Deck 48: Care of Surgical Patients

Question 1

The nurse is working in a postoperative care unit in an ambulatory surgery centre.Of the following patients that have come to have surgery,which one is at the greatest risk during surgery?

A) A 78-year-old taking an analgesic agent
B) A 43-year-old taking corticosteroids
C) A 27-year-old taking an anticoagulant agent
D) A 10-year-old taking an antibiotic agent

Answer 1

C

Question 2

An appendectomy is appropriately documented by the nurse as which following type of surgery?

A) Diagnostic surgery
B) Palliative surgery
C) Ablative surgery
D) Reconstructive surgery

Answer 2

C

Question 3

Which of the following lab results would cause the nurse to prepare to administer preoperative IV fluid replacement?

A) Fasting glucose 3.3 mmol/L
B) Serum creatinine 62 mcmol/L
C) BUN 8.9 mmol/L
D) International normalized ratio 1.01

Answer 3

C

Question 4

The patient is in the PACU recovering from a hysterectomy.Which one of the following is a normal expectation for the patient in this stage of recovery?

A) Returned normal bowel sounds on auscultation
B) Pain that is relieved with noninvasive comfort measures
C) Voluntary bladder control and function
D) A subdued level of consciousness and neurological function

Question 5

An obese patient is admitted for abdominal surgery.The nurse recognizes that this patient is more susceptible to which of the following postoperative complications?

A) Anemia
B) Seizures
C) Protein loss
D) Dehiscence

Question 6

The nurse is completing the preoperative checklist for an adult patient who is scheduled for an operative procedure later in the morning.Which preoperative assessment finding for this patient indicates a need to contact the anaesthesiologist?

A) Temperature 39ºC
B) Pulse 90 beats per minute
C) Respirations 20 breaths per minute
D) Blood pressure 130/74 mm Hg

Question 7

The nurse is evaluating the patient in the hospital's postanaesthesia care unit (PACU)and determines that the Aldrete score is 8.Based on this assessment,which of the following does the nurse anticipate will happen?

A) The patient will be sent to the intensive care unit.
B) The patient will be discharged back to his room on the nursing unit.
C) The patient will remain in the PACU until the score improves.
D) The patient will return to the operating room for surgical evaluation.

Question 8

Which of the following is classified as an urgent surgery?

A) Hernia repair due to a work-related injury
B) Cholecystectomy related to presence of stones
C) Appendectomy for a perforated appendix
D) Breast reconstruction after a previous motor vehicle accident injury one year before

Question 9

A 43-year-old patient is scheduled to have a gastrectomy.Which one of the following is a major preoperative concern?

A) The patient's brother had a tonsillectomy at 11 years of age.
B) The patient smokes a pack of cigarettes a day.
C) An intravenous (IV) infusion is present.
D) The patient has a history of employment as a computer programmer.

Question 10

In the morning,the patient had surgery that involved the right femoral artery.To assess the patient's circulation status to the right leg,at which site will the nurse make sure to check the pulse?

A) Radial artery
B) Ulnar artery
C) Brachial artery
D) Dorsalis pedis artery

Question 11

The nurse is completing the preoperative checklist for an adult female patient who is scheduled for an operative procedure later in the morning.Which preoperative assessment finding would the nurse report to the surgeon?

A) Hemoglobin 90 g/L
B) Creatinine 50 mcmol/L
C) Blood urea nitrogen (BUN) 3.0 mmol/L
D) Platelets 200 ´ 109 cells/L

Question 12

The patient is scheduled for abdominal surgery and has just received the preoperative medications.Which of the following actions should the nurse take to assure the patient's safety?

A) Keep the patient quiet.
B) Obtain the consent.
C) Prepare the skin at the surgical site.
D) Raise the side rails on the bed or stretcher.

Question 13

The patient tells the nurse,"Blowing into this tube thing (incentive spirometer)is a ridiculous waste of time." Which one of the following does the nurse tell the patient is the specific purpose of using an incentive spirometer?

A) It directly removes excess secretions from the lungs.
B) It increases pulmonary circulation.
C) It promotes optimal lung expansion.
D) It stimulates the cough reflex.

Question 14

The patient will have an incision in the lower left abdomen.Which of the following measures by the nurse will help decrease discomfort in the incisional area when the patient coughs postoperatively?

A) Applying a splint directly over the lower abdomen
B) Keeping the patient flat with feet flexed
C) Turning the patient onto the right side
D) Applying pressure above and below the incision

Question 15

A 92-year-old patient is scheduled for a colectomy.Which of the following physiological changes accompanies the aging process and increases this patient's risk for surgery?

A) An increased tactile sensation
B) An increased metabolic rate
C) A relaxation of arterial walls
D) Reduced glomerular filtration

Question 16

When speaking with the patient,the nurse discovers that the patient does not have a complete understanding of the surgical procedure.Which of the following courses of action should the nurse take?

A) Obtain the consent, as this is expected with preoperative anxiety.
B) Teach the patient all about the procedure.
C) Ask the unit manager to assist with a teaching plan.
D) Inform the surgeon, so that necessary information can be provided to the patient.

Question 17

Which of the following is one of the greatest risks of general anaesthesia?

A) Hypertension
B) Cardiovascular depression
C) Oral mucosa damage
D) Tachypnea

Question 18

Coughing postoperatively is contraindicated following which type of surgery?

A) Eye surgery
B) Chest surgery
C) Thoracic surgery
D) Perineal surgery

Question 19

Which drug class may interact with anaesthetic agents to cause bradycardia,hypotension,and impaired circulation?

A) Diuretics
B) Antibiotics
C) Anticoagulants
D) Antihypertensives

Question 20

In the postoperative period,the nurse recognizes that which one of the following is an early sign of malignant hyperthermia?

A) Fever
B) Tachycardia
C) Muscle relaxation
D) Skin pallor

Question 21

On admission to the PACU,in which manner does the nurse position the patient who has no orthopaedic or neurological restrictions?

A) With the bed flat and the patient's arms to the sides
B) With the patient's neck flexed and body in prone position
C) With the patient in side-lying position
D) With the patient's arms crossed over the chest and the bed in high Fowler's position