Deck 8: Preop

Question 1

Which of the following is a preoperative patient preparation procedure that may help to reduce the risk of infection as a result of surgery?

A)Keeping the preoperative visit as short as possible.
B)Wearing a mask, sterile gloves, gown and shoe covers when interacting with the patient.
C)Performing regular dressing changes to keep the incision clean and dry.
D)Taking careful measures to avoid contaminating the sterile field.

Answer 1

Keeping the preoperative visit as short as possible.

Question 2

Upon admission, a patient's laboratory analysis shows hypercalcemia. What kind of symptoms might the nurse expect to see in this situation?

A)Fever
B)Convulsions
C)Rapid breathing
D)Stupor

Answer 2

Stupor

Question 3

What is the purpose of performing a hemoglobin test upon admission prior to surgery?

A)To determine how well the patient's blood is clotting.
B)To determine if the patient is at high risk for infection.
C)To determine if the patient's blood can carry adequate amounts of oxygen.
D)To determine if the patient's body is utilizing calcium adequately.

Answer 3

To determine if the patient's blood can carry adequate amounts of oxygen.

Question 4

A patient decides to save some of their own blood before having an elective surgery. If complications arise, the healthcare team will then have access to the patient's blood if needed. What is the name of the procedure of returning a patient's own blood to themself during this process?

A)Blood return
B)Autotransfusion
C)Self receipt
D)Autotransmission

Question 5

Which of the following outcomes from an ECG may result in delaying a surgical procedure for patient safety purposes?

A)Aortic stenosis
B)Unstable angina
C)Sinus tachycardia
D)Both A and B

Question 6

Which of the following nursing diagnoses is most likely to be seen during the preoperative phase?

A)Body image disturbance
B)Knowledge deficit
C)Altered nutrition, less than bodily requirements
D)Impaired skin integrity

Question 7

Which of the following is a true statement describing a successful teaching program for the patient in the preoperative phase?

A)It should follow a standard set of guidelines to compare to other patients in similar situations.
B)It should consist of teaching from the perioperative nurse and the anesthesiologist.
C)It should include information about the preoperative, intraoperative, and postoperative periods.
D)Both B and C

Question 8

Which of the following might be a reason an adult patient has a pulse of 48 bpm on admission before surgery?

A)The patient is experiencing anxiety.
B)The patient has a fever.
C)The patient has low thyroid levels.
D)The patient is in pain.

Question 9

What is the reason for ensuring the patient maintains adequate levels of vitamin K throughout the surgical process?

A)To maintain a normal weight
B)To reduce the risk of infection
C)To ensure blood is clotting properly
D)To promote wound healing

Question 10

A nurse who is performing a preoperative assessment finds that the patient responds to questions by stuttering and speaking in a soft voice. The most likely nursing diagnosis for this patient would be:

A)Anxiety related to the upcoming surgical procedure
B)Altered thermal regulation related to environmental temperature
C)Altered role performance related to an identity shift to becoming a patient
D)Impaired verbal communication related to fear of surgery

Question 11

Upon admission, the patient tells the nurse that they are allergic to "every antibiotic out there" and that they are unable to take anything without getting sick. What is the nurse's response to this situation?

A)Write "all antibiotics" on an allergy armband and place it on the patient's wrist.
B)Tell the physician not to order antibiotics after surgery because the patient will have an allergic reaction.
C)Check the patient's chart and verify past medical history about exactly which antibiotics caused reactions and what the reactions were.
D)Tell the patient he is probably exaggerating and he will be fine receiving antibiotics.

Question 12

A 72-year old man is being admitted for a total hip replacement. What should the nurse assess in order to prevent the most common cause of mortality associated with this procedure?

A)Renal function
B)Deep vein thrombosis
C)Heart rhythm
D)Skin turgor

Question 13

During an admission assessment, the nurse notices that the patient has a small rash across the nose and cheeks that resembles the shape of a butterfly, and laboratory results show they have severe anemia. What is the most likely cause of these clinical manifestations?

A)Impetigo
B)Herpes zoster
C)Systemic lupus erythematosus
D)Polymyositis

Question 14

Which of the following is part of the skin preparation process during the preoperative period?

