Deck 17: Surgery

Question 1

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

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.

Answer 1

Ask the patient to rate the severity of the pain on a scale of 1 to 10.

Question 2

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.What should the nurse assess prior to providing this patient with clear liquids?

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

Answer 2

Bowel sounds

Question 3

Which modification should the nurse implement when caring for a postoperative patient after cataract surgery?

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

Answer 3

Omit instructions relative to coughing.

Question 4

A nurse is caring for a postoperative patient.What should the nurse ask when assessing for the complication of malignant hyperthermia?

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?"

Question 5

What is the goal of palliative surgery?

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 6

A postoperative patient is complaining of incisional pain.An order has been given for morphine every 4 to 6 hours as needed (PRN).What should the nurse assess first?

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 7

A nurse has completed giving discharge instructions to a patient after a hernia repair.What verbalization by the patient should lead the nurse to determine that the patient understands the instructions?

A) Go back to work tomorrow.
B) Do 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 8

Which member of the surgical team administers anesthetics and monitors the patient's status throughout the procedure?

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

Question 9

During a nurse's preoperative assessment, the nurse notices that a patient is extremely anxious.The patient's blood pressure is 142/92 mm Hg, the heart rate is 104 beats/min, and respirations are 32 breaths/min.What nursing action should be implemented?

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 10

A patient who has just undergone a colon resection complains to a 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.What nursing action should be implemented first?

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 11

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

A) Tell the patient to talk to the physician after he or she 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 12

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

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 13

What information should a nurse ask a patient during the preoperative assessment?

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

Question 14

A nurse is doing an assessment of a patient who has returned from a cardiac catheterization and had conscious sedation.Which finding should the nurse report?

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 15

A nurse should include the proper use of an incentive spirometer in teaching a preoperative patient.What postoperative assessment of this patient would reveal that the incentive spirometry teaching has been effective?

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

Question 16

A nurse is caring for a postoperative patient who has had spinal anesthesia.Which assessment is a priority for this patient?

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

Question 17

A nurse is assisting in the transfer of a postoperative patient from the postanesthesia care unit to the surgical nursing unit.What action should the nurse implement to ensure the safety of the patient?

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 18

A 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 beats/min.What should be the nurse's first action?

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 fluids.

Question 19

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

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 20

Which technique should a nurse implement when changing a postoperative dressing?

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

Question 21

What are the responsibilities of a circulating nurse? (Select all that apply.)

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 22

A patient who received Penthrane as an inhaled anesthesia complains of a sore throat and a raspy voice.What should the nurse explain as the probable cause of these discomforts?

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

Question 23

What should a nurse suggest to a patient to prevent the effects of postoperative immobility on the gastrointestinal system?

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 24

A patient scheduled for a liver biopsy has given a nurse a list of medications routinely taken at home.Which medication should the nurse question?

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

Question 25

A patient has an extensive bowel preparation of oral laxatives and enemas for a colon resection.What rationales should the nurse list when asked about the rigorous preparation? (Select all that apply.)

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.

Question 26

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

Question 27

Patients with preoperative disorders put them at risk during recovery.What disorders should a nurse be aware may pose this hazard? (Select all that apply.)

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

Question 28

A postanesthesia care nurse is evaluating a patient for possible transfer to the surgical unit.Which assessment should prevent the patient's transfer?

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

Question 29

A nurse carefully monitors an obese patient after a hysterectomy for the peculiar postoperative complications.Which postoperative complications are associated with obesity? (Select all that apply.)

A) Nausea
B) Wound infection
C) Hypertension
D) Hemorrhage
E) Respiratory difficulties

Question 30

Why should a nurse assess a patient's limbs and position the limbs frequently after a regional anesthesia?

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.