Question 1

The nurse is assisting a patient recovering from surgery on the use of an incentive spirometer.Which patient instruction is appropriate?

Accepted Answer

Instructions for incentive spirometer use include the following: Sit upright,at 45 degrees minimum,if possible.Take two normal breaths.Place mouthpiece of spirometer in mouth.Inhale deeply until target,designated by spirometer light or rising ball is reached,and hold breath for 3 to 5 seconds.Exhale completely.Perform 10 sets of breaths each hour.A.B.D.These are incorrect instructions when teaching on the use of an incentive spirometer.

Question 2

The practical/vocational nurse is preparing a patient for surgery who has asthma and is hard of hearing.Which actions are within the scope of practice for the nurse? (Select all that apply.)

Accepted Answer

All actions are within the scope of practice for a practical/vocational except for providing informed consent.E.The physician provides information for informed consent.

Question 3

The nurse is contributing to the intraoperative plan of care for a patient undergoing an appendectomy.Which statement would be an appropriate intraoperative outcome for this patient?

Accepted Answer

Risk for perioperative-positioning injury related to positioning,chemicals,electrical equipment,and effect of being anesthetized is an intraoperative concern of the nurse and has an outcome of being free from injury.A.C.These are preoperative outcomes.D.This is a postoperative outcome.

Question 4

The nurse is caring for a patient in the post anesthesia care unit (PACU).What is the nurse's priority responsibility for the patient while in this unit?

Accepted Answer

Ensuring a patent airway is the highest priority.A.C.D.These actions will be performed by the PACU nurse and are not the highest priority.

Question 5

The nurse is reviewing the medication history of a preoperative patient who is NPO.The patient is noted to have been on long-term oral steroid therapy.What action should the nurse take?

Accepted Answer

Patients on chronic oral steroid therapy cannot abruptly stop their medication even though they are told to take nothing by mouth before or after surgery.Serious complications,such as circulatory collapse,can develop if steroids are stopped abruptly.The physician should be informed so the patient's steroid therapy can be given by a parenteral route if the patient is NPO.A.The nurse needs to do more than monitor and document vital signs.B.The nurse cannot change the route of a prescribed medication.C.The nurse needs to do more than hold the medication.

Question 6

The nurse is collecting data from a patient recovering from epidural anesthetic during surgery.What finding should the nurse make a priority to report?

Accepted Answer

Hypotension can result after epidural anesthesia and is caused by sympathetic blockade causing vasodilation which reduces venous return to the heart and therefore reduces cardiac output.This finding must be reported.B.C.As the block wears off,patients feel as if their legs are very heavy and numb.This is normal.D.This is not related to the epidural.

Question 7

The home health nurse is visiting a patient recovering after an abdominal hysterectomy.Which action should the home health nurse take before promoting patient intake of oral fluids?

Accepted Answer

Patients can be hydrated and fed early for nutrition to promote healing and faster recovery.The nurse just needs to check the physician's orders for oral intake.C.D.Traditionally after GI surgery,bowel sounds were monitored by the nurse and the patient was kept NPO until flatus and bowel sounds returned.No evidence exists to support this practice.However,research about this practice shows that bowel sounds are not correlated with bowel motility and a patient's ability to safely drink and eat postoperatively.A.Pain is expected after surgical intervention and should be treated with analgesics.

Question 8

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

Accepted Answer

Studies have shown that preventing surgical site infections include giving prophylactic antibiotics within 1 hour prior to surgery (which means the actual incision time).A.The antibiotic is to be given before the surgery begins.C.This period of time is too long before the surgery begins.D.An antibiotic given after the surgery would not be a prophylactic dose.

Question 9

The nurse recommends early ambulation as ordered to be included in the plan of care for a patient recovering from surgery.Which adverse effect is the nurse planning to prevent by early ambulation?

Accepted Answer

B.Early postoperative ambulation helps prevent thrombosis.C.Peristalsis should increase to prevent the development of an ileus.A.The patient should be encouraged to cough to prevent respiratory problems.D.Wound healing is not directly aided by early ambulation.

Question 10

The nurse is caring for a postoperative patient at risk for deep vein thrombosis.Which actions should the nurse recommend be included in the patient's plan of care? (Select all that apply.)

Accepted Answer

For the patient at risk of developing deep vein thrombosis,it is important to encourage hourly leg exercises while awake,assist with early ambulation,apply knee- or thigh-length anti-embolic stockings,and give low molecular weight heparin if ordered.D.It is also important to avoid pressure under the knee from pillows to prevent clot formation.C.Legs should not be massaged,as a clot,if present,could be dislodged and become an embolus.