A)Hair removal at the planned incision site
B)Bathing the patient the night before surgery with an antimicrobial soap
C)Cleansing the incision site with sodium hypochlorite
D)Both A and B

Question 15

Which of the following should the nurse try to adhere to when performing hair removal prior to the surgical procedure?

A)Shaving the skin three hours before surgery to allow the skin to rest
B)Using the dry shave method to reduce the amount of trauma to the skin
C)Testing hair removal cream on a small area to determine the potential for a skin reaction
D)Both A and B

Question 16

A patient is admitted for surgery and tells the nurse, "I can't believe I have to have this done. I'm so angry right now!" Which of the following responses from the nurse is an example of reflection?

A)"You're feeling angry right now?"
B)"Why are you so angry?"
C)"I'm not sure why you are angry. Tell me more."
D)"You shouldn't feel angry. You need this."

Question 17

A patient is being admitted for surgery and during the initial assessment, the nurse notices that they barely respond to any questions directed toward them. They appear to hear the nurse's questions, but their voice is monotone and their facial expression does not change. What type of abnormality of affect is this patient displaying?

A)Flat
B)Depressed
C)Labile
D)Anxious

Question 18

During the interview at admission, the nurse questions the patient about any recent changes in sense of taste or smell. What is the rationale for this type of question?

A)To determine if the patient has had a recent head injury.
B)To determine if the patient will have nausea following surgery.
C)To determine if the patient is at risk for altered nutrition.
D)To determine if the patient has food allergies.

Question 19

Upon assessing a patient during the admission process, the nurse notices the patient's left lower eyelid droops out and away from the globe of the eye. What is this type of condition called?

A)Epicanthal fold
B)Conjunctivitis
C)Ectropion
D)Retinopathy

Question 20

What nursing interventions are recommended for a patient who complains of a dry mouth and difficulty swallowing food?

A)Use ice chips to keep the mucous membranes moist.
B)Eat small, frequent meals.
C)Lie in a recumbent position after eating.
D)Both A and B

Question 21

The body system that incorporates the transmission and sensitivity to painful impulses is called the:

A)Opioid system
B)Noxious system
C)Visceral system
D)Nociceptive system

Question 22

What symptoms might the nurse admitting a patient with hypernatremia expect to see?

A)Nausea and vomiting
B)Elevated body temperature
C)Flaccid paralysis
D)Distended neck veins

Question 23

What type of electrolyte imbalance may the nurse encounter in a patient with a history of hypoparathyroidism?

A)Hypokalemia
B)Hyponatremia
C)Hypocalcemia
D)Hypomagnesemia

Question 24

The nurse is preparing to insert an intravenous catheter to administer fluids for a patient who will have surgery. What is the most important factor that affects the nurse's choice of location for this site?

A)The type of cannula to be used
B)The duration of the infusion
C)The condition of the vein for use
D)Both B and C

Question 25

Which of the following measures can the nurse perform to improve the respiratory status of a patient who will need surgery?

A)Advise the patient to quit smoking one week before surgery.
B)Educate the patient about deep breathing exercises and incentive spirometry.
C)Request an arterial blood gas analysis from the physician upon patient admission.
D)Both A and B

Question 26

The nurse is planning to teach the patient cognitive techniques to help with pain control when the surgery is complete. Which of the following is an example of guided imagery?

A)The patient repeats to themself that they will heal and be free from infection.
B)The patient focuses on soothing thoughts of their home and family.
C)The patient learns to change television channels until they find something they like.
D)The patient repeatedly rehearses a favorite poem in their mind.

Question 27

The nurse is providing teaching about preoperative plans for surgery and tells the patient they must not eat or drink anything for eight hours before the procedure. The patient asks why this is required. What is the nurse's most appropriate response?

A)"If you do not eat before surgery, you will be less likely to get sick after the procedure."
B)"Eating before surgery slows the digestion process and you could become constipated."
C)"If you eat before surgery, you run the risk of food coming up from your stomach and being aspirated into your lungs."
D)"When you do not eat before surgery, the stomach is deflated and the surgeon will have more room to see during the procedure."

Question 28

The nurse checks an oxygen saturation level for a patient admitted for surgery and discovers that he has an oxygen saturation of 92% on room air. What is the nurse's first response?

