insurance coverage.

Question 12

Why might the older adult patient not respond to surgical treatment as well as a younger adult patient?

Accepted Answer

A)  Poor skin turgor 
B)  Fear of the unknown 
C)  Response to physiological changes 
D)  Decreased peristalsis related to anesthesia 
A)  Poor skin turgor 
B)  Fear of the unknown 
C)  Response to physiological changes 
D)  Decreased peristalsis related to anesthesia

Question 13

The nurse anticipates that the patient will be given ______________anesthesia because of the extensive tissue manipulation involved in a hysterectomy.

Accepted Answer

A)  general 
B)  regional 
C)  specific 
D)  preoperative 
A)  general 
B)  regional 
C)  specific 
D)  preoperative

Question 14

The patient is brought into PACU still unconscious. What should the nurse do when the nurse assesses an oral temperature of 94° F?

Accepted Answer

A)  Notify the charge nurse immediately 
B)  Offer warm fluids through a straw 
C)  Do nothing, this is a normal reaction to anesthesia 
D)  Cover with a warm blanket 
A)  Notify the charge nurse immediately 
B)  Offer warm fluids through a straw 
C)  Do nothing, this is a normal reaction to anesthesia 
D)  Cover with a warm blanket

Question 15

What is the ideal time for preoperative teaching?

Accepted Answer

A)  Immediately before surgery to eliminate fear 
B)  2 months in advance so the patient can prepare 
C)  1 to 2 days before the surgery when anxiety is not as high 
D)  In the surgical holding area 
A)  Immediately before surgery to eliminate fear 
B)  2 months in advance so the patient can prepare 
C)  1 to 2 days before the surgery when anxiety is not as high 
D)  In the surgical holding area

Question 16

______________ therapy is performed to alleviate or decrease uncomfortable symptoms without curing the problem.

Accepted Answer

Palliative
Palliative therapy

Question 17

In performing the preoperative assessment, the nurse discovers that the patient is allergic to latex. What should the nurse do initially?

Accepted Answer

A)  Notify the diet kitchen to omit peaches from diet tray 
B)  Apply a medical alert band to patient's wrist 
C)  Tag chart with allergy alert 
D)  Place patient in an isolation room 
A)  Notify the diet kitchen to omit peaches from diet tray 
B)  Apply a medical alert band to patient's wrist 
C)  Tag chart with allergy alert 
D)  Place patient in an isolation room

Question 18

Which of the following are preoperative conditions that may affect the patient's response to surgery? (Select all that apply.)

Accepted Answer

A)  Age 
B)  Religion 
C)  Mental status 
D)  Occupation 
E)  Nutritional status 
A)  Age 
B)  Religion 
C)  Mental status 
D)  Occupation 
E)  Nutritional status

Question 19

Place the instructions for controlled coughing in the correct sequence. (Separate letters by a comma and space as follows: A, B, C, D)
A) Inhale deeply and hold breath for a count of three
B) Document exercise and patient reaction
C) Cough 2 or 3 times without inhaling then relax
D) Take several deep breaths
E) Inhale through nose 
F) Exhale through pursed lips

Accepted Answer

D, E, F, A, C, B
The patient should be i

Question 20

The postoperative nursing intervention that would be contraindicated for a 45-year-old patient who has had a repair of a cerebral aneurysm and is presenting signs of increased intracranial pressure (ICP) would be:

Accepted Answer

A)  coughing every 2 hours. 
B)  turning every 2 hours. 
C)  monitoring intravenous therapy at 50 ml/hr. 
D)  assessing vital signs every 2 hours. 
A)  coughing every 2 hours. 
B)  turning every 2 hours. 
C)  monitoring intravenous therapy at 50 ml/hr. 
D)  assessing vital signs every 2 hours.

Exam 41: Care of the Surgical Patient

In which situation might surgery be delayed?

A patient is transferred from the operating room to the recovery room after undergoing an open reduction and internal fixation (ORIF) of his left ankle. Which is the first assessment to make?

The patient who had a nephrectomy yesterday has not used the patient-controlled analgesia (PCA) delivery system but admits to being in pain but fearful of addiction. What is the nurse's best response?

