Deck 4: Care of Preoperative and Intraoperative Surgical Patients

Question 1

The nurse is caring for a patient who has received epoetin alfa (Epogen)2 to 3 weeks prior to a scheduled surgery.The nurse understands that this patient will likely:

A)require an antibiotic immediately prior to surgery.
B)have difficulty with blood clotting following surgery.
C)not require a blood transfusion during surgery.
D)develop an electrolyte imbalance during surgery.

Answer 1

not require a blood transfusion during surgery.

Question 2

The presurgical patient asks why it is that her height and weight are recorded.The nurse replies that the information is essential for:

A)calculating anesthesia dose.
B)predicting blood loss.
C)assessing respiratory volume.
D)anticipating fluid needs.

Answer 2

calculating anesthesia dose.

Question 3

The nurse is planning care for four postoperative patients.The nurse determines that the patient who is most likely to develop postoperative complications is the patient who is:

A)36 years old with a history of controlled diabetes.
B)52 years old with a history of hypothyroidism.
C)45 years old with a history of a myocardial infarction (MI).
D)79 years old with mild osteoarthritis.

Answer 3

79 years old with mild osteoarthritis.

Question 4

The nurse recognizes a need for further instruction about the emotional preparation for surgery when a patient says:

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 5

The patient has just been given medication to reverse neuromuscular blocking agents.The nurse is aware that the patient is in the general anesthetic stage of:

A)induction.
B)introduction.
C)emergence.
D)maintenance.

Question 6

The patient questions the nurse about robotics surgery.The nurse correctly responds,"Robotics: (Select all that apply.)

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

Question 7

The nurse warns the patient that,in order to retard the growth of microorganisms,the operating room is kept at a temperature of _____ to _____ degrees.

A)60; 65
B)66; 70
C)71; 74
D)75; 77

Question 8

During the course of surgery,a patient exhibits tachycardia,diaphoresis,and rising body temperature.The priority intervention by the circulating nurse is to:

A)continue to 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 9

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

A)record in the chart that the patient refused to remove 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 10

The nurse is caring for a postsurgical patient whose surgical procedure lasted 3 hours.The nurse anticipates that the patient will experience:

A)thrombophlebitis.
B)muscle spasms.
C)joint pain.
D)hyperthermia.

Question 11

Noting that the Asian patient was given atropine as a preoperative drug,the nurse will closely monitor for:

A)oliguria.
B)hyperventilation.
C)hypotension.
D)tachycardia.

Question 12

The nurse explains that the National Patient Safety Goals protocol requires that:

A)a licensed caregiver accompany the patient to the operating room.
B)side rails should be raised and head of bed elevated 30 degrees.
C)surgical site be verified and marked.
D)all prosthetic devices be identified.

Question 13

The nurse is aware that the 82-year-old patient returning from surgery will need special attention relative to:

A)combating thirst.
B)maintaining respiratory status.
C)stabilizing blood pressure.
D)maintaining core body temperature.

Question 14

The nurse clarifies that the difference between regional anesthesia and procedural sedation anesthesia is that procedural sedation anesthesia uses:

A)IV sedation and regional anesthesia.
B)general anesthesia and IV sedation.
C)alternative medicine herbs and regional anesthesia.
D)IV sedation and local anesthesia.

Question 15

The nurse explains that the person responsible for verifying that the consent form is signed and that the surgical site is marked is the:

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

Question 16

The nurse is reviewing the presurgical patient's lab reports and notes an elevated aspartate aminotransferase (AST)and bilirubin.The nurse is most concerned that this patient is at risk for:

A)excessive bleeding during or after surgery.
B)an increased serum albumin level.
C)postsurgical respiratory infection.
D)delayed wound healing.

Question 17

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." Which response by the charge nurse is correct?

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 18

Prior to administering the preoperative medication of Demerol and atropine,the nurse should confirm that:

A)a family member is present.
B)underwear is removed.
C)a consent form is signed.
D)bed rails are up.

Question 19

The nurse is performing a preoperative assessment on a patient scheduled for surgery today.The patient reports a history of drinking 2 glasses of wine daily,smoking cigarettes for 20 years,completing a round of corticosteroids for asthma control 2 days ago,and taking the last dose of passion flower extract yesterday.The nurse's best action is:

A)supply the patient with information on a smoking cessation class.
B)warn the patient regarding the dangers of drinking alcohol on a daily basis.
C)provide the patient with information regarding the use of herbal medications.
D)notify the physician immediately regarding the recent use of corticosteroids.

Question 20

The patient received a preoperative dose of lorazepam (Ativan)20 minutes ago.The safety precaution the nurse should take in regard to this drug is to:

A)monitor respiratory status.
B)raise bed rails.
C)elevate the head of the bed 30 degrees.
D)take seizure precautions.

Question 21

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 22

The nurse instructs the presurgical patient that hypothermia may occur during surgery due to: (Select all that apply.)

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 23

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

Question 24

The nurse reinforces that the purpose of preoperative medication is to: (Select all that apply.)

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

Question 25

The nurse working in a surgeon's office is providing preoperative teaching to a patient who is scheduled for a needle breast biopsy.Which statement by the patient demonstrates a need for further preoperative teaching? (Select all that apply.)

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 26

The nurse determines that the patient demonstrates an understanding of preoperative teaching with which responses? (Select all that apply.)

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 27

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

Question 28

The nurse is aware that the older adult is a greater surgical risk because the older adult has: (Select all that apply.)

A)fewer physiologic reserves.
B)more probability of a chronic illness.
C)more vulnerability to fluid loss.
D)less tolerance for pain.
E)less psychological stamina.