Deck 41: The Perianesthesia Patient

Question 1

A postoperative patient has developed laryngeal edema.What medication would the nurse anticipate being administered to the patient?

A) Racemic epinephrine
B) Succinylcholine
C) Albuterol
D) Morphine

Answer 1

Racemic epinephrine

Question 2

Nursing management of a patient in the immediate postoperative period includes implementation of the stir-up regimen.What actions are parts of the stir-up regimen?

A) Deep-breathing exercises, suctioning, warming, and nausea management
B) Incentive spirometry, abdominal breathing, warming, drinking, and pain management
C) Incentive spirometry, coughing, suctioning, warming, mobilization, and eating
D) Deep-breathing exercises, coughing, positioning, mobilization, and pain management

Answer 2

Deep-breathing exercises, coughing, positioning, mobilization, and pain management

Question 3

In the postanesthesia care unit,how often would the nurse stimulate the patient to take three to four deep breaths?

A) 1 to 2 minutes
B) 3 to 5 minutes
C) 5 to 10 minutes
D) 30 to 60 minutes

Answer 3

5 to 10 minutes

Question 4

The nurse is caring for a patient immediately after surgery.The patient is requesting something to drink.The nurse knows that oral intake is prohibited after anesthesia until what occurs?

A) The patient is ambulatory.
B) The patient is strong enough to hold a cup of water.
C) All nausea has ceased.
D) Laryngeal and pharyngeal reflexes are fully regained.

Question 5

The coughing maneuver in which a patient takes a deep breath and then performs multiple coughs on exhalation of that breath is known as what type of cough?

A) Serial
B) Cascade
C) Sustained maximal
D) Deep

Question 6

A postoperative patient has developed bronchospasms.What medication would the nurse anticipate being administered to the patient?

A) Racemic epinephrine
B) Methylprednisolone
C) Albuterol
D) Morphine

Question 7

A patient is oversedated after receiving a benzodiazepine.Which medication would the nurse administer to reverse the effects of the medication?

A) Naloxone
B) Neostigmine
C) Fentanyl
D) Flumazenil

Question 8

What are the effects of nitrous oxide?

A) Anesthesia, analgesia, and amnesia
B) Vasodilation, analgesia, and myocardial depression
C) Respiratory and cardiovascular depression
D) Bronchodilation, myocardial excitation, and muscle tremors

Question 9

A postoperative patient has developed laryngospasm.What medication would the nurse anticipate being administered to the patient?

A) Racemic epinephrine
B) Succinylcholine
C) Albuterol
D) Morphine

Question 10

A patient was oversedated and required a dose of naloxone.How long would the nurse expect the duration of action of the medication to last?

A) 30 minutes to 1 hour
B) 1 to 4 hours
C) 4 to 6 hours
D) 6 to 10 hours

Question 11

Which stage of general anesthesia is known as surgical anesthesia?

A) Stage I
B) Stage II
C) Stage III
D) Stage IV

Question 12

The nurse is caring for a patient who has just returned from surgery.The nurse is monitoring the patient's heart rhythm.In the postoperative period,when do dysrhythmias often occur?

A) During the first minute
B) During the first 2 minutes
C) During the first 5 minutes
D) At any time

Question 13

A patient returns from the surgical suite and is hypothermic.The nurse understands that hypothermia can lead to which problem?

A) Acute kidney failure
B) Metabolic alkalosis
C) Hypotension
D) Delayed emergence

Question 14

A nurse is administering a benzodiazepine to a patient to facilitate relaxation prior to surgery.Which benzodiazepine has a slow onset of action and long duration?

A) Diazepam
B) Midazolam
C) Lorazepam
D) Droperidol

Question 15

The nurse is teaching a patient how to do the sustained maximal inspiration (SMI)maneuver.Which instruction to the patient is correct?

A) Take a deep breath and hold it for 3 to 5 seconds before exhaling.
B) Take a slow deep breath and then forcefully exhale.
C) Take a deep breath and, at the peak of inspiration, expand the chest and take in a little more air.
D) Take a slow deep breath and then exhale slowly.

Question 16

The nurse is caring for a postoperative patient who is snoring and has stridor,nostril flaring,and intercostal retractions.The nurse knows that these findings are clinical manifestations of what problem?

A) Angina
B) Airway obstruction
C) Pain
D) Oversedation

Question 17

Which stage of general anesthesia begins with the initiation of an anesthetic agent and ends with loss of consciousness?

A) Stage I
B) Stage II
C) Stage III
D) Stage IV

Question 18

The nurse is caring for a patient who has developed laryngospasm.What action should the nurse take first?

A) Assist with intubation and then provide manual ventilation with 100% oxygen.
B) Hyperextend the patient's head and administer positive-pressure ventilations on 100% oxygen.
C) Administer 10 mg of succinylcholine.
D) Administer nebulized racemic epinephrine.

Question 19

The nurse is assisting with intubation of a patient.Which depolarizing skeletal muscle relaxant medication would the nurse anticipate being given to the patient?

