Deck 36: Caring for Perioperative Clients

Question 1

Which of the following laboratory tests are performed to help determine the nutritional status of a client considered high risk for heart surgery?

A)Complete blood count
B)Cardiac enzymes
C)Troponin
D)Albumin and pre-albumin

Answer 1

Albumin and pre-albumin

Question 2

The operating room nurse is preparing Mr.Jacobs's skin for femoral bypass surgery.What is the purpose of the skin preparation prior to surgery?

A)Sterilize the skin by killing all organisms
B)Remove operative site hair by shaving
C)Assess the surgical site for abrasions and wounds
D)Reduce the risk of post-operative wound infection

Answer 2

Reduce the risk of post-operative wound infection

Question 3

Mrs.Oliver,55 years old,is booked for a vaginal hysterectomy.Prior to admission to the hospital she had an appointment to have an admission history and diagnostic tests done.In which operative phase,is Mrs.Oliver in now?

A)Preoperative phase
B)Intraoperative phase
C)Post-operative phase
D)Perioperative period

Answer 3

Preoperative phase

Question 4

Mr.Morris has an incision with a penrose drain.How would the nurse change the dressing on Mr.Morris?

A)Remove the old dressing with a sterile glove
B)Clean the incision first,then around the drain
C)Use one swab to clean all around the drain
D)Place most of the dressings above the drain site to absorb the drainage

Question 5

On the morning of his surgery,Mr.Pollard tells the nurse that he takes St John's wort regularly.Why is it important that the nurse pass this information along to the surgeon and anaesthetist?

A)When it is combined with some anaesthetic agents,it may cause hemorrhage.
B)It potentiates the hypotensive action of some anaesthetic agents.
C)It decreases the antiinflammatory response required for healing.
D)It causes hypoglycemia when taken along with anaesthetic agents.

Question 6

Ms.Farron is a nursing student completing an observation shift in the OR.After completion of the surgery,she asks the scrub nurse what impact the use of surgical safety checklists have had on client outcomes.What would the nurse respond?

A)Decreased complications
B)Decreased lawsuits
C)Decreased wait times
D)Mortality rates stable

Question 7

Which of the following clients would be the best candidate for a general anaesthetic?

A)Mrs.Caron,who is anxious about a right mastectomy that cannot be postponed
B)Mr.Richards,who is having a minor surgical procedure done same-day surgery
C)Mrs.Alice,who has a serious chronic respiratory problem
D)Mr.George,who has circulatory insufficiency

Question 8

On her second post-op day,an X-ray determines that Mrs.Edwards has bilateral atelectasis.She is not showing any clinical signs at this time.What initial interventions should be recommended by the nurse?

A)Encourage deep breathing and coughing
B)Encourage ambulation
C)Encourage adequate intake of fluids
D)Oxygen by cannula

Question 9

Mr.Comartin has returned to the surgical unit with a nasogastric (NG)tube in place.How can the nurse confirm that the NG tube is in the stomach?

A)Listen over the stomach for a swishing sound when air is injected into the NG tube
B)Ask Mr.Comartin to swallow and check him to see if the gag reflex is present
C)Check the NG tube aspirate for acidity using a pH strip
D)Connect the NG tube to suction and observe the aspirate

Question 10

Mrs.Koloneles has had her surgery and is transferred to the PACU.Which of the following interventions would the nurse implement to reduce the risk of thrombophlebitis?

A)Oxygen by mask
B)Deep breathing and coughing
C)Ambulate every 2 hours
D)Leg exercises

Question 11

Mrs.Oliver,55 years old,is booked for a vaginal hysterectomy.She is 165 cm tall and weighs 120 kg.She has recently recovered from an upper respiratory infection and has diabetes mellitus for which she takes Humulin N insulin at bedtime.Which of the following factors increases her surgical risk?

A)Her age
B)Her BMI
C)Malnutrition
D)Upper respiratory infection (URI)

Question 12

Mrs.Maddison,25,is preparing for an upper GI endoscopy.Which of the following types of anaesthesia would the nurse anticipate she will receive?

A)Local anaesthesia
B)General anaesthesia
C)Surface anaesthesia
D)Conscious sedation

Question 13

Mr.Elliott is scheduled to have a bowel resection in 1 hour.He has been fasting since midnight and states that his mouth is very dry.What can the nurse suggest for Mr.Elliott?

A)Offer him a small sip of water or some ice chips
B)Give him a piece of hard candy to suck on
C)Explain that he cannot have anything by mouth until after surgery
D)Encourage him to brush his teeth and rinse his mouth,but not to swallow the water

Question 14

Mr.Clifton's abdomen is distended and firm to touch.He has a rapid,weak pulse.What post-operative complication is Mr.Clifton most likely experiencing?

