Deck 12: Nursing Care of Patients Having Surgery

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?

A)Document the response and send the patient to surgery.
B)Notify the surgeon immediately.
C)Tell the patient to come back that afternoon.
D)Ask the patient what he ate; liquids are okay.

Answer 1

Notify the surgeon immediately.

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?

A)Reinsert the indwelling urinary catheter.
B)Notify the health care provider (HCP).
C)Perform an in-and-out catheterization.
D)Massage the patient's bladder.

Answer 2

Notify the health care provider (HCP).

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?

A)Notify the physician immediately.
B)Prepare the patient for immediate surgery.
C)Place the patient in low Fowler position.
D)Cover the wound with sterile saline-soaked towels.

Answer 3

Place the patient in low Fowler position.

Question 4

Which procedure involves removal of an organ?

A)Endoscopy
B)Urostomy
C)Angioplasty
D)Gastrectomy

Question 5

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

A)During surgery
B)1 hour prior to surgery
C)4 hours prior to surgery
D)Within the first 2 hours postoperatively

Question 6

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

A)The surgical technician is scrubbing for the OR while wearing a ring.
B)The scrub technician is wearing surgical scrubs, shoe covers, a cap, and a mask.
C)The circulating nurse sets the temperature of the OR to 74.6°F.
D)The surgeon removes his watch prior to scrubbing for the surgery.

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?

A)One large apple and a plate of leafy greens
B)One small grilled chicken breast with one small egg
C) cup of rice and cup of broccoli 4.1 cup of pasta with no sauce and a slice of bread

Question 8

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

A)Offer a hot beverage.
B)Provide an extra blanket.
C)Help the patient ambulate.
D)Apply an abdominal binder.

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?

A)Warfarin (Coumadin)
B)Regular insulin
C)Atenolol (Tenormin)
D)Gabapentin (Neurontin)

Question 10

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

A)A 32-year-old who plays volleyball daily
B)A 41-year-old who occasionally drinks
C)A 52-year-old construction worker who is vegan
D)A 65-year-old who smokes pack per day

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?

A)Give the ibuprofen as ordered for pain.
B)Consult the physician for a stronger analgesic.
C)Start the ibuprofen on the second postoperative day.
D)Hold the ibuprofen due to risk of GI upset.

Question 12

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

A)Elective
B)Emergency
C)Urgent
D)Optional

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?

A)Oxygen saturation of 82%
B)Temperature of 99.1°F
C)Pulse of 74 beats/min
D)Blood pressure 112/64 mm Hg

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?

A)Administer oxygen and continue the anesthesia and surgery.
B)Warm the patient, administer fluids, and then continue surgery.
C)Switch to a different type of anesthetic agent to continue the surgery.
D)Immediately cease anesthesia and surgery, cool patient, and administer dantrolene sodium.

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?

A)Notify the registered nurse (RN).
B)Ask why the patient is taking steroid therapy.
C)Give the oral steroid with a small sip of water.
D)Contact the pharmacy to obtain an IV equivalent dose.

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?

A)Reconstructive
B)Curative
C)Diagnostic
D)Palliative

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?

A)Restrict oral fluids.
B)Give antipyretic medication.
C)Encourage coughing and deep breathing.
D)Provide passive range of motion exercises.

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?

A)Read the consent to the patient, ask if he or she has questions, then have him or her sign.
B)Explain the risks and benefits of surgery to the patient and have him or her sign.
C)Sign the consent for the patient since the nurse was present during explanation.
D)Notify the surgeon and inform him or her the patient has not signed the form and does not understand the surgery.

Question 19

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

A)Blood urea nitrogen (BUN) of 12 mg/dL
B)Glucose of 383 mg/dL
C)Potassium of 4.1 mEq/L
D)Sodium of 140 mEq/L

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%

A)80%-85%
B)86%-90%
C)Above 90%

Question 21

The nurse is witnessing an adult patient's surgical consent. What should the nurse confirm before witnessing the surgical consent? (Select all that apply.)

