Deck 17: Priorities for the Postoperative Patient

Question 1

Which of the statements by a patient undergoing a craniotomy indicates the need for further teaching?
1)"I will probably go to the intensive care unit immediately surgery."
2)"I will be attached to a cardiac monitor while recovering."
3)"I will be able to get some good sleep after I leave the operating room."
4)"My family will be able to visit me while I am recovering."

Answer 1

3

Question 2

Which clinical manifestations does the nurse correlate to inadequate anesthesia reversal in a patient in the post-anesthesia care unit (PACU)?
1)Elevated blood pressure
2)Elevated temperature
3)Decreased oxygen saturation
4)Decreased urinary output

Answer 2

3

Question 3

The nurse receives care of a postoperative patient in the post-anesthesia care unit (PACU). Which is the priority action by the nurse?
1)Monitoring level of pain
2)Monitoring blood pressure
3)Monitoring peripheral pulses
4)Monitoring oxygen saturation

Answer 3

4

Question 4

The post-anesthesia care nurse is providing care to a patient with fluid volume overload who is experiencing cardiac dysrhythmias. Which laboratory result does the nurse correlate to this finding?
1)Glucose 60 mg/dL
2)Potassium 3 mEq/L
3)Sodium 136 mEq/L
4)Blood urea nitrogen (BUN) 15 mg/dL

Question 5

Which is the priority laboratory test that the post-anesthesia care nurse monitors closely in the older adult patient with renal disease who retained fluid during a surgical procedure?
1)Glucose
2)Potassium
3)Prothrombin time (PT)
4)Blood urea nitrogen (BUN)

Question 6

The nurse is providing care to a patient in the post-anesthesia care unit (PACU) who lost a large amount of blood during a surgical procedure. Which assessment finding correlates to this post-operative complication?
1)Bradypnea
2)Tachycardia
3)Hypothermia
4)Hypertension

Question 7

Which of the following nursing actions is completed during phase III of postanesthesia care?
1)Recovery from anesthesia
2)Urinary catheterization if no voiding
3)Vital signs every 15 to 30 minutes
4)Discharge teaching

Question 8

In teaching the patient about post-operative pain management, which statement by the nurse is best?
1)"It is important that you request pain medication before the pain gets too severe."
2)"You will be given the lowest strength pain medication first."
3)"It is better not to have visitors if you are in pain,"
4)"The goal for your pain is 0 on a 0 to 10 scale."

Question 9

The nurse provides care to a patient who is experiencing moderate pain in the post-anesthesia care unit (PACU). Which prescribed medication does the nurse administer to the patient?
1)Ibuprofen (Advil)
2)Naproxen sodium (Aleve)
3)Acetaminophen (Tylenol)
4)Hydromorphone (Dilaudid)

Question 10

Which laboratory test does the post-anesthesia care unit (PACU) nurse monitor in the patient who is having difficulty regaining consciousness after a surgical procedure?
1)Glucose
2)Potassium
3)Prothrombin time (PT)
4)Blood urea nitrogen (BUN)

Question 11

Which patient is at greatest risk for the development of postoperative nausea and vomiting?
1)68-year-old male who had a total hip replacement under general anesthesia
2)55-year-old female who had a mastectomy under general anesthesia
3)38-year-old male with a 15 pack-year history of smoking who had a fractured humerus repair under regional anesthesia
4)25-year-old female who underwent a cholecystectomy under general anesthesia

Question 12

In providing preoperative care to a patient scheduled for an arthroscopic procedure, the nurse explains that postanesthesia care will most likely be provided in which setting?
1)Intensive care unit
2)Medical-surgical unit
3)Outpatient post-anesthesia care unit
4)Procedure areas

Question 13

The nurse is providing care to a postoperative patient who is experiencing pain. The patient rates the pain at a 4 on a 1 to 10 numeric pain assessment scale. Which prescribed medication does the nurse administer to this patient?
1)Fentanyl
2)Morphine
3)Ibuprofen
4)Hydromorphone

Question 14

The nurse correlates which laboratory value as increasing the risk of infection in the postoperative patient?
1)Hematocrit 32%
2)Potassium 3 mEq/L
3)Sodium 150 mEq/L
4)Glucose 120 mg/dL