Question 11

The nurse has reinforced preoperative teaching with a patient about coughing and deep breathing techniques.Which patient statements indicate a correct understanding of the teaching? (Select all that apply.)

Accepted Answer

Deep breathing helps prevent the development of atelectasis.Coughing moves secretions to prevent pneumonia.They are done 10 times hourly while the patient is awake for 24 to 48 hours postoperatively.A.These exercises should be done after surgery.B.Shallow breaths are not recommended.E.This exercise should be done up to 2 days after the surgery.

Question 12

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

With malignant hyperthermia,surgery is stopped,and anesthesia is discontinued immediately.Oxygen is given,and the patient is cooled.Dantrolene sodium (Dantrium),a muscle relaxant,is given.
A.B.C.These protocols are not appropriate for the patient experiencing malignant hyperthermia.

Question 13

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

Accepted Answer

Ibuprofen can be effectively used for postoperative pain relief.B.The nurse does not need to consult the physician since the patient's pain level is 4.C.The medication is prescribed ibuprofen which the nurse should provide.D.There is no evidence to suggest that the patient will experience GI upset from the medication.

Question 14

The nurse works on a preoperative unit.For which conditions should the nurse recognize that urgent surgery is needed?

Accepted Answer

Urgent surgery is the need for an operation within 24 to 30 hours.C.D.An aortic aneurysm and ruptured appendix require emergency surgery.A.A hernia repair is elective surgery.

Question 15

A patient recovering from surgery received an IV analgesic in the post-anesthesia care unit.Upon arrival to the medical-surgical care area one hour later the patient rates pain as being 8 on a scale of 0 to 10.The patient is prescribed morphine 10 mg IM injection every 3 hours PRN.What should the nurse do?

Accepted Answer

For the first dose of an IM analgesic postoperatively,patients in pain should not have to wait the ordered time interval of the IM dose after an IV analgesic dose (i.e.,3 hours if the IM order is morphine 10 mg IM q3hr PRN).Having to wait when the IV analgesic is no longer effective can cause needless pain.IV analgesics usually have a shorter duration than IM analgesics.A.It is not known if the patient is prescribed nonnarcotic analgesics.B.The patient is not prescribed IV pain medication.C.The patient does not have to wait for pain medication.

Question 16

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?

Accepted Answer

Oxygen saturation must be above 90% for discharge.A.B.C.These oxygen saturation levels do not meet the criteria to discharge from the ambulatory surgical center.

Question 17

A patient recovering from surgery in the post-anesthesia care unit begins to thrash in bed and pull at the endotracheal tube and IV lines.For which health problem should the nurse provide care for this patient?

Accepted Answer

Until its effects wear off,anesthesia can alter neurologic function.Patients may arrive in the PACU awake,arousable,or sleeping.Patients who are sleeping should become more alert during their stay in the PACU.As they emerge from anesthesia,they may become agitated or wild acting for a short time; this is called emergence delirium.Once resolved,the patient returns to calm state and has no recollection of the episode.A.B.C.The patient recovering from anesthesia is not experiencing delusions,sundowning,or hallucinations.

Question 18

A patient scheduled for surgery expresses a fear of dying.What action should the nurse take?

Accepted Answer

Allowing patients to express concerns offers an opportunity to dispel inaccurate information about the surgical procedure.B.False reassurance does not help the patient's fears.D.National statistics are not likely helpful to the individual patient situation.A.The nurse should collect data first about the fear to help with planning care and not pass the issue to the family.

Question 19

While dangling a patient in preparation for ambulation after surgery the abdominal incision suddenly eviscerates.What action should the nurse take after positioning the patient supine with flexed knees?

Accepted Answer

After placing the patient in the low Fowler's position with the knees flexed the nurse should cover the wound with sterile dressings or towels moistened with warm sterile normal saline.Notify the physician immediately of this surgical emergency.Apply gentle pressure over the wound,and keep the patient still and calm.A.The abdomen should not be cleansed.B.Pain medication can be provided after the immediate problem is addressed.C.An abdominal binder should not be applied at this time.

Question 20

A patient with chronic obstructive pulmonary disease is scheduled for total hip replacement.What should the nurse instruct the patient about smoking before the surgery?

Accepted Answer

Patients should be encouraged to avoid smoking for at least 3 to 4 weeks before surgery if they have a chronic lung disorder.A.C.This patient needs to avoid smoking for longer than 3 to 4 or 24 hours.D.The patient should not smoke at all for 3 to 4 weeks before the surgery.

Quiz 12: Nursing Care of Patients Having Surgery