Question 1

The nursing student in the preoperative area forgot to ask the client about any supplements or herbs being used. What response by the faculty member is best?&#10;A) &#34;Even medications only used occasionally are important to document.&#34;&#10;B) &#34;Supplements and herbs aren't usually too problematic, so it's alright.&#34;&#10;C) &#34;It is critical that you return to the client and ask if these are being used.&#34;&#10;D) &#34;Go back and ask; even supplements and herbs can affect surgical outcomes.&#34;

Accepted Answer

All substances, medications, herbs, supplements, and traditional healing practices the client uses are documented because they may affect surgical outcomes. The best answer is the one that gives specific information. The question did not ask about medications used occasionally. Telling the student that it is critical to get the information does not provide a rationale so the student can learn from the mistake.

Question 2

An alert and oriented client seems confused about the operation he/she just gave consent for. What action by the nurse is most appropriate?&#10;A) Re-explain the procedure.&#10;B) Have the client re-sign the form.&#10;C) Notify the charge nurse.&#10;D) Notify the authorized provider.

Accepted Answer

This client, being alert and oriented, most likely has capacity to make decisions, but not competency. The purpose of informed consent is to verify client understanding of the surgical procedure, benefits, possible risks, and alternative approaches, which is competency. The authorized provider, not the nurse, should re-explain the procedure. The client may or may not need to resign the form or sign a new one depending on policy, and the charge nurse could be notified, but this is not the nurse's priority.

Question 3

A client is in the preoperative area and the nurse is teaching incentive spirometry use. The student asks why this is necessary before the operation. What response by the nurse is best?&#10;A) &#34;It saves time for the postoperative nurse who will be too busy.&#34;&#10;B) &#34;It's always best to do as much teaching as possible preoperatively.&#34;&#10;C) &#34;After surgery, the client may be too medicated to understand directions.&#34;&#10;D) &#34;We will have the client demonstrate in the post-anesthesia care unit.&#34;

Accepted Answer

The more teaching that is done in the preoperative phase, the better because clients are often too medicated, too sedated, or in too much pain for learning to be effective. It is not done because the postoperative nurse is too busy and the client will most likely be too sedated to do a return demonstration in the post-anesthesia care unit. While it is always best to do teaching preoperatively, this does not give the student a rationale for the statement.

Question 4

A student is observing a preoperative nurse showing a client how to dorsiflex and plantar flex the feet and do straight leg raises from the mattress. The student asks what these exercises are for. What answer by the nurse is best?

A) "They help prevent pressure injuries."
B) "The help prevent joint stiffness."
C) "They provide distraction from pain."
D) "They help prevent thrombosis."

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Accepted Answer

The main purpose of these exercises is to prevent postoperative thrombosis. They are not to prevent pressure injuries or provide distraction from pain. While they can help prevent joint stiffness, that is not their main purpose.

Question 5

The new perioperative nurse learns that which of the following is the purpose of the Universal Protocol?&#10;A) Prevent wrong site/wrong patient operations.&#10;B) Ensure all equipment is functioning properly.&#10;C) Verify the use of Standard Precautions.&#10;D) Double-count all supplies prior to the incision.

Accepted Answer

The Universal Protocol is designed to prevent wrong site/wrong client/wrong procedure errors. It is not designed to ensure working equipment or to double count all supplies. In the operating room, surgical aseptic technique is followed, which is more prescriptive than Standard Precautions.

Question 6

A client is considering a minor surgical procedure and asks the difference between conscious sedation and general anesthesia. What response by the nurse is best?&#10;A) &#34;With conscious sedation you are drowsy but can still follow commands.&#34;&#10;B) &#34;With conscious sedation you will be conscious the entire time.&#34;&#10;C) &#34;Conscious sedation blocks pain in larger areas of the body.&#34;&#10;D) &#34;You lose sensation and movement during a conscious sedation procedure.&#34;

Accepted Answer

Conscious sedation is often used for minor surgical or diagnostic procedures. Using a combination of short-acting sedatives, the client maintains consciousness, but is drowsy. Clients can protect their own airways and follow commands and may have amnesia for the event. While telling the client he or she will be conscious the whole time is technically accurate it does not let the client know about the sedation. A regional anesthetic will block pain in larger areas of the body. Losing sensation and movement happens after spinal anesthesia.

