Deck 38: Perioperative Nursing

Question 1

A student nurse is observing in the operating theatre. She notices that there is a routine where two staff members count all the sponges and sharps several times during the procedure. The staff members who are responsible for this check are:

A) surgeon and circulating nurse.
B) anaesthetist and circulating nurse.
C) surgeon and instrument nurse.
D) circulating nurse and instrument nurse.

Answer 1

circulating nurse and instrument nurse.

Question 2

The nurse is preparing a 6-year-old child for a tonsillectomy. Which of the following strategies would the nurse use for teaching this client?

A) Pamphlets.
B) Play.
C) Books.
D) Involve the parents in the preoperative teaching.

Answer 2

Play.
Involve the parents in the preoperative teaching.

Question 3

The nurse is preparing a care plan for a client about to undergo surgery. Which of the following nursing diagnoses would take priority during the intraoperative phase of surgery?

A) Ineffective Protection.
B) Risk for Aspiration.
C) Impaired Skin Integrity.
D) Risk for Falls.

Answer 3

Risk for Aspiration.

Question 4

The nurse is caring for an 80-year-old client preparing for surgery. The nurse knows this client is at increased risk because:

A) the older adult will turn, cough, and deep breathe more effectively.
B) the older adult has an increase in sensory function.
C) the physiological deficits of ageing increase the surgical risk for older adults.
D) the older adult has increased kidney function.

Question 5

The nurse is preparing a 23-year-old female client for surgery. The nurse would anticipate which of the following diagnostic tests to be ordered?

A) ECG.
B) EKG.
C) Pregnancy test.
D) BUN and creatinine.

Question 6

The nurse is admitting a client to the medical-surgical unit following a cholecystectomy. Which intervention should the nurse perform first?

A) Level of consciousness.
B) Drains.
C) Dressing.
D) Skin colour.

Question 7

The nurse is preparing the skin of a client for surgery. The nurse knows the purpose of the surgical skin preparation is to:

A) assess the surgical site before surgery.
B) clean any moles the client may have.
C) reduce the risk of postoperative wound infection.
D) sterilise the skin.

Question 8

The nurse is preparing to complete a physical assessment before surgery. Which of the following should the nurse obtain?

A) Mental status.
B) Assessment of hearing.
C) Assessment of the respiratory system.
D) Gastrointestinal assessment.
E) Maintain NPO status.

Question 9

The nurse is caring for a client on the postoperative unit. Which of the following nursing diagnoses is the priority for this client?

A) Disturbed Body Image.
B) Risk for Falls.
C) Self-care Deficit.
D) Ineffective Airway Clearance.

Question 10

The nurse is obtaining preoperative assessment data. Which of the following should be included?

A) Current health status.
B) Allergies.
C) Current medications.
D) Mental status.
E) Previous surgeries.

Question 11

The nurse is caring for a client in the recovery area. Which of the following positions should the unconscious client be assuming while in the immediate post-anaesthesia phase?

A) Supine.
B) Supine with a pillow under the head.
C) Side-lying.
D) Prone.

Question 12

The nurse is assisting the client with turning, coughing, and deep breathing exercises. The client asks why this is important. How should the nurse reply?

A) "These exercises help prevent pneumonia."
B) "All surgical clients must do these exercises."
C) "These exercises prevent thrombophlebitis."
D) "The doctor ordered the exercises."

Question 13

The nurse is preparing a client for a cholecystectomy. The purpose of this surgery is which of the following?

A) Constructive.
B) Ablative.
C) Palliative.
D) Diagnostic.

Question 14

When a nurse signs a consent form as a witness, the nurse is:

A) responsible for informed consent by the client.
B) a witness to the signature only.
C) verifying that informed consent has been given.
D) breaching the code of conduct.

Question 15

The nurse is preparing to conduct preoperative teaching. Which of the following should be included?

A) Information related to what will happen to the client.
B) The role of the nurse during surgery.
C) Referral of the client to the physician for any misconceptions the client may have.
D) How to perform ADLs following surgery.

Question 16

The nurse is providing preoperative education to an elderly, blind client. In order to reduce the client's anxiety, the nurse:

A) asks the client to discuss the visit by the surgeon.
B) describes the sensory experiences through the procedure.
C) explains the need to remove all prostheses.
D) explains deep breathing techniques.

Question 17

On completing a preoperative assessment, a nurse notes that a client routinely takes a non-prescribed tranquilliser. The nurse notifies the anaesthetist because:

A) the client won't need as much anaesthetic.
B) the anaesthetist should have noted this.
C) the client is at risk for respiratory difficulties.
D) the client is at risk of delayed wound healing.

Question 18

The nurse is preparing to apply anti-emboli stockings to a postoperative client. Which of the following should be done first, before applying the stockings?

A) Clean the stockings.
B) Assess the client's blood pressure.
C) Measure the calf.
D) Assess for circulatory problems.

Question 19

The operative period that begins when the decision to have surgery is made and ends when the client is transferred to the operating table is which of the following?

A) Preoperative phase.
B) Intraoperative phase.
C) Postoperative phase.
D) Perioperative phase.

Question 20

The client is preparing for an upper GI endoscopy. Which of the following types of anaesthesia would the nurse anticipate the client to receive?

A) Epidural anaesthesia.
B) Spinal anaesthesia.
C) Local anaesthesia.
D) Conscious sedation.

Question 21

The nurse knows the surgical client is at risk for thrombophlebitis. Which of the following nursing interventions would the nurse implement to decrease the risk of this occurring?

A) Administer an anticoagulant.
B) Early ambulation.
C) Cough every two hours.
D) Intake and output every two hours.

Question 22

A nursing intervention to reduce the risk of atelectasis is:

A) leg movements hourly.
B) incentive spirometry.
C) pain relief.
D) pressure dressings.

Question 23

The nurse has just inserted a nasogastric tube for gastric suction. Which of the following is the most reliable test for confirming tube placement?

A) Place the stethoscope over the stomach and listen while inserting water into the tube for a swishing sound.
B) Place the stethoscope over the stomach and listen while inserting air into the tube for a swishing sound.
C) Aspirate stomach contents and check the acidity using a pH test strip.
D) Connect the tube to suction and observe the contents.

Question 24

The nurse is assessing an abdominal wound in the postoperative period. Which of the following signs would alert the nurse to an infection?

A) Absence of bleeding.
B) Edges well approximated.
C) Sutures in place.
D) Edges warm to the touch.

Question 25

The nurse is caring for a client in the immediate postoperative period (PACU). Which of the following interventions would the nurse implement to reduce the risk of thrombophlebitis?

A) Leg exercises.
B) Cough every two hours.
C) Ambulate every two hours.
D) Oxygen by mask.