Question 1

The LPN/LVN is taking a history on a patient who is scheduled for surgery in which he was to remain NPO after midnight. The nurse asks the patient when he last had something to eat, to which the patient replies, "About 2 hours ago." Which action should the nurse take?

Accepted Answer

Eating within a short period before surgery can increase the risk of aspiration during anesthesia. It is important to notify the surgeon immediately to assess the situation and decide on the best course of action.

Question 2

The nurse is caring for a patient who underwent a colostomy yesterday morning. The nurse removed the catheter 1 hour after surgery, and the patient has not yet voided. Which action should the nurse take?

Accepted Answer

It is important to notify the health care provider if a patient has not voided within a reasonable time frame after catheter removal, typically 6-8 hours, to assess for potential urinary retention or other complications. The other options may be considered based on the HCP's assessment and orders.

Question 3

The nurse answers a patient's call light and finds the patient sitting up in bed with a wound evisceration. What action should the nurse take first?

Accepted Answer

C

Question 4

Which procedure involves removal of an organ?

Accepted Answer

Gastrectomy involves the removal of a part or the whole stomach, which is an organ.

Question 5

The nurse is assisting in the surgical holding area. When should the nurse administer a prophylactic antibiotic to a patient?

Accepted Answer

Administering a prophylactic antibiotic 1 hour prior to surgery is recommended to ensure adequate tissue levels of the antibiotic during the surgery to help prevent surgical site infections.

Question 6

The LPN/LVN is assisting in the operating room (OR). Which practice requires correction by the nurse?

Accepted Answer

Wearing jewelry, such as a ring, while scrubbing for surgery is against aseptic principles because it can harbor bacteria and compromise the sterile field.

Question 7

The nurse is teaching a patient about following a high-protein diet before and after surgery to promote healing. Which food choice made by the patient indicates an understanding of the teaching?

Accepted Answer

The answer of The nurse is teaching a patient about...

Question 8

A patient recovering from an abdominal hysterectomy is experiencing abdominal gas pain. Which action should the nurse take?

Accepted Answer

Ambulation helps stimulate peristalsis and can relieve gas pain by promoting the passage of gas through the intestines.

Question 9

The nurse is taking a medication history of a patient who is to undergo surgery the next morning. Which medication requires immediate notification of the surgeon?

Accepted Answer

Warfarin (Coumadin) is an anticoagulant that increases the risk of bleeding during surgery. It is crucial for the surgeon to be aware of a patient taking Warfarin to manage the risk appropriately.

Question 10

The nurse is caring for a group of patients about to undergo surgery. Which patient is at highest risk for surgical complications?

Accepted Answer

The answer of The nurse is caring for a group...

Question 11

A patient recovering from hernia repair surgery reports pain level of 4 on a 0-to-10 scale. The patient's orders include ibuprofen (Motrin) 400 mg orally every 6 hours prn (as needed) for pain. Which action should the nurse take?

Accepted Answer

Ibuprofen is an appropriate choice for managing mild to moderate pain, as indicated by a pain level of 4 on a 0-to-10 scale. The order for ibuprofen every 6 hours as needed provides the nurse with the discretion to administer the medication for pain management.

Question 12

A patient is preparing to undergo an appendectomy for a ruptured appendix. Which level of urgency is this surgery?

Accepted Answer

A ruptured appendix is a medical emergency that requires immediate surgery to remove the appendix and prevent widespread infection or peritonitis. Therefore, the surgery is classified as an emergency.

Question 13

The licensed practical nurse/licensed vocational nurse (LPN/LVN) is working in the postoperative care unit. Which assessment finding should be reported to the RN?

Accepted Answer

An oxygen saturation of 82% is significantly below the normal range (95-100% for most patients), indicating potential hypoxemia which requires immediate attention and intervention by a registered nurse (RN) or physician.

Question 14

The nurse is assisting during surgery when a patient develops malignant hyperthermia. Which protocol should the nurse prepare to assist with as directed?

Accepted Answer

Malignant hyperthermia is a life-threatening condition triggered by certain anesthetic agents, leading to a hypermetabolic state. Immediate cessation of triggering agents, cooling of the patient, and administration of dantrolene sodium, a muscle relaxant that mitigates the hypermetabolic process, are critical steps in the management of this emergency.

Question 15

A patient who is NPO (nothing by mouth) for scheduled surgery has been on long-term oral steroid therapy and should receive a dose of Prednisone 10 mg by mouth at 0600. Which action should the nurse take?

Accepted Answer

The patient is NPO (nothing by mouth) for scheduled surgery, so the nurse should notify the registered nurse (RN) to determine the appropriate course of action.

Question 16

The nurse is caring for a patient with stage IV lung cancer who is preparing to undergo surgery. What is most likely the purpose of the surgery?

Accepted Answer

Palliative surgery is often used in advanced stages of cancer, like stage IV lung cancer, to relieve symptoms or improve quality of life rather than to cure the disease.

Question 17

The nurse is caring for a patient who has developed an increased temperature during the first 24 hours postoperatively. Which action should the nurse take?

Accepted Answer

Encouraging coughing and deep breathing can help prevent atelectasis, a common cause of fever in the first 24 hours postoperatively.

Question 18

The nurse is caring for a patient who is about to undergo a mastectomy. The nurse notes that the patient has not signed the consent. The patient tells the nurse, "The doctor didn't explain the risks of the surgery to me." Which action should the nurse take?

Accepted Answer

The nurse should notify the surgeon that the patient has not signed the consent form and does not understand the surgery. It is the responsibility of the surgeon to explain the procedure, including risks and benefits, and obtain informed consent from the patient.

Question 19

The nurse is reviewing laboratory values for a patient who will undergo surgery. Which value requires notification of the surgeon?

Accepted Answer

A glucose level of 383 mg/dL is significantly elevated and could indicate poorly controlled diabetes or acute stress response, which can increase surgical risk and complications. The surgeon needs to be informed to manage the patient's condition appropriately before proceeding with surgery.

Question 20

The nurse is caring for a patient after ambulatory surgery. Which oxygen saturation level should the nurse use as evidence that the patient is ready for discharge? 1.70%-79%

Accepted Answer

An oxygen saturation level above 90% is generally considered acceptable and indicates that the patient is maintaining adequate oxygenation, which is a key factor in determining readiness for discharge after surgery.

Quiz 12: Nursing Care of Patients Having Surgery