Question 7

The nurse is providing preoperative instructions to the client on surgical site preparation. Which instruction for site care is most appropriate?&#10;A) &#34;Shave your leg the morning of surgery.&#34;&#10;B) &#34;Do not get the site wet the day before surgery.&#34;&#10;C) &#34;Use antibacterial agent when you shower.&#34;&#10;D) &#34;Rub your skin with this antiseptic lotion.&#34;

Accepted Answer

To help prevent surgical site infections, current recommendations are for clients to shower the night before and the morning of the operation using an antibacterial agent. Shaving is no longer recommended; needed hair removal is done with clippers just before the start of the procedure.

Question 8

A postoperative client's PARS score is 9. What action does the post-anesthesia care unit (PACU) nurse take?&#10;A) Transfers the client to the Intensive Care Unit&#10;B) Holds the client in the PACU for another hour&#10;C) Prepares to transfer the client to the postoperative unit&#10;D) Informs the staff the client needs to return to the operating room

Accepted Answer

The Post-Anesthesia Recovery Score (PARS) provides nurses a tool to evaluate the client's level of consciousness, oxygen saturation level, respiratory status, and blood pressure. A score of 8 to 10 means the client is ready to transfer to a postoperative unit. A score below 8 means the client needs continued monitoring in the PACU or transfer to the Intensive Care Unit. The client does not need to return to the operating room.

Question 9

A postoperative unit nurse is caring for four clients. Which client does the nurse assess as the priority?&#10;A) Nurse's aide reports pulse rate of 106 beats/minute.&#10;B) Client requesting something for pain&#10;C) Nurse's aide reports temperature of 35.5 $\degree$C (95.9 $\degree$F).&#10;D) Client needing to use the bathroom

Accepted Answer

Inadvertent post-operative hypothermia (IPH) occurs when the client's temperature drops below 36 $\degree$C (96. $\degree$ F) and can lead to various problems, including shivering, prolonged bleeding, infection, and cardiac dysrhythmias that may result in cardiac arrest or death. The nurse would assess this client first. A pulse of 106 beats/minute is slightly tachycardic but not unexpected after surgery. The nurse would see the client requesting pain medication next. The nurse can delegate helping a client to the bathroom.

Question 10

The nurse is assessing a postoperative client 30 minutes after arrival on the postoperative care unit. The nurse notes the client to have a pulse of 138 beats/min, respiratory rate of 32 breaths/min, and stiff muscles. What action does the nurse anticipate implementing as the priority?

A) Assessing the patient's pain level
B) Administering IV dantrolene sodium
C) Obtaining a rectal temperature
D) Requesting arterial blood gasses

Accepted Answer

This client is exhibiting signs of malignant hyperthermia. The nurse needs to provide medication to slow the client's metabolic rate and anticipates an order for dantrolene sodium. Hyperthermia itself is a late sign and the nurse can delegate obtaining a temperature, although a rectal temperature is probably unnecessary. While the client's pain is important, it is not the priority in this situation.

Question 11

A client had surgery earlier this morning. The nurse assesses the client's dressing to have a 2 * 2 centimeter spot of blood on it. What action by the nurse is best?&#10;A) Remove the dressing and inspect the incision.&#10;B) Reinforce the dressing with more gauze pads.&#10;C) Document the findings in the client's chart.&#10;D) Outline the spot on the dressing with a pen or marker.

Accepted Answer

The answer of A client had surgery earlier this morning....

Question 12

A client who had an operation 3 days ago reports not having a bowel movement since. What action by the nurse is best?&#10;A) Assess the client's bowel sounds.&#10;B) Measure the client's girth.&#10;C) Request an order for a laxative.&#10;D) Ask about the presence of flatus.

Accepted Answer

The answer of A client who had an operation 3...

Question 13

A client had abdominal surgery this morning. The spouse runs into the hallway and yells "Quick, come here! There's blood gushing everywhere!" The nurse identified bright red blood on the client's gown. What action does the nurse take first?

A) Applies direct pressure to the bleeding site
B) Locates a large dressing to apply to the site
C) Performs hand hygiene and puts on gloves
D) Takes the client's pulse and blood pressure

Accepted Answer

The answer of A client had abdominal surgery this morning....

Question 14

A very elderly client is having an operation. For client safety, which action does the circulating nurse take?&#10;A) Pads the client's bony prominences when in the OR&#10;B) Assesses the skin before and after the procedure&#10;C) Positions the client in a semi-Fowler's position&#10;D) Educates the client on turning frequently in bed

Accepted Answer

The answer of A very elderly client is having an...