A)The patient's next of kin
B)When the patient last ate or drank
C)The last time a sedative was administered
D)Whether the patient is informed about the surgery
E)If family members have questions related to the surgery

Question 22

The nurse receives an order to administer hydromorphone (Dilaudid) 1 mg IV for postoperative pain. The available dose is hydromorphone (Dilaudid) 2 mg/mL. How many mL will the nurse administer? Enter the numeral only.

Question 23

The nurse provides recommendations for the plan of care for a patient scheduled to undergo a cholecystectomy. Why should the nurse include preoperative teaching of deep-breathing exercises to prevent postoperative complications for this patient? (Select all that apply.)

A)Incisional pain promotes decreased lung expansion.
B)Anesthesia increases retention of respiratory secretions.
C)Anesthesia decreases production of respiratory secretions.
D)Location of incision contributes to decreased lung expansion.
E)Immobility after surgery promotes retention of respiratory secretions.

Question 24

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.)

A)"I should avoid deep breathing after surgery."
B)"I should take shallow breaths after surgery to prevent pain."
C)"Deep breathing and coughing helps prevent respiratory problems."
D)"I should deep breathe and cough every hour while awake."
E)"I should cough and deep breathe beginning 2 days after my surgery."

Question 25

The nurse assesses a patient's pain level to be an 8 on a 0-to-10 scale. The nurse notes the patient has an order for morphine 4 mg IV as needed for pain. The patient's blood pressure is 80/54 mm Hg, respirations 10 breaths/min, and pulse 64 beats/min. Which action should the nurse take?

A)Tell the patient he cannot have any more pain medication.
B)Administer half the dose of morphine, 2 mg IV.
C)Administer 4 mg of morphine IV as ordered.
D)Notify the RN.

Question 26

The nurse is assessing a patient who underwent an epidural block for a procedure 6 hours ago. Which findings should the nurse report to the RN? (Select all that apply.)

A)Clear fluid leaking from puncture site
B)Headache
C)Dizziness
D)Nausea
E)Oxygen saturation 97%
F)Visual disturbances

Question 27

The nurse is reviewing preoperative orders for a patient scheduled for a surgical repair of the liver. Which laboratory values should the nurse ensure are ready and placed in the chart before surgery? (Select all that apply.)

A)Potassium
B)Complete blood count
C)Type and crossmatch
D)Bleeding time
E)Amylase 6.Thyroid-stimulating hormone

Question 28

The nurse is preparing to administer cefazolin (Ancef) 1 g in 100 mL of normal saline to run over 30 minutes intravenously to a patient as a surgical prophylactic medication. At what rate will the nurse set the infusion pump? Enter the numeral only.

Question 29

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.)

A)Assist with early ambulatation.
B)Apply anti-embolic stockings.
C)Massage the patient's legs daily.
D)Place a pillow under the patient's knees.
E)Perform leg exercises 10 times hourly while awake.

Question 30

The nurse is contributing to an education program for older adults who are preparing for joint replacement surgery. Which interventions should the nurse use to enhance older patient learning? (Select all that apply.)

A)Avoid repetition in presentation.
B)Utilize medical terminology to promote understanding.
C)Provide handouts with black print on white nonglare paper.
D)Conduct session in a room with bright, fluorescent lighting.
E)Convey positive attitude and self-care promotion for older adults.

Question 31

The nurse is reinforcing discharge teaching for a patient who underwent abdominal surgery. Which statements made by the patient indicate an understanding of the teaching? (Select all that apply.)

A)"I will need to schedule a follow-up appointment with the surgeon."
B)"I can remove my own stitches in a few days; I have seen the nurse remove my son's."
C)"If the pain medication does not help with the pain, I will take an extra dose."
D)"I need to have my spouse help change my dressing every day."
E)"I will let the doctor know if I run a fever after I go home."

Question 32

The nurse is calculating the intake of a patient who underwent surgery. The patient consumed two 240-mL juice boxes, 800 mL of water, 120 mL of gelatin, and two 40-mL cups of soda. The patient also received 1 L of lactated ringer's IV. Calculate the patient's total intake (in mL). Enter the numeral only.

Question 33

The nurse reviews an order to administer lactated Ringer 1,000 mL to run over 2 hours intravenously to a patient in the recovery room. At what rate will the nurse set the infusion pump? Enter the numeral only.