The nurse explains that to promote deep breathing and improve lung expansion and oxygenation the patient should use the _____________ ______________ at regular intervals during the day.

Which of the following early postoperative observations should be reported immediately?

The nurse would include the nursing diagnosis of deficient knowledge, postoperative, when the patient scheduled for a bowel resection tomorrow remarks:

Which medication would cause surgery to be delayed if it had not been discontinued several days before surgery?

What should the nurse do to minimize the potential for venous stasis?

A postoperative patient who had a left inguinal hernia repair is ready for his discharge instructions. Which information should the nurse provide? (Select all that apply.)

Which interventions in preparing the patient for abdominal surgery may be delegated to unlicensed assistive personnel (UAP)?

Which circumstance could prevent the patient from signing his informed consent for a cholecystectomy?

Why might the older adult patient not respond to surgical treatment as well as a younger adult patient?

The nurse anticipates that the patient will be given ______________anesthesia because of the extensive tissue manipulation involved in a hysterectomy.

The patient is brought into PACU still unconscious. What should the nurse do when the nurse assesses an oral temperature of 94° F?

What is the ideal time for preoperative teaching?

______________ therapy is performed to alleviate or decrease uncomfortable symptoms without curing the problem.

In performing the preoperative assessment, the nurse discovers that the patient is allergic to latex. What should the nurse do initially?

Which of the following are preoperative conditions that may affect the patient's response to surgery? (Select all that apply.)

The postoperative nursing intervention that would be contraindicated for a 45-year-old patient who has had a repair of a cerebral aneurysm and is presenting signs of increased intracranial pressure (ICP) would be:

Evolution of Nursing

Legal and Ethical Aspects of Nursing

Documentation

Communication

Nursing Process and Critical Thinking

Cultural and Ethnic Considerations

Asepsis and Infection Control

Body Mechanics and Patient Mobility

Hygiene and Care of the Patient’s Environment

Safety

Vital Signs

Physical Assessment

Admission, Transfer, and Discharge

Surgical Wound Care

Specimen Collection and Diagnostic Testing

Care of Patients Experiencing Urgent Alterations in Health

Complementary and Alternative Therapies

Pain Management, Comfort, Rest, and Sleep

Nutritional Concepts and Related Therapies

Fluids and Electrolytes

Mathematics and Medication Administration

Care of Patients with Alterations in Health

Life Span Development

Loss, Grief, Dying, and Death

Health Promotion and Pregnancy

Labor and Delivery

Care of the Mother and Newborn

Care of the High-Risk Mother, Newborn, and Family with Special Needs

Health Promotion for the Infant, Child, and Adolescent

Basic Pediatric Nursing Care

Care of the Child with a Physical and Mental or Cognitive Disorder

Health Promotion and Care of the Older Adult

Concepts of Mental Health

Care of the Patient with a Psychiatric Disorder

Care of the Patient with an Addictive Personality

Home Health Nursing

Long-Term Care

Rehabilitation Nursing

Hospice Care

Introduction to Anatomy and Physiology

Care of the Patient with an Integumentary Disorder

Care of the Patient with a Musculoskeletal Disorder

Care of the Patient with a Gastrointestinal Disorder

Care of the Patient with a Gallbladder, Liver, Biliary Tract, or Exocrine Pancreatic Disorder

Care of the Patient with a Blood or Lymphatic Disorder

Care of the Patient with a Cardiovascular or a Peripheral Vascular Disorder

Care of the Patient with a Respiratory Disorder

Care of the Patient with a Urinary Disorder

Care of the Patient with an Endocrine Disorder

Care of the Patient with a Reproductive Disorder

Care of the Patient with a Sensory Disorder

Care of the Patient with a Neurologic Disorder

Care of the Patient with an Immune Disorder

Care of the Patient with HIV/AIDS

Care of the Patient with Cancer

Professional Roles and Leadership

Filters

The nurse explains that to promote deep breathing and improve lung expansion and oxygenation the patient should use the _ __ at regular intervals during the day.