Deck 37: Care of the Surgical Patient

Question 1

When the patient is ready to return from the postanesthesia care unit (PACU), a minimal Aldrete score of _______ is an indicator that the patient is ready to return to the floor.

A) 2 to 4
B) 4 to 8
C) 9 to 10
D) 11 to 12

Answer 1

9 to 10

Question 2

A patient who has returned to the surgical nursing unit from the postanesthesia care unit (PACU) is drowsy and requires verbal stimulation to remain aroused. The best position to maintain an airway for this patient is:

A) supine.
B) side lying.
C) head of bed at 30 degrees with head and neck midline.
D) head of bed at 45 degrees with head and neck midline.

Answer 2

side lying.

Question 3

A nurse is instructing a patient who had surgical removal of a brain tumor on how to prevent respiratory complications from surgery. The nurse would teach the patient to:

A) turn, cough, and deep breathe.
B) use humidified oxygen.
C) turn gently from side to side.
D) use deep breathing and an incentive spirometer.

Answer 3

use deep breathing and an incentive spirometer.

Question 4

A postoperative surgical patient asks how the sequential pneumatic compression boots applied in the operating room will help lower the risk of blood clots forming in the legs. The nurse's most appropriate response would be that the boots:

A) measure pressure in the leg blood vessels and sound an alarm if pressure rises.
B) alternately compress and release to help blood flow through vessels.
C) provide gentle continuous compression at low pressure.
D) provide firm continuous compression at high pressure.

Question 5

The nurse discovers that the signed operative permit has misspelled the patient's name. The nurse must:

A) request a corrected consent form to be signed.
B) inform the surgeon of the error.
C) have the new form attached to the old incorrect one and document it.
D) allow the patient to be taken to surgery after notifying the circulating nurse.

Question 6

In order for the anesthesiologist to accurately calculate the amount of anesthesia needed for an 82-year-old patient, the nurse should have data available on the medical record, such as:

A) time of last meal.
B) pulse rate and blood pressure.
C) respiratory rate and oxygen saturation.
D) height and weight.

Question 7

A patient undergoing preadmission testing before same day surgery asks how long he will remain in the recovery area before being allowed to go home. The nurse's most informative response would be:

A) 30 to 60 minutes.
B) 2 to 6 hours.
C) 5 to 6 hours.
D) 6 to 8 hours.

Question 8

A patient who had surgery earlier in the day using general anesthesia asks whether he can have something to eat. The diet order indicates clear liquids can be taken. Before giving a Jell O to the patient, the nurse should check for the presence of:

A) clear lung sounds.
B) adequate urinary drainage.
C) bowel sounds in all quadrants.
D) palpable peripheral pulses.

Question 9

The nurse is aware that in both the very young and the older adult surgical patient, the risk is much higher for:

A) nausea and vomiting.
B) hydration issues.
C) delayed healing.
D) anorexia.

Question 10

The circulating nurse is responsible for:

A) preparing the sterile field.
B) assisting with sterile draping of the patient.
C) maintaining an accurate count of sponges.
D) pointing out the observation of contamination immediately to the personnel involved.

Question 11

A nurse is monitoring the urinary drainage from a patient who returned to the unit a few hours ago from the postanesthesia care unit (PACU) following a surgical procedure. The urine total is 54 mL for the last 2 hours. The most appropriate nursing action is to:

A) increase the flow rate of the IV for 10 to 15 minutes.
B) irrigate the indwelling urinary catheter.
C) apply manual pressure to the patient's bladder.
D) notify the surgeon of the findings.

Question 12

A patient who had abdominal surgery is complaining of "gas pains" and has distention of the abdomen and flatus. To promote patient comfort, the nurse should advise:

A) early ambulation.
B) turning to the left side.
C) drinking fluids that are very hot.
D) lying supine with knees flexed.

Question 13

The circulating nurse notes that the anesthetized patient has tensed muscles and irregular respirations. The nurse is aware that the patient has reached stage:

A) I and the patient's hearing is amplified.
B) II and the surgical environment should be kept quiet.
C) III and the patient has depressed reflexes.
D) IV and the patient will not depend on the anesthesia machine of oxygenations.