A)Paralytic ileus
B)Infection
C)Post-operative hemorrhage
D)Pneumonia

Question 15

The nurse is preparing Mr.Drever for surgery.He has diabetes and takes Humulin N at bedtime.Given his history,what diagnostic tests are most likely before the surgery?

A)INR
B)BUN and Creatinine
C)Fasting blood glucose
D)Chest X-ray

Question 16

Eighty year-old Mr.Janisse has arrived on the surgical unit following a right femoral bypass.He has chronic obstructive pulmonary disease (COPD),as a result of many years of smoking.Which of the following nursing interventions is of most importance to Mr.Janisse's general recovery?

A)Explaining how to perform leg exercises
B)Restricting fluid intake to less than 1000 mL
C)Ambulating Mr.Janisse to the end of the hall and back every 2 hours
D)Having Mr.Janisse demonstrate coughing and deep breathing

Question 17

Mr.Jeffries is booked for surgery in 2 hours.The nurse is organizing her teaching prior to surgery.Which of the following should the nurse include in Mr.Jeffries's preoperative preparation?

A)Post-operative complications
B)Exercises to perform to prevent complications
C)A written description of the surgery
D)The potential side effects of the anaesthetic to be administered

Question 18

Jane has returned from the PACU to the surgical unit.Which of the following nursing interventions should the nurse do first?

A)Check to see if the correct intravenous (IV)solution is hanging
B)Check to see in what position Jane should be placed
C)Check for estimated blood loss
D)Check the appropriate health care provider's orders

Question 19

Mr.Pollard,72 years old,is scheduled for a hernia repair at 8 am the following morning.He is in the preoperative clinic having lab work drawn and an EKG.What statement by Mr.Pollard to the nurse would prompt the need for further health teaching?

A)I should take all my medications the morning of surgery.
B)I will get pain medication regularly after surgery.
C)Deep breathing and coughing will help my recovery.
D)I need to shower with chlorhexidine wash the morning of surgery.

Question 20

The nurse is caring for Mrs.Blok in the PACU after a right pneumonectomy.In the immediate post-anaesthesia phase,which of the following positions should Mrs.Blok be placed in until she regains consciousness?

A)Supine
B)Prone
C)Side-lying
D)Semi-Fowlers

Question 21

Prior to an exploratory laparotomy,60-year-old Mrs.Lily has screening tests performed.Which of the following tests provides information about red and white blood cells and the oxygen carrying capacity of the blood?

A)Blood urea nitrogen (BUN)
B)Blood grouping and cross-matching
C)Serum albumin and total protein
D)Complete blood count (CBC)

Question 22

Sixty-year-old Mrs.Lily develops sudden chest pain on her third post-operative day.She is diagnosed with a pulmonary embolism.Which of the following nursing interventions would help prevent a pulmonary embolism?

A)Early ambulation
B)Deep breathing and coughing exercises
C)Incisional splinting
D)Monitoring intake and output

Question 23

Mrs.Reddy,78 years old,had an abdominal hysterectomy 2 days ago.She has a history of COPD.Which of the following assessment findings would prompt further action by the nurse?

A)Oxygen saturation of 92%
B)Every 4 hour requests for pain medication
C)Urine output < 30 mL per hour
D)Redness and swelling at the wound edges

Question 24

Mrs.Monaghan has terminal cancer.She has decided not to pursue any further curative treatments.She does agree to the removal of a small tumour that is compressing her small bowel.What type of surgery is this considered?

A)Exploratory
B)Ablative
C)Diagnostic
D)Palliative

Question 25

List three responsibilities of the nurse planning the perioperative nursing care for Mr.Kent,who is having an endoscopic gastroscopy.

Question 26

The nurse is applying antiembolism stockings to Mr.Clifton,a 75-year-old man with circulatory problems.What is the purpose of antiembolism stockings?

A)Facilitate venous return to the heart
B)Ensure mobility and prevent contractures
C)Prevent varicose veins in the legs
D)Prevent atrophy of the leg muscles

Question 27

Mr.Chester returns from post-anaesthesia recovery room following an abdominal aneurism repair.He has a midline incision with a hemovac drain in place.What should the nurse do first after emptying the drain for 80 mL of sanguineous drainage?

A)Hand hygiene
B)Report output to the physician
C)Document output on health record
D)Cleanse opening with alcohol,close opening

Question 28

The nurse is assessing Mr.Clarence's abdominal wound.Which of the following signs would alert the nurse to an infection?

A)Absence of bleeding
B)Edges well approximated
C)Edges warm to the touch
D)Sutures in place