Deck 23: Perioperative Nursing

Question 1

The nurse knows the term perioperative phase refers to care given to the client:

A) before, during, and after the operative phase.
B) from the start of surgery until its conclusion.
C) immediately before an operative procedure.
D) immediately after the operative phase.

Answer 1

before, during, and after the operative phase.

Question 2

A client undergoing which surgery will likely return to activities in their everyday lives more quickly?

A) Vaginal hysterectomy
B) Laparoscopic cholecystectomy
C) Right nephrectomy
D) Open-heart surgery

Answer 2

Laparoscopic cholecystectomy

Question 3

A client has arrived in the same-day surgery suite. He or she states, "I am so worried about being put to sleep and having the surgery." What would be the nurse's best response?

A) You don't have to worry. It will be fine.
B) Tell me what you are most worried about?
C) I will have the anesthesiologist talk to you?
D) Have you ever had surgery before?

Answer 3

Tell me what you are most worried about?

Question 4

After which surgery would a client likely see the greatest permanent changes in lifestyle following surgery?

A) Right total knee replacement
B) Left mastectomy
C) Ileostomy
D) Appendectomy

Question 5

When educating a client in the postoperative period, it is important to educate the client to consume a diet high in:

A) protein.
B) calcium.
C) bicarbonate.
D) potassium.

Question 6

A client in the immediate postoperative period begins to report nausea and ultimately begins vomiting. The nausea and vomiting are most likely related to:

A) movement of bowels during surgery.
B) inactivity and emotional upset.
C) the effects of anesthetic agents.
D) severe pain at the operative site.

Question 7

A surgical client has been ordered a dose of IV cephalosporin. Why is it important that this drug be administered as close as possible to the time of surgery?

A) To prevent the development of atelectasis postoperatively.
B) To prevent the development of aspiration intraoperatively.
C) To allow for decreased level of white blood cells.
D) To maximize serum levels of the medication during surgery.

Question 8

Which statement, if made by an adolescent preparing for abdominal surgery, would indicate to the nurse that the client requires additional instruction?

A) I can have a hamburger and French fries as soon as I wake up.
B) The better I eat before surgery, the more likely I will heal.
C) I might be sick to my stomach and throw up after surgery.
D) When I can eat again, the best meal would be steak and orange juice.

Question 9

Surgery can lead to hypothermia. Which client is at greatest risk for hypothermia?

A) A woman delivering by C-section
B) An adolescent for arthroscopic surgery
C) A young adult with a fractured leg
D) An older adult man with a fractured hip

Question 10

The nurse anesthetist is monitoring the client during surgery and notices a ventricular dysrhythmia and unstable blood pressure. The nurse anesthetist notifies the surgeon. The operative team suspects:

A) myocardial infarction.
B) malignant hyperthermia.
C) mitral valve prolapse.
D) major blood loss.

Question 11

What is the rationale for having the client void before surgery?

A) To assess for pregnancy in women
B) To assess for urinary tract infection
C) To prevent bladder distention
D) To prevent electrolyte imbalance

Question 12

In the postoperative phase of abdominal surgery, the client reports severe abdominal pain. In the 2nd postoperative day, the client's bowel sounds are absent. What does the nurse suspect?

A) Normal response
B) Abdominal infection
C) Hernia development
D) Paralytic ileus

Question 13

Which nursing action provides the greatest assistance in healing?

A) Maintaining a restful environment
B) Providing solid food in the first day
C) Allowing family members to visit often
D) Keeping the client recumbent

Question 14

Which nursing action will assist in pain management for a client in the postoperative phase?

A) Client education
B) Relaxation techniques
C) Dim lighting
D) Provide food and medication

Question 15

A client is being discharged following surgery for cancer care. The client will require extensive dressing changes two times per day. The client is on a fixed income and cannot afford to purchase dressing supplies. The nurse contacts a local nonprofit agency to assist in the provision of dressings. This contribution in care will assist in improving the client's:

A) family relationships.
B) knowledge base.
C) decision making.
D) self-concept.

Question 16

The nurse has been waiting until after the administration of a toddler's anesthesia before removing the child's clothing and applying monitoring equipment. Doing these actions after the administration of anesthesia will:

A) minimize blood loss.
B) enhance thermoregulation.
C) provide more accurate baseline vital signs.
D) prevent anxiety.