Question 15

Which is the priority initial assessment for a patient who is admitted to the post-anesthesia care unit (PACU) after surgery with general anesthesia?
1)Heart rate
2)Temperature
3)Respirations
4)Blood pressure

Question 16

The nurse correlates a change in the ST segment on the cardiac monitoring to which potential complication?
1)Blood loss
2)Atrial fibrillation
3)Myocardial infarction
4)Pulmonary edema

Question 17

The nurse is assessing a patient's postoperative wound and finds it has separated from the suture line with extrusion of the bowel through the opening. How does the nurse document this finding?
1)Wound infection
2)Wound dehiscence
3)Wound evisceration
4)Wound tunneling

Question 18

The nurse correlates hypertension and tachycardia in the post-anesthesia care unit to which of the following factors?
1)Oversedation
2)Stress
3)Regional anesthesia
4)Hypothermia

Question 19

Which laboratory test is the most important for the postanesthesia care nurse to monitor closely in the patient who is prescribed warfarin in the treatment of atrial fibrillation?
1)Hemoglobin
2)Hematocrit
3)Prothrombin time (PT)
4)White blood cell count

Question 20

Which patient finding indicates the need for further monitoring rather than discharge home after an outpatient surgical procedure?
1)Pain management with opioid analgesics
2)Lethargy that resolves after several hours
3)Inability to void without fluid retention
4)Persistent nausea without vomiting

Question 21

Which information does the post-anesthesia care unit (PACU) nurse receive from the operating room nurse during hand-off communication? Select all that apply.
1)Estimated blood loss
2)Anticipated length of hospital stay
3)The surgical procedure
4)Fluid intake during the procedure
5)Names of family members in the waiting room

Question 22

The nurse working in the post-anesthesia care unit (PACU) recognizes which of the following as risk factors for postoperative nausea and vomiting (PONV)? Select all that apply.
1)Female
2)Male
3)History of smoking
4)Undergoing a neurosurgical procedure
5)Procedure performed under general anesthesia

Question 23

The post-anesthesia care unit (PACU) nurse receives report from which of the following providers from the operating room? Select all that apply.
1)Anesthesia care provider
2)Operating room nurse
3)Respiratory therapist
4)Scrub technician
5)Surgical team member

Question 24

The nurse working on the medical-surgical unit has received a patient from the post-anesthesia care unit (PACU). Which clinical manifestations are indicative of pain in the postoperative patient? Select all that apply.
1)Restlessness
2)Diaphoresis
3)Hypotension
4)Constricted pupils
5)Piloerection

Question 25

The post-anesthesia care unit (PACU) is receiving a patient from the operating room. What is the correct order to perform the following assessments?

Question 26

Which information does the post-anesthesia care unit (PACU) nurse include in the hand-off that to the nurse who will assume care on the medical-surgical unit? Select all that apply.
1)Fluid intake and blood loss
2)Placement of intravenous (IV) lines
3)Patient identification using one identifier
4)Information regarding the surgical procedure
5)Over-the-counter (OTC) medications taken at home

Question 27

Before advancing to phase II of postanesthesia care, the patient must achieve which outcomes? Select all that apply.
1)Voiding clear urine
2)Stable vital signs
3)Alert and talking
4)Oxygenation saturation 98%
5)Stable airway

Question 28

Which staffing ratios are appropriate nurse-to-patient ratios in the post-anesthesia care unit (PACU)? Select all that apply.
1)1:1
2)1:2
3)1:3
4)1:4
5)1:5

Question 29

Which nursing actions are appropriate during phase I of the postoperative period? Select all that apply.
1)Providing discharge instructions
2)Assessing vital signs per protocol
3)Monitoring electrocardiogram continuously
4)Providing ongoing care until a bed is available
5)Transferring to the medical-surgical unit

Question 30

The perioperative nurse educator is preparing an inservice for new staff. In describing settings where postanesthesia care is provided, the nurse includes which of the following? Select all that apply.
1)Inpatient post-anesthesia care units
2)Intensive care units
3)Medical-surgical inpatient units
4)Outpatient post-anesthesia care units
5)Procedure areas

Question 31

Level of consciousness
2) Airway status
3) Skin color
4) Oxygen saturation
5) Apical pulse