Deck 17: Surgical Care

Question 1

Because malignant hyperthermia is a potential postoperative complication,the nurse should ask:

A) "Do you think you might have a fever?"
B) "Do you currently have an infection?"
C) "Has anyone in your family ever had problems with general anesthesia?"
D) "Have you ever had any type of malignancy?"

Answer 1

"Has anyone in your family ever had problems with general anesthesia?"

Question 2

The technique the nurse should use to change a postoperative dressing is:

A) Enteric isolation
B) Aseptic technique
C) Clean technique
D) Respiratory isolation

Answer 2

Aseptic technique

Question 3

The nurse is caring for the postoperative patient who has had spinal anesthesia.The nurse would place highest priority on reporting which of these assessments?

A) Complaints of a headache
B) Pulse rate of 78 beats per minute
C) Voided 300 ml
D) Blood pressure of 126/78 mm Hg

Answer 3

Complaints of a headache

Question 4

A patient who had a hysterectomy yesterday has not been allowed food or drink by mouth (NPO).The physician has now ordered the patient's diet to be clear liquids.Before administering the diet,the nurse should check for:

A) Feelings of hunger
B) Bowel sounds
C) Positive Homans sign
D) Gag reflex

Question 5

The postoperative patient who has no previous medical conditions is difficult to arouse when transferred to the surgical unit from the postanesthesia care unit.The nurse monitors the pulse oximeter and gets a reading of 85%.The nurse's next action should be to:

A) Assess the pulse oximeter reading again in 1 hour.
B) Arouse the patient, have him cough, and encourage deep breathing.
C) Administer a dose of pain medication.
D) Suction fluid from the oral cavity.

Question 6

The nurse should include the proper use of an incentive spirometer in teaching a preoperative patient.Postoperative monitoring of this patient would reveal that the incentive spirometry has been effective if the patient has:

A) Adventitious breath sounds
B) Expiratory wheezing
C) Thick, green respiratory secretions
D) Clear breath sounds

Question 7

The nurse is doing an assessment of a patient who has returned from a cardiac catheterization and had conscious sedation.The nurse should report which of the following findings?

A) Difficulty arousing the patient
B) Blood pressure of 124/72 mm Hg
C) Oxygen saturation of 96%
D) Patient complaints of the need to void

Question 8

The nurse has completed giving discharge instructions to the patient after a hernia repair.The nurse would determine that the patient understands the instructions if he verbalizes that he will:

A) Be going back to work tomorrow.
B) Not change the dressing until he sees his physician in 2 weeks.
C) Ignore changes in the size of his abdomen.
D) Report fever, redness, swelling, or increased pain at the incision site.

Question 9

The nurse understands that palliative surgery is intended to:

A) Remove and study tissue to make a diagnosis.
B) Relieve symptoms or improve function without correcting the basic problem.
C) Remove diseased tissue or correct defects.
D) Correct serious defects that only affect appearance.

Question 10

When obtaining the patient's signature on the surgical consent form,the patient seems confused about the procedure to be performed.The appropriate response by the nurse is to:

A) Tell the patient to talk to the physician after he gets to the surgical department.
B) Ask the patient to go ahead and sign the consent.
C) Ask the patient what the physician told him, and then call the physician, if necessary.
D) Encourage the patient to ask his family what the physician told them.

Question 11

The nurse modifies postoperative care for a patient who has had cataract surgery from that given most general surgical patients as follows:

A) Early ambulation is not necessary.
B) Remove dressing immediately
C) Omit instructions relative to coughing.
D) Omit use of incentive spirometer for deep breathing.

Question 12

During the nurse's preoperative assessment,the nurse notices that the patient is extremely anxious.The patient's blood pressure is 142/92 mm Hg,the heart rate is 104 beats per minute,and respirations are 32.The nurse should:

A) Give the preoperative medicine early to help calm the patient.
B) Call the surgical department, and cancel the surgery.
C) Notify the anesthesiologist or surgeon.
D) Instruct the patient on possible postoperative complications.

Question 13

During the preoperative assessment,the nurse must ask the patient for information about:

A) Current address and telephone number
B) Food preferences
C) Allergies, medications, and past medical conditions
D) Bathing and sleep patterns

Question 14

The nurse is performing a postoperative assessment on a patient who has just returned from a hernia repair.The patient's blood pressure is 90/60 mm Hg,and the apical pulse is 108.The nurse's first action would be to:

A) Check the dressing for bleeding.
B) Notify the registered nurse (RN).
C) Document the vital signs.
D) Increase the rate of infusion of intravenous (IV) fluids.

Question 15

A nurse is assisting in the transfer of a postoperative patient from the postanesthesia care unit to the surgical nursing unit.To ensure the safety of the patient,the nurse would:

A) Put the side rails up after moving the patient from the stretcher to the bed.
B) Ask the patient to move from the stretcher to the bed.
C) Move the patient rapidly from the stretcher to the bed.
D) Uncover the patient before transferring from the stretcher to the bed.