Question 17

A client has been taking aspirin since his or her heart attack in 1997. The client is at risk for:

A) infection.
B) thrombophlebitis.
C) hemorrhage.
D) blood clots.

Question 18

A client states he or she has a latex allergy. Which action should the nurse take?

A) Inform the client to tell the anesthesiologist.
B) Have the client take diphenhydramine before surgery.
C) Send the client to the OR with epinephrine.
D) Place an allergy identification band on the client.

Question 19

When an older adult client is brought to the recovery room and presents with irregular, loud respirations, the nurse determines that this is most likely a result of:

A) effects of anesthesia.
B) normal return of reflexes.
C) partial airway obstruction.
D) type of surgery.

Question 20

The nurse is caring for a client admitted for an outpatient surgical procedure. Which action will the nurse include in the care? Select all that apply.

A) Begin discharge education as soon as the procedure is completed.
B) Allow family members to be present during discharge education.
C) Begin discharge education in the preoperative period.
D) Investigate the client's home care and discharge transportation following the procedure.
E) Discuss discharge transportation during the preoperative period.

Question 21

A preoperative client has called the nurse about his or her upcoming surgical procedure, 6 weeks from now. He or she is concerned about receiving blood after surgery for fear of acquiring a blood-borne disease. What is the nurse's most appropriate response?

A) Instruct the client to notify the physician promptly.
B) Remind the client that blood is tested prior to administration, guaranteeing it is free of disease.
C) Ask the client if he or she has ever had any other blood products in the past.
D) Explain to the client the practice of autologous blood donation.

Question 22

The client has been transported to the operating suite and positioned on the operating table. Suddenly, the client states, "I don't want to do this. Get me out of here now!" Which action should occur?

A) The client should be given the anesthesia.
B) The surgeon should tell the client to remain calm and the procedure will be over soon.
C) The client should be told it is too late to change his or her mind.
D) The procedure should be stopped.

Question 23

The healthy adult client is given a narcotic prior to a surgical procedure. The nurse is completing the chart and notices the consent form was not signed by the client. Which of the following should the nurse do first?

A) Immediately have the client sign the consent form.
B) Have the client's family member sign the consent form.
C) Ask the client if he or she still wants to proceed with the procedure.
D) Notify the physician of the oversight.

Question 24

The nurse is preparing to start an IV in a client who is to go to surgery. The nurse would likely choose which gauge of IV catheter?

A) 22 gauge
B) 25 gauge
C) 18 gauge
D) 14 gauge

Question 25

The adult male client with significant body hair is being prepared for abdominal surgery. The client states, "My dad had the same surgery many years ago and was shaved prior to the procedure." The nurse would explain to the client:

A) "That practice is no longer standard as shaving may cause breaks in the skin."
B) "We no longer shave skin before procedures but we will apply a lotion that will remove the hair."
C) "Your abdomen will be shaved in the operating room."
D) "You will be shaved as well."

Question 26

The nursing instructor is discussing the role of the circulating nurse in the operative suite with the student nurses. What would the nursing instructor include as duties of the circulating nurse? Select all that apply.

A) The circulating nurse is included in the responsibility of accounting for all sponges and instruments following the surgical procedure.
B) The circulating nurse is responsible for preparing the surgical table for the procedure.
C) The circulating nurse is responsible for assisting the surgeon with instruments during the procedure.
D) The surgical nurse is responsible for maintaining the client's rights during the surgical procedure.
E) The circulating nurse coordinates activities of related personnel (e.g., laboratory, x-ray).

Question 27

The nurse is caring for the postoperative client in the PACU. The client is concerned about the abdominal staples closing the wound for fear they will open and the client's "insides will fall out." What is the best response by the nurse?

A) "Don't worry, the staples are properly placed and will not come out until they are removed by the physician."
B) "If you are very careful and follow your postoperative instructions, there is no need to worry."
C) "There are sutures in various levels below the staples that assist in keeping your wound intact."
D) "Would you tell me why you are worried about that?"

Question 28

Following a surgical procedure, who is generally responsible for moving the client to the recovery area?

A) The surgeon
B) The orderly
C) The recovery nurses
D) The anesthesiologist, circulating nurse, and surgeon

Question 29

The recovery nurse is caring for a surgical client in the PACU. The client's blood pressure is dropping and the heart rate is increasing. The nurse suspects the client is:

A) overmedicated.
B) experiencing normal adaptation to the postoperative period.
C) allergic to the anesthesia.
D) developing shock.