Deck 4: Care of Preoperative and Intraoperative Surgical Patients

Question 1

The nurse is caring for a patient who has just been given medication to reverse neuromuscular blocking agents.The nurse is aware that the patient is in which general anesthetic stage?

A) Induction
B) Introduction
C) Emergence
D) Maintenance

Answer 1

Emergence

Question 2

Which action should the nurse take prior to administering the preoperative doses of Demerol and atropine?

A) Ensure that a family member is present.
B) Remove the patient's underwear.
C) Verify that a consent form is signed.
D) Raise each of the bed rails.

Answer 2

Verify that a consent form is signed.

Question 3

The nurse warns the patient that,in order to retard the growth of microorganisms,the operating room temperature must be maintained in which range?

A) 60 to 65° F
B) 66 to 70° F
C) 71 to 74° F
D) 75 to 77° F

Answer 3

66 to 70° F

Question 4

The nurse is caring for a presurgical patient.The patient asks the nurse why her height and weight are recorded.How should the nurse respond?

A) "This information helps us to correctly calculate the anesthesia dose."
B) "Height and weight are important predictors of blood loss."
C) "This information is used to assess respiratory volume."
D) "Height and weight help us anticipate your fluid needs."

Question 5

Which patient statement indicates a need for further instruction about the emotional preparation for surgery?

A) "I'm going to hug my surgeon tomorrow."
B) "My fate is in the hands of my surgeon. I'm frightened about the outcome."
C) "I'll be ready for a cheeseburger when I get back."
D) "I know I may have some pain, but this gallbladder will be gone when I wake up."

Question 6

The nurse is caring for an 82-year-old presurgical patient.Which abnormal finding is most important for the nurse to report immediately?

A) Respiratory rate of 22 breaths/min
B) Report of extreme thirst
C) Dizziness
D) Temperature of 99.8° F

Question 7

During the course of surgery,a patient exhibits tachycardia,diaphoresis,and rising body temperature.Which is the circulating nurse's priority intervention?

A) Monitor the patient for any further changes in condition.
B) Note the patient's oxygen saturation and blood pressure.
C) Ask the scrub nurse to verify the assessment findings.
D) Alert the anesthesiologist and surgeon immediately.

Question 8

The nurse is planning care for four postoperative patients.Which patient is most likely to develop postoperative complications?

A) 36-year-old with a history of controlled diabetes
B) 62-year-old with a history of hypothyroidism
C) 49-year-old with a history of a myocardial infarction (MI)
D) 76-year-old with mild osteoarthritis

Question 9

The nurse is caring for a postsurgical patient whose surgical procedure lasted 3 hours.Which complication should the nurse anticipate?

A) Thrombophlebitis
B) Muscle spasms
C) Joint pain
D) Hyperthermia

Question 10

The LPN/LVN is in the patient's room while the charge nurse is obtaining the patient's signature on the surgical consent form.The patient states,"I didn't really understand what my surgeon explained,but I trust him completely." How should the nurse respond?

A) "I need to contact your surgeon so your questions can be answered."
B) "I can answer any questions that you might have regarding your surgery."
C) "As long as you are comfortable, then you may sign the consent form."
D) "Maybe we should call your surgeon to be sure it is okay to sign the consent."

Question 11

The nurse is caring for a patient in the immediate preoperative period.Which action best demonstrates compliance with the National Patient Safety Goals protocol?

A) The nurse accompanies the patient to the operating room.
B) The nurse raises all side rails and elevates the head of the bed to 30 degrees.
C) The nurse verifies and marks the surgical site.
D) The nurse identifies all prosthetic devices before the time-out.

Question 12

The nurse is caring for an Asian patient who received atropine as a preoperative drug.For which problem should the nurse should carefully monitor the patient?

A) Oliguria
B) Hyperventilation
C) Hypotension
D) Tachycardia

Question 13

The patient received a preoperative dose of lorazepam (Ativan)20 minutes ago.Which safety precaution should the nurse take?

A) Monitor respiratory status.
B) Raise the bed rails.
C) Elevate the head of the bed 30 degrees.
D) Take seizure precautions.

Question 14

The nurse is reviewing the presurgical patient's laboratory reports and notes an elevated aspartate aminotransferase (AST)and bilirubin.The nurse understands that this patient is most at risk for which potential complication?