Question 14

A 16-year-old boy injured in a motorcycle accident is unconscious and cannot sign the emergency surgical consent form; no family members can be located. The nurse anticipates that:

A) the hospital social worker can sign the permit.
B) the surgeon will write a detailed note about the need for surgery and a registered nurse will then sign the consent.
C) the opinion of a second surgeon is sought regarding the necessity of the surgery.
D) the hospital attorney must authorize the surgery and sign the consent form.

Question 15

To help prevent errors in the surgical procedure, the National Patient Safety Goal instituted a directive that prior to presurgical medication, each patient must:

A) verbally state the location of the surgical site and the expected procedure.
B) when still conscious participate in marking the surgical site.
C) have the unit nurse confirm their identity.
D) have a photograph of the surgical site in the medical record.

Question 16

A patient scheduled for surgery has an order for a preoperative surgical skin preparation. The nurse may be required to:

A) shave the entire surgical site.
B) spray the surgical area with an antimicrobial solution.
C) scrub the surgical area for 1 minute with antibacterial solution.
D) instruct the patient in the use of an antimicrobial soap in the shower.

Question 17

A patient who has recently arrived on the surgical unit after being transferred from the postanesthesia care unit asks for a drink. The nurse should first check the:

A) status of the IV fluids.
B) ability to swallow.
C) nursing progress notes.
D) anesthesia record.

Question 18

The illiterate patient signs the surgical consent form with an "X." The nurse is aware that this "X" is:

A) not an acceptable signature.
B) required to be accompanied by a picture identification.
C) legal if it is witnessed.
D) acceptable if the surgeon is willing.

Question 19

While completing the preoperative checklist, a patient who is almost ready for transport to the operating room states that he does not want to remove his wedding band. The nurse should:

A) tape it in place on his finger.
B) remind him it must be removed, and lock it in the narcotic cabinet.
C) ask a family member to take care of it.
D) inform him that the hospital cannot be responsible for its loss.

Question 20

The nurse is assessing the surgical dressing of a patient who arrived on the unit an hour ago. The surgical dressing has serosanguineous drainage on the dressing. The nurse should:

A) make a note of the drainage on the worksheet to report it at the end of shift.
B) change the surgical dressing immediately to prevent infection.
C) outline the area of drainage with a pen and mark it with the date and time.
D) reinforce the dressing with clean gauze sponges and tape.

Question 21

The nurse explains that the informed surgical consent form should include information relative to: (Select all that apply.)

A) the procedure to be performed.
B) the related risks of the procedure.
C) consent to blood transfusion.
D) time and date signed.
E) marital status.

Question 22

To help prevent surgical site infections in the diabetic patient, the glycemic should be maintained with a blood glucose of less than _____ mg/dL.

Question 23

A nurse preparing to get a patient out of bed for the first time since surgery will initially:

A) assist the patient to sit and dangle his or her legs on the side of the bed.
B) allow the patient to sit with the head of bed raised to the high Fowler's position.
C) assist the patient from a supine position to a standing position.
D) place a walker at the side of the bed.

Question 24

A postoperative patient experiences separation of the layers of his abdominal surgical wound during coughing. Separation of the layers of a surgical wound is known as ___________.

Question 25

The nurse preparing the surgical patient's room for the patient's return from the postanesthesia unit should: (Select all that apply.)

A) fan fold the sheets on the near side of the bed.
B) lower the bed for easy transfer of the patient.
C) place an IV pole at the head of the bed.
D) gather an emesis basin, tissues, and a small towel.
E) collect extra dressing supplies and place them on the bedside table.

Question 26

A patient is ready for discharge following same day surgery. The education plan for this patient includes:

A) limiting wine intake for 12 hours.
B) reporting temperatures greater than 99° F.
C) not driving or making important decisions for 24 hours.
D) that vomiting might be an expected symptom.

Question 27

The nurse reminds the patient that the member of the surgical team who is responsible for obtaining the surgical consent is the ____________.

Question 28

The patient informs the admitting nurse that she has been drinking feverfew tea for the herbal treatment of migraine headaches. The nurse reports this to the surgeon because this herb can cause ________________.