Question 15

A client scheduled for pelvic surgery asks why a chest x-ray is needed. What rationale will the nurse provide?&#10;A) &#34;It's standard for all operations.&#34;&#10;B) &#34;To assess your heart and lungs.&#34;&#10;C) &#34;To determine anesthesia risk.&#34;&#10;D) &#34;I will ask the surgeon for you.&#34;

Accepted Answer

The answer of A client scheduled for pelvic surgery asks...

Question 16

The nurse is applying sequential compression devices to a postoperative client. The client asks what they are for. What explanation does the nurse provide?&#10;A) Compress and move the joints so they don't get stiff.&#10;B) Help prevent blood clots from forming in the lower legs.&#10;C) Monitors the client's blood pressure continuously.&#10;D) Helps remove absorbed anesthetic gas from tissues.

Accepted Answer

The answer of The nurse is applying sequential compression devices...

Question 17

The post-anesthesia care unit (PACU) nurse has provided handoff report to the inpatient unit nurse. After finishing, which of the following topics would the nurse inquire about if not provided?&#10;A) Recent diet history&#10;B) Discharge needs&#10;C) Estimated blood loss&#10;D) All today's lab results

Accepted Answer

The answer of The post-anesthesia care unit (PACU) nurse has...

Question 18

A client has a latex allergy. What actions does the nurse take to protect him or her in the surgical suite? (Select all that apply.)&#10;A) Schedule latex allergy cases late in the afternoon.&#10;B) Rinse instruments sterilized in ethylene oxide before using.&#10;C) Use polyvinyl chloride intravenous tubing without latex ports or cover latex ports with tape.&#10;D) Prepare as many doses of anticipated IV medications as possible prior to the operation.&#10;E) Wrap cords from equipment in stockinette and tape if they will contact the client.

Accepted Answer

The answer of A client has a latex allergy. What...

Question 19

The preoperative nurse performs which actions as the priorities? (Select all that apply.)&#10;A) Provide client education.&#10;B) Identify any health concerns.&#10;C) Provide information about the operative phase.&#10;D) Plan for discharge needs.&#10;E) Explain postoperative care.

Accepted Answer

The answer of The preoperative nurse performs which actions as...

Question 20

The perioperative nurse knows that which factors may lead to poor surgical outcomes? (Select all that apply.)&#10;A) Age&#10;B) High blood glucose&#10;C) Smoking&#10;D) Nutritional status&#10;E) Client weight

Accepted Answer

The answer of The perioperative nurse knows that which factors...

Question 21

What are the elements of informed consent? (Select all that apply.)&#10;A) Capacity&#10;B) Competence&#10;C) Control&#10;D) Duty&#10;E) Disclosure

Accepted Answer

The answer of What are the elements of informed consent?...

Question 22

Intraoperative positioning provides which functions? (Select all that apply.)&#10;A) Optimal access to the surgical site&#10;B) Maintain the airway&#10;C) Allow for ongoing assessment&#10;D) Holds the client still&#10;E) Limit vomiting and aspiration

Accepted Answer

The answer of Intraoperative positioning provides which functions? (Select all...

Question 23

Which surgical procedures are matched with correct positioning? (Select all that apply.)&#10;A) Sims: Kidney procedures&#10;B) Dorsal recumbent: Spinal procedures&#10;C) Lithotomy; Rectal procedures&#10;D) Supine: Vaginal procedures&#10;E) Trendelenburg: Pelvic procedures

Accepted Answer

The answer of Which surgical procedures are matched with correct...

Question 24

A client is going home with a prescription for anti-embolism stockings. What information does the nurse provide this client? (Select all that apply.)&#10;A) &#34;Take the stockings off each night before going to bed.&#34;&#10;B) &#34;Let your provider know if you lose or gain a lot of weight.&#34;&#10;C) &#34;You should wash your stockings once a week.&#34;&#10;D) &#34;Dry these stocking lying flat and not in the dryer.&#34;&#10;E) &#34;It would be good to get more than one pair of stockings.&#34;

Accepted Answer

The answer of A client is going home with a...

Question 25

Which are functions of the circulating nurse? (Select all that apply.)&#10;A) Controls the room temperature&#10;B) Protects the client's rights&#10;C) Regulates the room lighting&#10;D) Adjusts the room humidity&#10;E) Sets up the sterile field

Accepted Answer

The answer of Which are functions of the circulating nurse?...

Deck 17: Perioperative Care