A) Succinylcholine
B) Pancuronium
C) Mivacurium
D) Rocuronium

Question 20

The nurse is caring for a postoperative patient who is complaining of being cold and shivering.The patient's temperature is normal.The nurse understands that shivering can occur in the normothermic patient for what reason?

A) Dehydration
B) Delayed response to being hypothermic during surgery
C) Effects of anesthetic agents
D) Anxiety

Question 21

What is the most common cause of hypoxemia in the immediate postoperative period?

A) Pulmonary vasoconstriction
B) Airway obstruction
C) Intrapulmonary shunting
D) Ventilation/perfusion mismatching

Question 22

Which of the following dysrhythmias are common in the postanesthetic period?

A) Ventricular tachycardia
B) Ventricular fibrillation
C) Supraventricular tachydysrhythmias
D) Sinus bradycardia
E) Premature ventricular contractions

Question 23

The patient's body temperature is 33° C.The patient is shivering and the nurse needs to initiate which interventions?

A) Cover the patient with warm blankets.
B) Apply heat lamps.
C) Provide fluid and blood warming.
D) Apply supplemental oxygen.
E) Provide a thermal mattress.

Question 24

A patient emerges from general anesthesia screaming,shouting,and thrashing wildly.The nurse suspects the patient is experiencing what problem?

A) Emergence hallucination
B) Emergence fever
C) Emergence hyperactivity
D) Emergence delirium

Question 25

What are the causes of a postoperative fever?

A) Medication reactions
B) Hypotension
C) Blood transfusion reaction
D) Pulmonary emboli
E) Atelectasis

Question 26

A patient was transferred to the postanesthesia care unit from the operating room after the induction of halothane anesthesia.The patient has no significant medical history.On admission,the patient appeared comatose and extremely diaphoretic,with severe muscle rigidity and tremors.The patient's vital signs were heart rate,145 beats/min; monitor reveals sinus tachycardia; blood pressure,85/50 mm Hg; respiratory rate,35 breaths/min; and temperature,103.8° F.Arterial blood gases on 100% oxygen by ventilator were PaO₂,70%; PaCO₂,35 mm Hg; pH,7.21; HCO₃,16 mm Hg; and SaO₂,90%.Fluid resuscitation and vasoactive therapy were started.Initial abnormal laboratory results were BUN,66 mg/dL; sodium,155 mEq/L; potassium,5.5 mEq/L; glucose,68 mg/dL; creatinine,2.4 mg/dL; and creatine phosphokinase,1896 U/L.The nurse would anticipate a diagnosis of which condition?

A) Noncardiogenic pulmonary edema
B) Sepsis
C) Malignant hyperthermia
D) Emergency delirium

Question 27

When a patient emerges in a very restless state,what is the first problem the nurse must suspect?

A) Anxiety
B) Hypoxia
C) Pain
D) Gastric distention

Question 28

What is the most definitive test for detecting malignant hyperthermia (MH)susceptibility?

A) Creatine phosphokinase (CPK) test
B) Ionized calcium test
C) Core temperature reading
D) Skeletal muscle biopsy

Question 29

When a patient develops postoperative hypertension,what potential cause would the nurse investigate?

A) Opioid administration
B) Fluid overload
C) Bladder distention
D) Dysrhythmias

Question 30

What is the most effective treatment of postoperative nausea and vomiting?

A) Prevention
B) Droperidol given immediately when nausea is reported
C) Phenergan given immediately when nausea is reported
D) Metoclopramide given immediately when nausea is reported

Question 31

The nurse suspects that a patient has aspirated.What action would the nurse take immediately?

A) Raise the head of the bed to a 45- to 90-degree angle.
B) Lower the bed and turn the head to the side.
C) Notify the physician and prepare to intubate the patient.
D) Call for chest radiography to verify aspiration.

Question 32

Management of an airway obstruction begins with immediate recognition and treatment.Place these nursing interventions in the appropriate order for initial care of a postanesthesia patient with airway obstruction.
1)Positive-pressure mask ventilation
2)Head-tilt/chin-lift maneuver (nonreactive patient)
3)Insertion of oropharyngeal or nasopharyngeal airway
4)Intubation with mechanical intubation
5)Stimulation of the patient

A) 1, 2, 3, 5, 4
B) 5, 2, 3, 1, 4
C) 2, 3, 1, 5, 4
D) 4, 2, 3, 1, 5

Question 33

Which medication has a direct myocardial depressant effect on the heart?

A) Ketamine
B) Barbiturates
C) Succinylcholine
D) Opioids

Question 34

Nursing management of a postoperative patient who is experiencing prolonged vomiting might benefit from which intervention?

A) Withholding all pain medication until the nausea has subsided
B) Removing the nasogastric tube
C) Inserting an oral airway
D) Increasing intravenous fluids

Question 35

A postoperative patient is experiencing delayed arousal after a transurethral prostatectomy.To assist with finding the cause,the nurse would assess the patient's laboratory values for which finding?

A) Hypercalcemia
B) Hyponatremia
C) Hyperkalemia
D) Hypermagnesemia