A) Excessive bleeding during or after surgery
B) An increased serum albumin level
C) Postsurgical respiratory infection
D) Delayed wound healing

Question 15

The nurse clarifies the difference between regional anesthesia and procedural sedation anesthesia.Which statement about procedural sedation anesthesia is true?

A) Procedural sedation anesthesia uses both intravenous (IV) sedation and regional anesthesia.
B) Procedural sedation anesthesia uses both general anesthesia and IV sedation.
C) Procedural sedation anesthesia uses both alternative medicine herbs and regional anesthesia.
D) Procedural sedation anesthesia uses both IV sedation and local anesthesia.

Question 16

The nurse is caring for a patient who has received epoetin alfa (Epogen)2 to 3 weeks prior to a scheduled surgery.Which statement best explains the goal for Epogen administration prior to surgery?

A) The patient will only require a single antibiotic immediately prior to surgery.
B) The patient will have greater numbers of white blood cells (WBCs) following surgery.
C) The patient will not require a blood transfusion during surgery.
D) The patient will maintain stable potassium levels during surgery.

Question 17

The nurse is performing a preoperative assessment on a patient scheduled for surgery today.The patient reports drinking two glasses of wine daily,smoking one pack of cigarettes daily × 20 years,completing a round of corticosteroids for asthma control 2 days ago,and taking a dose of passion flower extract yesterday.Which action should the nurse take next?

A) Supply the patient with information on a smoking cessation class.
B) Educate the patient regarding the dangers of drinking alcohol on a daily basis.
C) Provide the patient with information regarding the dangers of using herbal medications.
D) Notify the physician immediately regarding the patient's recent use of corticosteroids.

Question 18

The patient refuses to take off her diamond wedding band prior to going to the operating room.What action should the nurse take first?

A) Document the patient's refusal to remove the jewelry.
B) Tape the ring to finger, covering the ring.
C) Request that the patient sign a waiver to release the hospital from responsibility.
D) Alert the surgery team to the presence of the jewelry.

Question 19

The patient questions the nurse about robotics surgery.Which information should the nurse include?

A) "Robotics gives the surgeon greater magnification than the human eye."
B) "Robotics allows the surgeon to be more precise than normal."
C) "Robotics allows for a smaller incision."
D) "Robotics increases healing time."
E) "Robotics procedures generally cause less postoperative pain."

Question 20

Which person is responsible for verifying that the consent form is signed and that the surgical site?

A) The scrub nurse
B) The surgeon
C) The anesthesiologist
D) The circulating nurse

Question 21

Which factor(s)may contribute to hypothermia during surgery?

A) Warm atmosphere of the operating room
B) Infusion of cool IV fluids
C) Inhalation of cool anesthetic gases
D) Exposure of body surfaces
E) Lowered metabolism

Question 22

The nurse reminds the patient that in laparoscopic surgery,with the small incision and less tissue trauma,there is less pain because of the diminished ______________.

Question 23

The _____________functions within the sterile area of the operating room and maintains sterile technique.

Question 24

A(n)________________ allows a patient to donate her own blood to be used during or after surgery.

Question 25

Which physiological change(s)explain why the older adult is at greater surgical risk?

A) Fewer physiologic reserves
B) Greater probability of a chronic illness
C) Greater vulnerability to fluid loss
D) Less tolerance for pain
E) Less psychological stamina

Question 26

The nurse is providing preoperative teaching to a patient who is scheduled for a needle biopsy of the breast.Which statement(s)demonstrate(s)a need for further preoperative teaching?

A) "This procedure will help the doctor determine if I have breast cancer."
B) "I will most likely have general anesthesia since this is a painful procedure."
C) "The surgeon will need to perform this procedure within the next 24 to 48 hours."
D) "I will have less breast pain after having this procedure performed."
E) "I will not require any further treatment after this procedure is performed."

Question 27

Which responses indicate to the nurse that the patient understands preoperative teaching?

A) "I will need to sign a consent form before I am given my medications prior to my surgery."
B) "The surgeon will want me to ambulate as soon as possible after my surgery."
C) "My nurse will want me to take the deepest breaths I can tolerate following my surgery."
D) "I may experience some constipation if I am taking much pain medication after my surgery."
E) "The general anesthesia will prevent me from having pain for the first 24 hours after surgery."

Question 28

What are the purposes of preoperative medication?

A) To reduce anxiety
B) To decrease mucus secretion
C) To counteract nausea
D) To synergize anesthesia
E) To enhance ventilation