Question 16

The member of the surgical team who administers anesthetics and monitors the patient's status throughout the procedure is the:

A) Surgeon
B) Circulating nurse
C) Perfusionist
D) Anesthesiologist

Question 17

The suprapubic area of a postoperative patient is distended.The patient states that he has not voided since surgery approximately 9 hours ago.The nurse's first action would be to:

A) Notify the head nurse or physician.
B) Insert a catheter and document insertion.
C) Seat the patient on the side of the bed to try to void.
D) Prepare the patient to return to surgery.

Question 18

A postoperative patient is complaining of incisional pain.An order has been given for morphine every 4 to 6 hours as needed (PRN).The first assessment by the nurse should be to:

A) Assess for the presence of bowel sounds.
B) Assess pupillary reaction.
C) Ask the patient's family if she is having pain.
D) Determine when the patient last received pain medication.

Question 19

To best prevent deep vein thrombosis (DVT)in the postoperative patient,the nurse plans to ensure that the patient:

A) Splints the incision.
B) Coughs and deep-breathes every 2 hours.
C) Regularly removes antiembolism stockings.
D) Ambulates frequently.

Question 20

A patient who has just undergone a colon resection complains to the nurse that he felt something pop under his dressing while trying to get out of bed.The nurse removes the dressing and finds that dehiscence of the wound has occurred.The nurse's first action should be to:

A) Replace the dressing; dehiscence is normal.
B) Call the physician.
C) Pull the wound edges together, and replace the dressing.
D) Cover the wound with sterile dressings saturated with normal saline.

Question 21

The patient scheduled for a bronchoscopy is placed on an NPO status after midnight before the procedure.The patient is complaining of being thirsty and requests some water on the morning of the procedure.The nurse should:

A) Deny any oral fluid per order.
B) Allow 8 ounces of tap water.
C) Offer ice chips.
D) Administer only carbonated drinks.

Question 22

To prevent the effects of postoperative immobility on the gastrointestinal system,the nurse suggests that the patient:

A) Avoid taking antibiotics.
B) Increase her fluid intake.
C) Avoid high-fiber foods.
D) Limit her activity for the first 3 to 4 days.

Question 23

When the patient who received Penthrane as an inhaled anesthesia complains of a sore throat and a raspy voice,the nurse explains that these discomforts are probably due to:

A) Drying effect of the anesthesia
B) Insertion of an endotracheal tube
C) Postsurgical dehydration
D) Possible upper respiratory infection

Question 24

Patients with preoperative disorders put them at risk during recovery.The nurse should be aware of disorders that may pose this hazard,which are:

A) Diabetes
B) Warfarin therapy
C) Fungal skin infection
D) Hepatitis C
E) Chronic obstructive pulmonary disease (COPD)

Question 25

The postanesthesia care nurse is evaluating the patient for possible transfer to the surgical unit.The following assessment would prevent the patient's transfer:

A) Blood pressure: 126/78 mm Hg
B) Pulse rate: 82 beats per minute
C) Pulse oximeter reading: 85%
D) Respirations: 22 breaths per minute

Question 26

The nurse assesses the patient's limbs and position frequently after a regional anesthesia because:

A) Pain is not perceived although motion is possible.
B) Rashes and skin eruptions would indicate an allergy.
C) Permanent paralysis is a concern.
D) Contracture deformities may occur.

Question 27

A patient has just returned to the surgical unit after varicose vein stripping and ligation.To evaluate pain relief,the best technique for the nurse is to:

A) Check the patient's record for the last dose of pain medication administered.
B) Ask the patient to rate the severity of the pain on a scale of 1 to 10.
C) Ask the family if they think that the patient is having pain.
D) Tell the patient to ask for pain medicine when it is needed.

Question 28

The circulating nurse is responsible for:

A) Assisting the surgeon with the procedure
B) Setting up the surgical room
C) Scrubbing in to handle instruments
D) Maintaining patient safety
E) Documenting nursing care

Question 29

The nurse discovers on the preoperative assessment that the patient has a condition that would require increased amounts of general anesthesia.The condition is ____________________.

Question 30

The nurse carefully monitors the obese patient after her hysterectomy for the peculiar postoperative complications associated with obesity:

A) Nausea
B) Vomiting
C) Hypertension
D) Hemorrhage
E) Respiratory difficulties

Question 31

The patient scheduled for a liver biopsy has given the nurse a list of medications routinely taken at home.The nurse should be concerned about the:

A) Aspirin
B) Multivitamin
C) Furosemide
D) Acetaminophen

Question 32

The patient has an extensive bowel preparation of oral laxatives and enemas for a colon resection.When asked about the rigorous preparation,the nurse would list as the rationales:

A) Reduces possibility of fecal contamination of the operative site.
B) Flattens the colon.
C) Decreases postoperative distention.
D) Avoids postoperative constipation.
E) Decreases straining at stool