A)Check the pulse oximetry probe to ensure that it is placed properly and the waveform pattern is normal.
B)Tell the patient to take a deep breath while listening to their lungs.
C)Administer oxygen via nasal cannula at 6L/min.
D)Notify the surgeon of the potential need to postpone the surgery.

Question 29

Which of the following would not be a common nursing diagnosis for a patient undergoing a total laryngectomy?

A)Anxiety
B)Body image disturbance
C)Acute confusion
D)Altered nutrition

Question 30

The nurse notes that a patient recently had a tuberculin skin test that produced a 3 mm reaction of erythema without induration at the site. What is the nurse's most appropriate response regarding surgery in this situation?

A)Move the patient to a negative-pressure room and begin wearing a particulate respirator mask.
B)Notify the surgeon of the results to determine if the surgery must be postponed.
C)Obtain a chest x-ray and contact the patient's primary physician regarding the results.
D)Note the reaction in the chart and proceed as usual.

Question 31

The nurse is reviewing the medical history for a patient who has sleep apnea. Which of the following symptoms is not associated with this condition?

A)Irritability
B)Snoring
C)Erectile dysfunction
D)Nausea

Question 32

Which of the following is part of the education process for teaching a patient how to use incentive spirometry?

A)Persuade the patient to use the spirometer twice a day.
B)Instruct the patient to lie in the lateral recumbent position.
C)Teach the patient to take a breath and slowly exhale.
D)Tell the patient not to cough while using the spirometer.

Question 33

Which of the following is an important part of an accurate assessment of blood pressure?

A)The patient's arm should be either at the level of the heart or raised above the head.
B)Initial readings are measured in both arms, with successive measurements taken in the arm with the lowest pressure.
C)The patient should avoid talking during a blood pressure measurement.
D)Both A and B

Question 34

What is the term used to define a pulse rate that increases while a person breathes in and then slows while breathing out?

A)Pulse deficit
B)Maximal pulse
C)Auscultatory gap
D)Sinus dysrhythmia

Question 35

Which of the following procedures during electrode placement is important for obtaining an accurate measurement during cardiac monitoring?

A)Shave the area where electrodes will be placed to avoid interference.
B)If the electrodes are not staying in place, apply cyanoacrylate to the site for better adherence.
C)Change the electrodes every 24 hours by moving them to new locations.
D)Both A and C

Question 36

A patient admitted for surgery has a history of peripheral vascular disease and is complaining of intermittent claudication with rest pain. Which of the following nursing interventions is most appropriate for this patient?

A)Elevating the affected legs
B)Assisting the patient with ambulating
C)Placing the legs in a dependent position
D)Keeping the legs in a horizontal position

Question 37

The process of the body forming new blood cells is known as:

A)Phagocytosis
B)Agranulocytosis
C)Hematopoiesis
D)Hemolysis

Question 38

Which of the following nursing interventions is appropriate for the patient with sickle cell crisis?

A)Moving and stretching swollen extremities.
B)Educating male patients to try and hold urine in the bladder to avoid developing priapism.
C)Providing rest in a quiet environment as much as possible.
D)Both A and B

Question 39

Which of the following is an important part of the assessment process for a patient being admitted for placement of a gastrostomy tube?

A)The patient's body image and self-care abilities
B)The patient's medical history of cardiovascular disease
C)The patient's ability to tolerate a liquid diet
D)Both A and B

Question 40

A patient is being admitted for a surgical procedure to place an abdominal catheter for continuous ambulatory peritoneal dialysis. Which of the following complications should the nurse educate the patient about as they prepare for the procedure?

A)Diarrhea
B)Abdominal hernia
C)Chest pain
D)Syncope

Question 41

Which of the following is an important part of the preoperative process for a patient preparing for a kidney transplant?

A)Ensuring the patient's pain is under control
B)Performing hemodialysis a week before the surgery
C)Assessing the patient's teeth for gingivitis and tooth decay
D)Both A and B

Question 42

A nurse is admitting a patient for surgery who has a history of Sjogren's syndrome. Which of the following manifestations might the nurse see in this patient during the admission process?

A)Lesions on the buccal mucosa
B)Conjunctivitis
C)Blanched skin in the fingers
D)Dry, grainy eyes