Question 1

Anticholinergics such as atropine, scopolamine, and glycopyrrolate may be given to a patient preoperatively to decrease the risk for

Accepted Answer

Anticholinergics are given preoperatively to reduce secretions in the mouth and respiratory tract, which decreases the risk of aspiration during surgery.

Question 2

A nurse is working in a post-anesthesia care unit (PACU) when a patient arrives from the operating room. The nurse should provide assessments and documentation for this patient every

Accepted Answer

The recommended frequency for assessments and documentation in the PACU for a patient who has just arrived from the operating room is every 15 minutes. This allows for close monitoring of the patient's vital signs, pain level, level of consciousness, and other important parameters to ensure a smooth recovery from anesthesia. However, if the patient's condition deteriorates or there are specific concerns, assessments may need to be done more frequently.

Question 3

While caring for a patient in the surgical center, which of the following preoperative laboratory values would a nurse expect to be included in the orders?

Accepted Answer

Preoperative laboratory tests typically include a White blood cell (WBC) count to check for infection, Hemoglobin (Hgb) to assess for anemia, Platelet count (PLT) to evaluate clotting ability, and Urinalysis (UA) to detect urinary tract infections or renal function issues. Alkaline phosphatase (Alk Phos) is less commonly included unless specific liver or bone issues are suspected.

Question 4

An instructor observes a nurse conducting preoperative teaching to help reduce a patient's anxiety before surgery. The instructor should intervene if the nurse includes

Accepted Answer

Providing details of the surgical procedure may increase the patient's anxiety rather than reduce it. The nurse should focus on providing information that will help the patient feel prepared and informed, while minimizing specific details that may increase fear or anxiety.

Question 5

A nurse is caring for a patient with a history of congenital heart disease. To decrease the risk for infection and prevent bacterial endocarditis during surgery, the nurse identifies a need to administer preoperative

Accepted Answer

Antibiotics are administered to prevent bacterial endocarditis, an infection of the heart lining, valves or blood vessels. Patients with congenital heart disease are at increased risk for bacterial endocarditis during surgery, so administering prophylactic antibiotics is recommended. Anticholinergics, antiemetics, and anticoagulants do not play a role in preventing bacterial endocarditis.

Question 6

Before beginning surgery, a circulating nurse suspects that the wrong patient may be on the operating table. The first thing the nurse should do is

Accepted Answer

Calling a time-out is the best choice for the circulating nurse in this situation as it allows for a pause in the surgical procedure to confirm the correct patient, procedure, and surgical site. Checking the surgical site, consent form, and patient's identity are also important steps, but they should be done after calling a time-out.

Question 7

Most facilities require that several basic tests be performed on all patients before surgery. A nurse identifies that these tests include all of the following except

Accepted Answer

Blood urea nitrogen (BUN) is not typically a standard pre-surgery test for all patients, whereas EKG, CBC, and urinalysis are more commonly required to assess overall health and readiness for surgery.

Question 8

During standard preoperative testing, a nurse notices that a patient's urine has an elevated specific gravity. This finding is an indication that this patient is at risk for

Accepted Answer

Elevated specific gravity of urine indicates that the urine is concentrated, meaning that there is less water in the urine than usual. This suggests that the patient may be dehydrated and at risk for further dehydration during the perioperative period.

Question 9

A nurse recognizes that which of the following would be classified as elective surgeries?

Accepted Answer

Elective surgeries are those that are not urgent and can be scheduled in advance. A tonsillectomy for a child with frequent pharyngitis, a colectomy with colostomy for a young adult with Crohn disease, and a mastectomy for a woman with breast cancer are all elective surgeries.

Question 10

A nurse understands that a preoperative checklist is used to

Accepted Answer

A preoperative checklist is used for both confirming that all preoperative tasks have been completed and providing documentation. It does not provide instructions for the surgical assistant.

Question 11

To prepare the surgical environment and begin setting up sterile supplies, the first staff member to perform a surgical scrub is the

Accepted Answer

The scrub nurse is responsible for preparing the sterile field and setting up sterile supplies. They are the first staff member to perform a surgical scrub in order to maintain a sterile environment during the procedure. The circulating nurse assists with the procedure, while the anesthesia provider administers anesthesia and monitors the patient's vital signs. The RNFA is a specialized role that assists the surgeon during the procedure.

Question 12

A nurse is assisting a surgeon who will be performing a tonsillectomy. The nurse is able to identify from the descriptor ectomy that the procedure involves

Accepted Answer

The suffix -ectomy means surgical removal of a body part or tissue. Therefore, in this case, a tonsillectomy involves removal of the tonsils.

Question 13

After sending a patient to have a bowel resection, a nurse prepares the room for the patient's return. Preparations would include which of the following?

Accepted Answer

The answer of After sending a patient to have a...

Question 14

Once a patient enters the post-anesthesia care unit (PACU), a nurse's priority is the immediate application and observation of a(n)

Accepted Answer

All of the above options (pulse oximeter, EKG monitor, and blood pressure monitor) are essential for the immediate application and observation of the patient in the PACU. The pulse oximeter helps monitor the oxygen saturation level, the EKG monitor helps monitor the heart rate and rhythm, and the blood pressure monitor helps monitor the patient's blood pressure.

Question 15

Preoperative teaching provides a patient and family with the information, skills, and instructions that will

Accepted Answer

Preoperative teaching provides information about what to expect during and after surgery, as well as instructions on how to manage pain, monitor and care for surgical incisions, and prevent complications such as infection or blood clots. Having this knowledge and skill set can support optimal healing, shorten the recovery period, and prevent or reduce postoperative complications. Therefore, all of the options (A, B, and C) are correct.

Question 16

A nurse would include which of the following questions in a presurgical assessment?

Accepted Answer

A nurse would include all of the listed questions in a presurgical assessment as they are all relevant to the patient's surgical history, current health status, potential risks, and reasons for the procedure. It is important to gather as much information as possible to ensure patient safety and successful outcomes.

Question 17

The plan of care for a patient at risk for cardiac complications during the immediate postoperative period would include which of the following?

Accepted Answer

Monitoring the patient's heart rate continuously is important in identifying any fluctuations or changes that could indicate a cardiac complication. Administering intravenous fluids as ordered helps maintain fluid and electrolyte balance, which can affect cardiac function. Assessing the patient's skin color and capillary refill frequently can indicate poor perfusion and potential cardiac problems. Assessing the patient's peripheral pulses bilaterally can help identify any changes in peripheral circulation that could be indicative of cardiac complications. Evaluating for bowel sounds hourly may be important for overall postoperative care, but it is not directly related to cardiac complications.

Quiz 33: Care of the Surgical Patient